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Berenguer C, Rosa E, De Stasio S, Choque Olsson N. Sleep quality relates to language impairment in children with autism spectrum disorder without intellectual disability. Sleep Med 2024; 117:99-106. [PMID: 38522116 DOI: 10.1016/j.sleep.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 03/11/2024] [Accepted: 03/16/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVES This study aimed to identify sleep quality profiles of children with autism spectrum disorder (ASD), to compare these profiles with those of typically developing (TD) children, and to verify whether there are differences between them in terms of language skills. METHODS We evaluated the sleep quality and language skills of 47 children with ASD without intellectual disability (ID) and 32 children with TD. Using a hierarchical cluster analysis, we identified two sleep quality ASD profiles (poor and good). We then performed a series of MANCOVAs and ANOVAs to compare the sleep quality and language skills of the two ASD clusters and the TD group. RESULTS A main group effect (TD, "poor" cluster, and "good" cluster) was found in the total sleep quality and all its dimensions. Significant differences were revealed between the "good" and "poor" clusters in the total structural language score (F1,46 = 10.75, p < 0.001) and three of its subscales (speech: F1,46 = 9.19, p < 0.001; syntax, F1,46 = 8.61, p = 0.001; coherence: F1,46 = 11.36, p < 0.001); the total pragmatic language score (F1,46 = 7.00, p = 0.001) and three of its subscales (inappropriate initiation: F1,46 = 8.02, p = 0.001; use of context: F1,46 = 8.07, p = 0.001; nonverbal communication: F1,46 = 7.35, p = 0.001); and the social relations score (F1,46 = 9.97, p = 0.003). CONCLUSIONS Sleep quality in children with ASD (especially a subgroup) is worse than in children with TD. There is an association between sleep quality and language skills, both at the pragmatic and structural levels.
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Affiliation(s)
- Carmen Berenguer
- Department of Developmental and Educational Psychology, ERI-Lectura Faculty of Psychology and Speech Therapy University of Valencia, Blasco Ibanez, 21, 46010, Valencia, Spain.
| | - Eva Rosa
- Department of Basic Psychology, ERI-Lectura, Faculty of Psychology and Speech Therapy, University of Valencia, Blasco Ibanez, 21, 46010, Valencia, Spain.
| | - Simona De Stasio
- Department of Human Studies, LUMSA University, Piazza Delle Vaschette, 101, 00193, Rome, Italy.
| | - Nora Choque Olsson
- Department of Psychology, Stockholm University, 106 91, Stockholm, Sweden.
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2
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Tang C. Impacts of Online Studies Including Various Concept and Doubt for English Education in China. J Psycholinguist Res 2024; 53:41. [PMID: 38678498 DOI: 10.1007/s10936-024-10081-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 05/01/2024]
Abstract
The outbreak of Covid-19 has led to the need for institutions to provide online learning to their students. In this context, it is important to understand the views of both students and teachers regarding online classes. This study aims to explore the opinions of English teachers and students in vocational colleges in China about online English learning. A convenience sampling technique was used in the study. Data was collected using a questionnaire survey from the respondents. Data were analyzed using SPSS statistical software. Focused on the perceptions of English teachers and students in vocational colleges about online English learning. The results of the study revealed negative perceptions of both students and teachers about vocational English education in an online learning environment. This study highlights the importance of addressing both teachers' and students' negative feelings about online learning. The findings of this study are useful for educators and academic departments in improving the online learning experience for vocational students. It also emphasizes the need for effective implementation of ICT modules to improve the quality of online education. The study suggested that ICT modules should be implemented in various media platforms and applications to improve the quality of online learning by academic departments. Overall, this study emphasizes the importance of understanding stakeholder perceptions in online learning environments and provides insights for improving the quality of online education.
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Affiliation(s)
- Changjiang Tang
- Department of General Education, Guangzhou Vocational College of Technology & Business, Guangzhou, China.
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3
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Lian G, Xiao Y, Huang Y, Wang H, Huang L, Yang H, Zhu C, Mei W, Huang R. Attitudes toward communication skills with learner needs assessment within radiology residency programs in China: a cross-sectional survey. BMC Res Notes 2024; 17:114. [PMID: 38654288 PMCID: PMC11036608 DOI: 10.1186/s13104-024-06779-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Communication skills (CS) represent a core competency in radiology residency training. However, no structured curriculum exists to train radiology residents in CS in China. The aim of this study was to evaluate the status and prevalence of doctor-patient communication training among radiology residents in nine Chinese accredited radiology residency training programs and to determine whether there is a perceived need for a formalized curriculum in this field. METHODS We administered a cross-sectional online survey to radiology residents involved in CS training at nine standard residency training programs in China. The questionnaire developed for this study included CS training status, residents' demographics, attitudes toward CS training, communication needs, and barriers. Residents' attitudes toward CS training were measured with the Communication Skills Attitude Scale (CSAS) and its subscales, a positive attitude scale (PAS) and negative attitude scale (NAS). RESULTS A total of 133 (48.36%) residents participated in the survey. The mean total scores on the two dimensions of the CSAS were 47.61 ± 9.35 in the PAS and 36.34 ± 7.75 in the NAS. Factors found to be significantly associated with the PAS included receiving previous training in CS, medical ethics, or humanities and the doctor's attire. We found that first-year residents and poor personal CS were the most influential factors on the NAS. Only 58.65% of participants reported having previously received CS training during medical school, and 72.93% of respondents reported failure in at least one difficult communication during their residency rotation. Most of those surveyed agreed that CS can be learned through courses and were interested in CS training. Some of the most common barriers to implementing formal CS training were a lack of time, no standardized curriculum, and a lack of materials and faculty expertise. CONCLUSIONS Most residents had a very positive attitude toward CS training and would value further training, despite the limited formal CS training for radiology residents in China. Future efforts should be made to establish and promote a standard and targeted CS curriculum for Chinese radiology residents.
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Affiliation(s)
- GengPeng Lian
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Yubin Xiao
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Yingling Huang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Huanpeng Wang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Lipeng Huang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Hongwu Yang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Chunmin Zhu
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Wei Mei
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China.
| | - Ruibin Huang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, 515041, Guangdong, China.
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Gold CA, Jensen R, Sasnal M, Day HS, Miller-Kuhlmann RK, Blankenburg RL, Rassbach CE, Morris AM, Korndorffer JR, Nassar AK. Impact of a coaching program on resident perceptions of communication confidence and feedback quality. BMC Med Educ 2024; 24:435. [PMID: 38649901 PMCID: PMC11036561 DOI: 10.1186/s12909-024-05383-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND While communication is an essential skill for providing effective medical care, it is infrequently taught or directly assessed, limiting targeted feedback and behavior change. We sought to evaluate the impact of a multi-departmental longitudinal residency communication coaching program. We hypothesized that program implementation would result in improved confidence in residents' communication skills and higher-quality faculty feedback. METHODS The program was implemented over a 3-year period (2019-2022) for surgery and neurology residents at a single institution. Trained faculty coaches met with assigned residents for coaching sessions. Each session included an observed clinical encounter, self-reflection, feedback, and goal setting. Eligible residents completed baseline and follow-up surveys regarding their perceptions of feedback and communication. Quantitative responses were analyzed using paired t-tests; qualitative responses were analyzed using content analysis. RESULTS The baseline and follow-up survey response rates were 90.0% (126/140) and 50.5% (46/91), respectively. In a paired analysis of 40 respondents, residents reported greater confidence in their ability to communicate with patients (inpatient: 3.7 vs. 4.3, p < 0.001; outpatient: 3.5 vs. 4.2, p < 0.001), self-reflect (3.3 vs. 4.3, p < 0.001), and set goals (3.6 vs. 4.3, p < 0.001), as measured on a 5-point scale. Residents also reported greater usefulness of faculty feedback (3.3 vs. 4.2, p = 0.001). The content analysis revealed helpful elements of the program, challenges, and opportunities for improvement. Receiving mentorship, among others, was indicated as a core program strength, whereas solving session coordination and scheduling issues, as well as lowering the coach-resident ratio, were suggested as some of the improvement areas. CONCLUSIONS These findings suggest that direct observation of communication in clinical encounters by trained faculty coaches can facilitate long-term trainee growth across multiple core competencies. Future studies should evaluate the impact on patient outcomes and workplace-based assessments.
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Affiliation(s)
- Carl A Gold
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Rachel Jensen
- Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3639, Stanford, CA, 94305, USA
| | - Marzena Sasnal
- Department of Surgery, Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Stanford University School of Medicine, Stanford, CA, USA
| | - Heather S Day
- Department of Surgery, Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Stanford University School of Medicine, Stanford, CA, USA
| | - Rebecca K Miller-Kuhlmann
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Caroline E Rassbach
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Arden M Morris
- Department of Surgery, Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Stanford University School of Medicine, Stanford, CA, USA
| | - James R Korndorffer
- Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3639, Stanford, CA, 94305, USA
| | - Aussama K Nassar
- Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3639, Stanford, CA, 94305, USA.
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Madani SMS, Bahramnejad A, Farsi Z, Alizadeh A, Azizi M. The effect of psychological first-aid virtual education on the communication skills of nurses in disasters: a randomized controlled trial. BMC Psychol 2024; 12:194. [PMID: 38589972 PMCID: PMC11003174 DOI: 10.1186/s40359-024-01682-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 03/22/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Disasters have affected the physical and mental health of people around the world. Since nurses are frontlines in disasters, it seems necessary to prepare for this responsibility. This study investigates the effect of psychological first-aid virtual education on the communication skills of nurses in disasters such as COVID pandemic. METHODS In a randomized controlled trial, 55 nurses were selected by purposive sampling method from two hospitals in Isfahan and Tehran, Iran in December-November 2022 and randomly replaced in the intervention group who participated in psychological first aid virtual training and control group. The data were collected through the personal information form and Communication Skills -Test-Revised (CSTR). RESULTS Two groups were homogeneous in terms of communication skills (p = 0.177), the total score of communication skills was significant between the two groups after the intervention (p < 0.0001). Regarding communication skills, in the pre-intervention phase, the subscale of "the ability to receive and send messages" and "insight into the communication process" the difference before the intervention was not significant between the two groups (p > 0.05). However, it was significant between the two groups after the intervention (p < 0.05), and regarding "emotional control", "listening skills", and "communication along with assertiveness" the difference before and after the intervention was not significant between the two groups (p > 0.05). CONCLUSION Pre-disaster training and virtual education can increase nurses' communication skills in their ability to handle a disaster such as COVID pandemic. Virtual education of post-disaster psychological interventions is suggested. TRIAL REGISTRATION IRCT20220923056023N1; date: 2023-01-31.
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Affiliation(s)
| | - Ali Bahramnejad
- Neuroscience Research Center, Institute of Neuropharmacology, Aja University of Medical Sciences, Tehran, Iran
| | - Zahra Farsi
- Medical-Surgical Nursing, Research and Ph.D. Nursing Departments, Nursing School, Aja University of Medical Sciences, Tehran, Iran
| | - Azizeh Alizadeh
- NEZAJA Health Department, Assistance of Mental Health in Khanevadeh Hospital, Tehran, IR, Iran
| | - Maryam Azizi
- Health in Disaster and Emergencies Department, Faculty of Nursing, Aja University of Medical Sciences, Shareati Street, Tehran, IR, Iran.
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Kumar S, Marlapudi SK, Natraj R. New Frontiers in Newborn Hearing Screening: Understanding Auditory Neuropathy and its Predictive Trajectory. Indian J Otolaryngol Head Neck Surg 2024; 76:1690-1696. [PMID: 38566703 PMCID: PMC10982241 DOI: 10.1007/s12070-023-04386-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/18/2023] [Indexed: 04/04/2024] Open
Abstract
Auditory Neuropathy (AN) poses a substantial challenge in neonatal auditory screenings due to its complex course and potential for delayed onset. Early identification and intervention are important for optimizing developmental outcomes. This study aimed to explore the prevalence, determinants, and temporal progression of AN in neonates, and assess the therapeutic benefit of amplification devices on their communication skills. The study utilized a longitudinal cohort design to analyze a cohort of 200 neonates from a tertiary care center over the duration from January 2021 to December 2022. Auditory evaluations were conducted at specified intervals, utilizing a comprehensive battery of auditory assessments. Statistical analyses, including regression models, were employed to identify associations between various determinants and the progression of AN. The results of the study revealed a significant correlation between low birth weight and familial history with onset of AN. The data also revealed a gradual rise in AN prevalence over the study duration. However, a negative correlation was observed between AN severity and communication skills. The utilization of hearing aids was associated with enhanced communication outcomes. The study highlights the importance of comprehensive auditory screenings in newborns, particularly emphasizing the early detection and intervention of AN. Based on empirical findings, it emerged that amplification devices, particularly hearing aids, have the potential to mitigate the detrimental effects of auditory neuropathy (AN) on communication skills. This study provides a valuable contribution to the academic debate by highlighting the need for strengthening neonatal auditory screening protocols. The findings have profound implications for clinical practices, highlighting the role of early interventions in optimizing developmental prospects for neonates diagnosed with AN. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-04386-w.
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Affiliation(s)
- Sanjay Kumar
- Department of ENT-HNS, Air Force, Command Hospital, Bangalore, 560007 India
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Zou C, Deng L, Luo J, Dai H, Zhang Y, Guo R, Luo X, Yang R, Song H, Spicer J, Zhao Q, Liao X. The impact of communication training on the clinical care of hypertension in general practice: a cluster randomized controlled trial in China. BMC Prim Care 2024; 25:98. [PMID: 38532356 DOI: 10.1186/s12875-024-02344-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/15/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Hypertension is one of the most common chronic diseases with a low control rate globally. The effect of communication skills training contributing to hypertension control remains uncertain. The aim of the present study was to assess the effectiveness of an educational intervention based on the Calgary-Cambridge guide in improving hypertensive management. METHODS A cluster randomized controlled trial enrolled 27 general practitioners (GPs) and 540 uncontrolled hypertensive patients attending 6 community health centers in Chengdu, China. GPs allocated to the intervention group were trained by an online communication course and two face-to-face workshops based on Calgary-Cambridge guides. The primary outcome was blood pressure (BP) control rates and reductions in systolic and diastolic BP from baseline to 3 months. The secondary outcome was changes in GPs' communication skills after one month, patients' knowledge and satisfaction after 3 months. Bivariate analysis and the regression model assessed whether the health provider training improved outcomes. RESULTS After the communication training, the BP control rate was significantly higher (57.2% vs. 37.4%, p < 0.001) in the intervention groups. Compared to the control group, there was a significant improvement in GP's communication skills (13.0 vs 17.5, p < 0.001), hypertensive patients' knowledge (18.0 vs 20.0, p < 0.001), and systolic blood pressure (139.1 vs 134.7, p < 0.001) after 3 months of follow-up. Random effects least squares regression models showed significant interactions between the intervention group and time period in the change of GP's communication skills (Parameter Estimated (PE): 0.612, CI:0.310,0.907, p = 0.006), hypertensive patient's knowledge (PE:0.233, CI: 0.098, 0.514, p < 0.001), satisfaction (PE:0.495, CI: 0.116, 0.706, p = 0.004), SBP (PE:-0.803, CI: -1.327, -0.389, p < 0.001) and DBP (PE:-0.918, CI: -1.694, -0.634, p < 0.001), from baseline to follow-up. CONCLUSION Communication training based on the Calgary-Cambridge guide for GPs has shown to be an efficient way in the short term to improve patient-provider communication skills and hypertension outcomes among patients with uncontrolled BPs. TRIAL REGISTRATION The trial was registered on Chinese Clinical Trials Registry on 2019-04-03. (ChiCTR1900022278).
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Affiliation(s)
- Chuan Zou
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, NO.37 Guoxue Lane, Wuhou District, Chengdu, 611130, China
- The Department of General Practice, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu City, China
- Teaching&Research Section, General Practice Medical Center, West China Hospital,Sichuan University, Chengdu, China
| | - Lili Deng
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, NO.37 Guoxue Lane, Wuhou District, Chengdu, 611130, China
| | - Jianzhao Luo
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, NO.37 Guoxue Lane, Wuhou District, Chengdu, 611130, China
| | - Hua Dai
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, NO.37 Guoxue Lane, Wuhou District, Chengdu, 611130, China
| | - Yu Zhang
- The Department of Gastroenterology, The First Affiliated Hospital of Chengdu Medical College, Chengdu City, China
| | - Ru Guo
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, NO.37 Guoxue Lane, Wuhou District, Chengdu, 611130, China
| | - Xiaolu Luo
- The Department of General Practice, Community Health Center of South Railway Station, Chengdu City, China
| | - Rong Yang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, NO.37 Guoxue Lane, Wuhou District, Chengdu, 611130, China
| | - Haiqi Song
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, NO.37 Guoxue Lane, Wuhou District, Chengdu, 611130, China
| | - John Spicer
- Fellow of the Royal College of General Practitioners, Country Park Practice, London, UK
| | - Qian Zhao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, NO.37 Guoxue Lane, Wuhou District, Chengdu, 611130, China.
- Teaching&Research Section, General Practice Medical Center, West China Hospital,Sichuan University, Chengdu, China.
| | - Xiaoyang Liao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, NO.37 Guoxue Lane, Wuhou District, Chengdu, 611130, China.
- Teaching&Research Section, General Practice Medical Center, West China Hospital,Sichuan University, Chengdu, China.
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Kandevani NY, Labaf A, Mirzazadeh A, Pormehr PS. Attitudes toward learning communication skills among Iranian medical students. BMC Med Educ 2024; 24:193. [PMID: 38403653 PMCID: PMC10895772 DOI: 10.1186/s12909-024-05140-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/06/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Attitudes determine behavior, and alterations in attitude may result in behavioral changes. Medical students would benefit from learning communication skills. This study aimed to determine the attitude of medical students toward the importance of learning communication skills and the training courses and their role in contributing. METHODS In this cross-sectional study, 442 medical students from three different levels of medical training were enrolled. Students in the first 4 years of the medical program were classified as basic sciences and physiopathology students, those in the fifth and sixth years were classified as clerkship students, and those in the last three terms of medical training were classified as interns. The attitude among these three groups was assessed by the Communication Skills Attitude Scale (CSAS) questionnaire, and the contributing factors were determined. RESULTS The mean total points for attitude in positive and negative aspects were 50.7 and 30.9, respectively showing a positive attitude toward communication skills among medical students. The median scores of the scales Important in Medical Content, Excuse, Learning, and Overconfidence varied significantly from highest to lowest, respectively. Gender, educational level, ethnic origin, language, family burden, paternal literacy, history of presence in communication skills courses, self-report from communication skills, and need to further learning in this era showed significant association with attitude (P < 0.05). CONCLUSIONS It may be concluded that generally, medical students have a positive attitude toward communication skills, and this perspective is a multi-factorial entity that programming according to the various related factors would help to attainment of additional communication capabilities among medical students.
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Affiliation(s)
| | - Ali Labaf
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Azim Mirzazadeh
- Department of Medicine, Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Sullivan CC, O'Leary DM, Boland FM, Condron CM, Mulhall CM, Eppich WJ. A comparative analysis of student, educator, and simulated parent ratings of video-recorded medical student consultations in pediatrics. Adv Simul (Lond) 2024; 9:10. [PMID: 38365837 PMCID: PMC10874056 DOI: 10.1186/s41077-024-00282-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 02/01/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Simulation-based education (SBE) affords learners opportunities to develop communication skills, including those related to pediatrics. Feedback is an integral part of SBE, and while much research into feedback from multiple sources exists, the findings are mixed. The aim of this comparative study was to replicate some of this work in a novel area, pediatric medical education, to better understand how multisource feedback (self, educator, and simulated parent) may inform learning and curriculum design. METHODS During their pediatric rotation, medical students participated in a consultation with a simulated parent, engaged in video-assisted self-reflection, and received feedback from both an educator and the simulated parent through an e-learning platform. The Pediatric Consultation Skills Assessment Tool (PCAT) was used for self-assessment and educator feedback, and the Consultation and Relational Empathy (CARE) measure was used for simulated parent feedback. RESULTS Our results showed that high-performing students underrated their performance, and low-performing students overrated their performance. Feedback from multiple sources helps to identify both areas of weakness in student performance and areas of weakness in student self-appraisal. Overall, general areas of weakness identified for the learners related to making contingency plans and providing easy-to-understand explanations for simulated parents. Some simulated parent feedback did not align with educator and student ratings, highlighting the value of including the simulated parent perspective. Our findings question whether a third party can reliably judge the simulated parent's level of understanding. CONCLUSION Multisource feedback allows students to develop layered insights into their performance and supports self-appraisal. Aggregating feedback through an e-learning platform allows educators to gain greater insights into the strengths and weakness of students and design a more tailored teaching plan to support student needs.
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Affiliation(s)
- Clare C Sullivan
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland.
| | - Daire M O'Leary
- Department of Pediatrics, RCSI University of Medicine and Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Fiona M Boland
- Data Science Centre, RCSI University of Medicine and Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Claire M Condron
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Claire M Mulhall
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Walter J Eppich
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland
- Department of Medical Education & Collaborative Practice Centre, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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Zemlin C, Nourkami-Tutdibi N, Schwarz P, Wagenpfeil G, Goedicke-Fritz S. Teaching breaking bad news in a gyneco-oncological setting: a feasibility study implementing the SPIKES framework for undergraduate medical students. BMC Med Educ 2024; 24:134. [PMID: 38347593 PMCID: PMC10863240 DOI: 10.1186/s12909-024-05096-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/24/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND It is a crucial task for physicians to deliver life threatening information to patients (breaking bad news; BBN). Many aspects influence these conversations on both sides, patients, and doctors. BBN affects the patient-physician relationship, patients' outcome, and physicians' health. Many physicians are still untrained for this multi-facetted task and feel unprepared and overburdened when facing situations of BBN. Therefore, any faculties should aim to integrate communication skills into their medical curricula as early as possible. The SPIKES protocol is an effective framework to deliver BBN. Aim of this study is to evaluate the feasibility and obstacles of a BBN seminar and its acceptance and learning curve among undergraduate medical students. METHODS 158 2nd year undergraduate medical students attended a compulsory BBN seminar. The task was to deliver a cancer diagnosis to the patient within a patient - physician role-play in a gyneco-oncological setting before and after a presentation of the SPIKES protocol by the lecturer. The students evaluated important communication skills during these role-plays respectively. Self-assessment questionnaires were obtained at the beginning and end of the seminar. RESULTS Most students indicated that their confidence in BBN improved after the seminar (p < 0.001). They like the topic BBN to be part of lectures (76%) and electives (90%). Communication skills improved. Lecturer and seminar were positively evaluated (4.57/5). CONCLUSION The seminar significantly increased confidence and self-awareness in delivering life-threatening news to patients among undergraduate medical students. Important learning aspects of BBN and communication skills could be delivered successfully to the participants within a short time at low costs. The integration of communication skills should be implemented longitudinally into medical curricula starting before clinical education to increase the awareness of the importance of communication skills, to decrease anxiety, stress, and workload for future doctors and- most importantly- to the benefit of our patients.
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Affiliation(s)
- Cosima Zemlin
- Department of Gynecology and Obstetrics, Faculty of Medicine, Saarland University, Homburg, Germany
| | | | - Pascal Schwarz
- Department of Gynecology and Obstetrics, Faculty of Medicine, Saarland University, Homburg, Germany
| | - Gudrun Wagenpfeil
- Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Homburg, Germany
| | - Sybelle Goedicke-Fritz
- Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany.
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11
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Ashjian EJ, Genereaux M, Thompson AN, Ward K, Wells T, Bostwick JR, Vordenberg SE. Transitioning From Points-Based Grading to a Modified Pass/Fail Grading Approach in a Simulated Patient Program. Am J Pharm Educ 2024; 88:100645. [PMID: 38211881 DOI: 10.1016/j.ajpe.2024.100645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/17/2023] [Accepted: 01/03/2024] [Indexed: 01/13/2024]
Abstract
OBJECTIVE To determine the impact of transitioning from points-based grading to a modified pass/fail grading approach in a simulated patient (SP) program on first year pharmacy (P1) student performance in a PharmD curriculum. METHODS Course-level data from the 2021-2022 and 2022-2023 academic years were collected to assess the impact of transitioning to a modified pass/fail grading approach on P1 student performance. During the 2021-2022 academic year, points-based grading was used. In 2022-2023, a modified pass/fail grading approach was implemented: communication assessment used pass/fail grading and clinical assessment used points-based grading; each assessment was worth 50% of the total SP activity grade. Chi-square tests were used to compare the percentage of students who passed each assessment (≥70%) with those who failed. RESULTS Across both academic years, students completed 9 formative (18 rubrics) and 6 summative (12 rubrics) SP activities. Each activity included separate communication and clinical assessment rubrics. There were no significant differences in performance on 27 of 30 rubrics. There were two formative SP activities where the percentage of students who passed the communication assessment using pass/fail grading (2022-2023 academic year) was different than points-based grading (2021-2022 academic year). In one fall semester activity, the cohort with the modified pass/fail grading approach had lower pass rates, but the opposite trend was observed in the winter semester. CONCLUSION Our program was able to successfully move to a pass/fail approach for communication assessments of SP activities while maintaining points-based grading for clinical assessments in our P1 curriculum with minimal impact on student performance.
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Affiliation(s)
- Emily J Ashjian
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA.
| | - Molly Genereaux
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | - Amy N Thompson
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | - Kristen Ward
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | - Trisha Wells
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | - Jolene R Bostwick
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | - Sarah E Vordenberg
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA
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12
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Wenham J, Best M, Kissane DW. An Online Survey of Australian Medical Students' Perspectives on Spiritual History Taking and Spiritual Care. J Relig Health 2024; 63:257-273. [PMID: 37725268 PMCID: PMC10861599 DOI: 10.1007/s10943-023-01897-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/21/2023]
Abstract
It is reported that little spiritual care communication skills training occurs in Australian medical schools. This survey explored the experience of final year students in this domain in order to inform the construction of a new curriculum. Medical students in their final year at four Australian medical schools were invited to participate in an online survey, which included questions about demographic details, exposure to spiritual history taking, perceived learning needs, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being 12 item Non-Illness score. Two-hundred and sixty students from a cohort of 766 responded (34%). One in nine students had witnessed spiritual history taking, and one in ten students had been given the opportunity to do so. Barriers and enablers were identified. Two-thirds of the students reported no recollection of any training in spiritual care. When it did occur, it was limited in scope and structure. Final year medical students recognise that spiritual care deserves a place in the modern, broad-based medical school curriculum. This supports the argument for inclusion of spiritual care training as part of all medical student curricula in Australia.
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Affiliation(s)
- John Wenham
- Broken Hill Department of Rural Health, Sydney Medical School, Corrindah Court, PO Box 457, Broken Hill, NSW, 2880, Australia.
| | - Megan Best
- Institute for Ethics and Society, The University of Notre Dame Australia, 104 Broadway, PO Box 944, Broadway, NSW, 2007, Australia
| | - David W Kissane
- Palliative Medicine Research, The University of Notre Dame Australia, Broadway, NSW, 2007, Australia
- The Cunningham Centre for Palliative Care Research, St Vincent's Hospital, Sydney, NSW, Australia
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13
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Doyle AJ, Sullivan C, O'Toole M, Tjin A, Simiceva A, Collins N, Murphy P, Anderson MJ, Mulhall C, Condron C, Nestel D, MacAulay R, McNaughton N, Coffey F, Eppich W. Training simulated participants for role portrayal and feedback practices in communication skills training: A BEME scoping review: BEME Guide No. 86. Med Teach 2024; 46:162-178. [PMID: 37552799 DOI: 10.1080/0142159x.2023.2241621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
BACKGROUND Providing feedback is a key aspect of simulated participants' (SPs) educational work. In teaching contexts, the ability to provide feedback to learners is central to their role. Suboptimal feedback practices may deny learners the valuable feedback they need to learn and improve. This scoping review systematically maps the evidence related to SPs' role as educators and identifies how SPs prepare for their role and feedback practices. METHODS The authors conducted a scoping review and included a group of international stakeholders with experience and expertise in SP methodology. Five online databases were systematically searched and ERIC, MedEdPortal and MedEdPublish were hand searched to identify relevant studies. Inclusion/exclusion criteria were developed. Data screening and subsequently data charting were performed in pairs. The results of data charting were thematically analysed including categories relating to the Association of SP Educators (ASPE) Standards of Best Practice (SOBP). RESULTS From 8179 articles identified for the title and abstract screening, 98 studies were included. Studies reported the benefit of SPs' authentic role portrayal and feedback interactions for learners and on the reported learning outcomes. Data was heterogeneous with a notable lack of consistency in the detail regarding the scenario formats for communication skills training interventions, SP characteristics, and approaches to training for feedback and role portrayal. CONCLUSIONS The published literature has considerable heterogeneity in reporting how SPs are prepared for role portrayal and feedback interactions. Additionally, our work has identified gaps in the implementation of the ASPE SOBP, which promotes effective SP-learner feedback interactions. Further research is required to identify effective applications of SP methodology to prepare SPs for their role as educators.
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Affiliation(s)
- Andrea J Doyle
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Clare Sullivan
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Michelle O'Toole
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anna Tjin
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anastasija Simiceva
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Naoise Collins
- Department of Visual & Human Centred Computing, Dundalk Institute of Technology, Co. Louth
| | - Paul Murphy
- RCSI Library, RCSI University of Medicine and Health Sciences, Dublin Ireland
| | - Michael J Anderson
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Mulhall
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Condron
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Debra Nestel
- School of Clinical Sciences, Faculty of Medicine, Nursing & Health Sciences, Monash University, Australia
- Department of Surgery, University of Melbourne, Australia
| | - Robert MacAulay
- School of Medicine, University of California San Diego, United States of America
| | - Nancy McNaughton
- The Wilson Centre for Research in Education, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Frank Coffey
- DREEAM (Department of Research and Education in Emergency and Acute medicine, Nottingham University Hospitals' NHS Trust)
- School of Health Sciences, University of Nottingham, UK
| | - Walter Eppich
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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14
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Ta'an WF, Allama F, Williams B. The role of organizational culture and communication skills in predicting the quality of nursing care. Appl Nurs Res 2024; 75:151769. [PMID: 38490801 DOI: 10.1016/j.apnr.2024.151769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/30/2023] [Accepted: 02/18/2024] [Indexed: 03/17/2024]
Abstract
AIMS This study aims to identify the level of nursing care quality and examine its predictors considering nurses' demographic data, organizational culture, and communication skills. BACKGROUND Quality of care is a determinant of the sustainability of any healthcare organization. Therefore, it is imperative to understand how factors may contribute to the quality of nursing care. Limited research is available on the interaction between the concepts of quality of nursing care, communication skills, and organizational culture. METHODS A cross-sectional multi-site correlational design was used in this study. A convenience sample of 200 nurses from four Jordanian hospitals was recruited. Data was collected using self-reported questionnaires. Descriptive statistics, Pearson correlations, and multiple regression were performed to achieve the study's aims. RESULTS The majority of the nurses in this study were females with bachelor's degrees. Age ranged between 22 and 53 years whereas experience ranged from 1 to 30 years. Communication skills significantly predicted the quality of nursing care; however, organizational culture was not a significant predictor of the quality of nursing care. Nevertheless, Pearson r correlation results revealed a significant correlation between organizational culture and communication skills (r = 0.57, p < 0.05). CONCLUSION Nurses and organizational managers can increase the level of quality of nursing care by investing in programs that target improving nurses' communication skills. Providing a good environment in the hospital can increase communication skills between staff members, ultimately increasing the quality of nursing care. Further studies are recommended to elaborate and further uncover concerns related to the current research.
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Affiliation(s)
- Wafa'a F Ta'an
- Community and Mental Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan.
| | - Fadi Allama
- Community and Mental Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan.
| | - Brett Williams
- Department of Paramedicine, Monash University, Clayton, Victoria, Australia.
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15
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Kastrinos A, Schofield EA, Moreno A, Korc-Grodzicki B, Nelson C, Alexander K, Parker PA, Manna R, Alici Y, Banerjee SC. Geriatric Communication Skills Training Program for Oncology Healthcare Providers: a Secondary Analysis of Patient and Caregiver Outcomes. J Cancer Educ 2024; 39:12-17. [PMID: 37676422 DOI: 10.1007/s13187-023-02367-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 09/08/2023]
Abstract
Geriatric cancer patients and their caregivers have unique needs that make it difficult for their healthcare providers (HCPs) to effectively communicate with them. As ineffective communication can lead to negative health outcomes, it is important that oncology HCPs receive specialized training on communication with older adult patients and their caregivers. We conducted a small pilot study examining audio recordings of clinical encounters between HCPs and older adult cancer patients/caregivers and questionnaires completed by the patients and their caregivers before and after the HCPs participated in a geriatric communication skills training program. Eleven HCPs completed the 6-h Geriatric Comskil Training. Two clinic consultations with unique geriatric patients (n = 44) and their caregivers (n = 29) were recorded before and after training and coded for HCPs' use of communication skills. Patients and caregivers also completed surveys measuring their satisfaction with HCP communication and perceived empathy. Analysis of the audio recordings revealed that HCPs did not increase their use of communication skills after training. Although our sample was too small to detect statistical significance, measures of effect size showed trending improvements in patients' and caregivers' perceptions of HCPs' empathy and satisfaction with their communication after training. Our findings build on previous studies evaluating the feasibility and effectiveness of the Geriatric Comskil Training in real world setting and indicate that the training may have improved HCPs' communication with older adult patients and their caregivers even if their use of their observable communication skills did not change.
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Affiliation(s)
- Amanda Kastrinos
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY, 10017, USA
| | - Elizabeth A Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY, 10017, USA
| | - Aimee Moreno
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY, 10017, USA
| | - Beatriz Korc-Grodzicki
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY, 10017, USA
| | - Christian Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY, 10017, USA
| | - Koshy Alexander
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY, 10017, USA
| | - Patricia A Parker
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY, 10017, USA
| | - Ruth Manna
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY, 10017, USA
| | - Yesne Alici
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY, 10017, USA
| | - Smita C Banerjee
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Ave., 4th Floor, New York, NY, 10017, USA.
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16
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Mandel EI, Fox M, Schell JO, Cohen RA. Shared Decision-Making and Patient Communication in Nephrology Practice. Adv Kidney Dis Health 2024; 31:5-12. [PMID: 38403394 DOI: 10.1053/j.akdh.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/22/2023] [Accepted: 12/06/2023] [Indexed: 02/27/2024]
Abstract
Shared decision-making (SDM) is the standard of care for patient or surrogates and their clinicians to arrive at a medical decision. Evidence suggests that SDM increases patients' understanding of their illness and satisfaction with their decision-making process. Dialysis patients often report the perception that they were passive participants in the decision to start dialysis, suggesting further opportunities for enhancing the application of SDM in decision-making with patients with kidney disease. The hallmark feature of SDM is sensitive, culturally- and equity-informed communication and effective partnership between patient or surrogate and clinician. In the process, the patient's personal expertise in the realm of their values and priorities is elicited, and the clinician's medical expertise is shared. The integration of this shared expertise then leads to an informed treatment decision. Frameworks such as the Serious Illness Conversation Guide and REMAP are guides for the SDM process, and communication tools and mnemonics can help facilitate SDM conversations. This paper will address SDM in nephrology practice, reviewing underlying supportive evidence, context, and timing for employing SDM in the trajectory of chronic kidney disease and acute kidney injury, special considerations in vulnerable populations to promote health equity, and communication tools and frameworks to facilitate the SDM process. By learning and applying these frameworks and tools, nephrology providers will be able to employ SDM in the management of kidney disease.
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Affiliation(s)
- Ernest I Mandel
- Division of Renal Medicine, Brigham and Women's Hospital, Department of Medicine, Hebrew SeniorLife, Harvard Medical School, Boston, MA.
| | - Monica Fox
- National Kidney Foundation of Illinois, Chicago, IL
| | - Jane O Schell
- Section of Palliative Care and Medical Ethics, Division of General Medicine and Division of Renal-Electrolyte, UPMC Health System, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Robert A Cohen
- Nephrology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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Kleinstäuber M, Diefenbach MA, Rief W. "It is not just in your mind" - Improving physician-patient communication in individuals with persistent somatic symptoms. J Psychosom Res 2023:111580. [PMID: 38176986 DOI: 10.1016/j.jpsychores.2023.111580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Maria Kleinstäuber
- Department of Psychology, Emma Eccles Jones College of Education and Human Services, Utah State University, Logan, USA.
| | - Michael A Diefenbach
- Institute of Health System Science at the Feinstein Institutes for Medical Research, Northwell Health, 600 Community Dr, Manhasset, NY 11030, USA
| | - Winfried Rief
- Dept. of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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18
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da Cunha Oliveira M, Silva Menezes M, Cunha de Oliveira Y, Marques Vilas Bôas L, Villa Nova Aguiar C, Gomes Silva M. Novice medical students' perception about bad news training with simulation and spikes strategy. PEC Innov 2023; 2:100106. [PMID: 37214516 PMCID: PMC10194387 DOI: 10.1016/j.pecinn.2022.100106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/18/2022] [Accepted: 11/21/2022] [Indexed: 05/24/2023]
Abstract
Objective To analyze the medical students' perception about simulated consultations before and after training using the SPIKES protocol. Methods Quasi-experimental study, with a qualitative approach. It counted with the participation of 20 students as Simulated Physicians (SF), and 20 students as Simulated Patients (SP), all belonging to a medical course. Data were obtained from the responses given to a reflective question, applied before and after training with the SPIKES. The treatment and the analysis of the data were guided by the stages of thematic analysis. Results In the category "Simulated Medical Student's Self-Perception", the subcategories "Nervousness and Insecurity" were predominant after the first consultation, while "Tranquility and Security" after the second consultation after training. In the category "Simulated Medical Student's Perception about the Educational Process", the subcategory "Reflective Learning" emerged in the students' speeches, especially after the second consultation. In the speeches of SP, it was evidenced the improvement of the care provided by SF after training. Conclusion The strategy used for the development of communication skills showed evidence of short-term effectiveness. Innovation The research resulted in a teaching protocol for students in pre-clinical stages that involves four stages: simulation, self-assessment, feedback and new simulations.
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Affiliation(s)
| | | | | | | | | | - Mary Gomes Silva
- Bahiana School of Medicine and Public Health, Salvador, BA, Brazil
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Karabey T, Aras M. The effect of exposure to intimate partner violence of female nurses on communication skills and burnout levels. Arch Psychiatr Nurs 2023; 47:27-34. [PMID: 38070992 DOI: 10.1016/j.apnu.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 02/08/2023] [Accepted: 04/23/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE Although intimate partner violence is a type of violence that women are frequently exposed to, its victims are adversely affected by violence at various levels, bio-psycho-socially. This study was conducted to determine the relationship between exposure to spousal violence, communication skills and burnout levels in female nurses. MATERIAL AND METHODS The study was carried out in a descriptive and cross-sectional research design. The study was conducted in a university hospital in the Black Sea region of Turkey in September 2021. Sample selection was not made in the study, and female nurses who agreed to participate in the study were included in the study. The study's sample size is 165 female nurses. A personal Information Form, Intimate Partner Violence Scale, Communication Skills Scale, and Burnout Scale were used to collect data. FINDINGS It was concluded that the exposure of female nurses to spouse violence significantly affects their communication skills and there is a significant relationship between nurses' communication skills and burnout levels (P = 0.001). PRACTICAL IMPLICATIONS The attitudes and behaviors of nurses who are strong in the caregiving process are very important. Personal characteristics, communication styles and body language of nurses who are exposed to partner violence are reflected in nursing care practices and affect the caregiving process. In this context, prevention and intervention approaches for intimate partner violence of female nurses should be known.
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Affiliation(s)
- Tuba Karabey
- Gaziosmanpasa University Faculty of Health Science, Tokat, Turkey.
| | - Mehtap Aras
- Gaziosmanpasa University Faculty of Health Science, Tokat, Turkey.
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Drummond J. A visual ethnographic study on nurse lecturers' enactment of compassionate care within the adult pre-registration nursing curriculum. Nurse Educ Today 2023; 130:105901. [PMID: 37549557 DOI: 10.1016/j.nedt.2023.105901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/27/2023] [Accepted: 07/12/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Nurse lecturers make a valuable contribution to developing the future nursing workforce. However, how this is nurtured within nurse education requires further exploration. There is limited research exploring the experiences of nurse lecturers providing compassionate care within the adult pre-registration nursing curriculum. OBJECTIVES This study explores how nurse lecturers enact compassionate care within the adult pre-registration nursing curriculum. To elicit shared patterns of behaviours and use creative methods to promote a critical dialogue. METHOD A visual ethnographic approach was used to explore nurse lecturers' experiences at a University in England. Using purposive sampling, nine auto-driven photo-elicitation interviews took place, and five participants attended a focus group to develop individual and collaborative concept maps. A thematic approach to data analysis was employed. FINDINGS Five themes were identified, illustrating compassionate care as the human condition involving appropriate behaviours and competent action. Compassionate care is threaded through the curriculum using different teaching and learning approaches, requiring a culture of shared human relationships. The combination of photographs, maps and descriptions provide a unique perspective of how nurse lecturers nurture and role model compassionate care to their students. CONCLUSION There are many ways compassionate care is experienced, enacted and enhanced by nurse lecturers within the adult pre-registration nurse curriculum. The five main themes act as a framework to guide nursing education and nursing practice. Future research should aim to understand better how compassionate care can be nurtured within different fields of nursing.
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Affiliation(s)
- Juliet Drummond
- Faculty of Health and Wellbeing, School of Nursing, University of Wolverhampton, Wulfruna Street, Wolverhampton, WV1 1LY, United Kingdom..
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21
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Tamblyn R, Moraga T, Girard N, Boulet J, Chan FKI, Habib B. Do clinical and communication skills scores on credentialing exams predict potentially inappropriate antibiotic prescribing? BMC Med Educ 2023; 23:821. [PMID: 37915014 PMCID: PMC10621187 DOI: 10.1186/s12909-023-04817-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND There is considerable variation among physicians in inappropriate antibiotic prescribing, which is hypothesized to be attributable to diagnostic uncertainty and ineffective communication. The objective of this study was to evaluate whether clinical and communication skills are associated with antibiotic prescribing for upper respiratory infections and sinusitis. METHODS A cohort study of 2,526 international medical graduates and 48,394 U.S. Medicare patients diagnosed by study physicians with an upper respiratory infection or sinusitis between July 2014 and November 2015 was conducted. Clinical and communication skills were measured by scores achieved on the Clinical Skills Assessment examination administered by the Educational Commission for Foreign Medical Graduates (ECFMG) as a requirement for entry into U.S residency programs. Medicare Part D data were used to determine whether patients were dispensed an antibiotic following an outpatient evaluation and management visit with the study physician. Physician age, sex, specialty and practice region were retrieved from the ECFMG databased and American Medical Association (AMA) Masterfile. Multivariate GEE logistic regression was used to evaluate the association between clinical and communication skills and antibiotic prescribing, adjusting for other physician and patient characteristics. RESULTS Physicians prescribed an antibiotic in 71.1% of encounters in which a patient was diagnosed with sinusitis, and 50.5% of encounters for upper respiratory infections. Better interpersonal skills scores were associated with a significant reduction in the odds of antibiotic prescribing (OR per score decile 0.93, 95% CI 0.87-0.99), while greater proficiency in clinical skills and English proficiency were not. Female physicians, those practicing internal medicine compared to family medicine, those with citizenship from the US compared to all other countries, and those practicing in southern of the US were also more likely to prescribe potentially unnecessary antibiotics. CONCLUSIONS Based on this study, physicians with better interpersonal skills are less likely to prescribe antibiotics for acute sinusitis and upper respiratory infections. Future research should examine whether tailored interpersonal skills training to help physicians manage patient expectations for antibiotics could reduce unnecessary antibiotic prescribing.
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Affiliation(s)
- Robyn Tamblyn
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 2001 McGill College Avenue, H3A 1G1, Montreal, QC, Canada.
- Department of Medicine, McGill University Health Center, Montreal, QC, Canada.
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.
| | - Teresa Moraga
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada
| | - Nadyne Girard
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada
| | - John Boulet
- Foundation for Advancement of International Medical Education and Research (FAIMER), Philadelphia, PA, USA
| | - Fiona K I Chan
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 2001 McGill College Avenue, H3A 1G1, Montreal, QC, Canada
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada
| | - Bettina Habib
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada
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Abad-Corpa E, Guillén-Ríos JF, Pastor-Bravo MDM, Jiménez-Ruiz I. Assessment of high fidelity simulation with actors in palliative care in nursing students: a mixed methods study. Enferm Clin (Engl Ed) 2023; 33:401-411. [PMID: 37898170 DOI: 10.1016/j.enfcle.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 09/27/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE The most effective training methods are experiential, including those focused on experiences and emotions. Clinical simulation, especially high-fidelity simulation, is one of the most effective methodologies for the acquisition of competencies in care like palliative care. The simulation with actors can train future healthcare science professionals: in technical, intellectual, or interpersonal skills. The objective is to evaluate high-fidelity simulation with actors as a tool in palliative care training for nursing students. METHOD Over three years, the study was conducted in a Faculty of Nursing of the south of Spain with nursing students. A mixed methods study with sequential explanatory design in three moments was conducted: (1) Quasi-experimental study in a single group (n = 12) before and after attending the palliative care course with Clinical Simulation with actors to assess the communication skills (CICAA scale), (2) Qualitative study with phenomenological perspective after Clinical Simulation (174 reflective students' narratives), (3) Cross-sectional observational study, one year later, to assess the transfer of knowledge and skills to the clinical practice (71 students). RESULTS Students who interacted with actors in Clinical Simulation improved their communication skills and the ability to establish an effective helping relationship with both end-of-life patients and their families. The students perceived the Clinical Simulation as an innovative learning methodology that is useful to encourage reflection and transfer of learning during their clinical internship. CONCLUSIONS Standardization of the use of active learning methodologies is recommended for a better acquisition of transversal skills such as communication skills in palliative care.
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Affiliation(s)
- Eva Abad-Corpa
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Murcia, El Palmar, Murcia, Spain; ENFERAVANZA, Instituto Murciano de Investigación Biosanitaria (IMIB-Pascual Parrilla), El Palmar, Murcia, Spain; Hospital General Universitario Reina Sofía, Servicio Murciano de Salud, Murcia, Spain; Unidad de Investigación en Cuidados de la Salud (Investén-ISCIII), Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Francisco Guillén-Ríos
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Murcia, El Palmar, Murcia, Spain; Residencia de personas mayores San Basilio, Instituto Murciano de Acción Social, Murcia, Spain.
| | - María Del Mar Pastor-Bravo
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Murcia, El Palmar, Murcia, Spain; ENFERAVANZA, Instituto Murciano de Investigación Biosanitaria (IMIB-Pascual Parrilla), El Palmar, Murcia, Spain
| | - Ismael Jiménez-Ruiz
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Murcia, El Palmar, Murcia, Spain; ENFERAVANZA, Instituto Murciano de Investigación Biosanitaria (IMIB-Pascual Parrilla), El Palmar, Murcia, Spain
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23
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Johnson KM, Luff D, Macharia A, Troutman M, Lamberto A, Marchand K, Hacker MR, Brown S, O'Brien B. Clinician communication after discovery of a soft marker of aneuploidy during pregnancy: A mixed methods assessment of a communication workshop. J Gynecol Obstet Hum Reprod 2023; 52:102652. [PMID: 37633360 PMCID: PMC10615874 DOI: 10.1016/j.jogoh.2023.102652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Soft markers of aneuploidy are common findings on obstetric ultrasounds but disclosure often increases patient anxiety. It is unknown whether communication training affects patient experience of soft marker disclosure. Our objective was to evaluate clinician experience of a simulation-based communication workshop and assess workshop influence on patient anxiety, understanding, and perception of communication quality. METHODS We implemented a communication workshop for clinicians at an academic institution in 2019, and assessed clinician anxiety and confidence with counseling before and after. To assess effect of the workshop on patients, we surveyed pregnant people before and after workshop implementation for whom an echogenic intracardiac focus, choroid plexus cyst, or urinary tract dilation was identified. The primary outcome was anxiety. Some respondents completed a semi-structured interview. Interviews were analyzed using thematic analysis. RESULTS Twelve clinicians participated. Twenty-one out of 49 eligible patients (43%) completed a survey before the workshop and 40 out of 90 eligible patients (44%) completed a survey after. The risk of high anxiety after was similar to before the workshop (aRR 1.7, 95% CI 0.6-4.2). Twenty patients were recruited for an interview. Qualitative analysis revealed that patients' backgrounds, emotional impact of the conversation and clinician manner influenced perception of communication quality. CONCLUSION While a single clinician workshop did not affect patient anxiety, clinician manner and personalization play a large role in perception of counseling about soft markers of aneuploidy.
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Affiliation(s)
- Katherine M Johnson
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
| | - Donna Luff
- Boston Children's Hospital Immersive Design Systems, Center for Life Sciences Building, 18th Floor, 3 Blackfan Circle, Boston, MA 02115, USA; Department of Anesthesia, Critical Care Medicine, and Pain Medicine, Boston Children's Hospital, Boston MA 02115, USA
| | - Annliz Macharia
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Michele Troutman
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Anderson Lamberto
- Boston Children's Hospital Immersive Design Systems, Center for Life Sciences Building, 18th Floor, 3 Blackfan Circle, Boston, MA 02115, USA
| | - Karen Marchand
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Michele R Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Stephen Brown
- Department of Radiology, Boston Children's Hospital, Boston, MA 02115, USA
| | - Barbara O'Brien
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
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Tomohisa Y, Yumi I, Inoue M. Long-term outcome of selective mutism: factors influencing the feeling of being cured. Eur Child Adolesc Psychiatry 2023; 32:2209-2221. [PMID: 35984502 DOI: 10.1007/s00787-022-02055-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Abstract
Some long-term outcomes for participants with selective mutism (SM) are elevated rates of phobic disorders, particularly social phobia, persistent communicative problems, and reduced self-esteem. However, data on the long-term outcomes of SM are scarce. In this study, by analyzing interpersonal anxiety, communication skills, and self-esteem among those who experienced SM and felt cured (SM-C-group: 30 females, 6 males, mean age 28.0, SD = 7.42, range 19-47 years), those who experienced SM and did not feel cured (SM-NC-group: 37 females, 4 males, mean age 27.4, SD = 7.24, age range 19-50 years), and those who had not experienced SM (Non-SM-group: 30 females, 30 males, mean age 26.4, SD = 7.62, age range: 20-48 years), we examined the long-term outcomes of SM and the factors that influence the feeling of being cured of SM. Results showed that the SM-C-group and SM-NC-groups had significantly higher interpersonal anxiety and significantly lower communication skills than the Non-SM-group. Moreover, the SM-C-group showed significantly lower interpersonal anxiety and significantly higher communication skills than the SM-NC-group. However, while there was no significant difference in self-esteem between the SM-C and SM-NCgroups, there was a significant difference between the SM-NC and Non-SM groups. The SM-C and SM-NC groups did not differ on the retrospective symptom load (SMQ-J), but did on the Current level of difficulty with speaking. The results of the logistic regression analysis predicted that communication skills and self-esteem did not influence the feeling of being cured of SM, but interpersonal anxiety and Current level of difficulty to speak did. Therefore, it is speculated that the intensity of this interpersonal anxiety and whether people with SM still felt difficulty in talking to others may have affected the feeling of being cured from SM.
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Affiliation(s)
- Yamanaka Tomohisa
- Department of Clinical Psychology, Graduate School of Medical Sciences, Tottori University, 86 Nishi-cho, Yonago, 683-8503, Japan
| | - Ishida Yumi
- Department of Psychology, Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiko Inoue
- Department of Clinical Psychology, Graduate School of Medical Sciences, Tottori University, 86 Nishi-cho, Yonago, 683-8503, Japan.
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Kodikara K, Seneviratne T, Premaratna R. Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability. BMC Med Educ 2023; 23:729. [PMID: 37803328 PMCID: PMC10559527 DOI: 10.1186/s12909-023-04722-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 09/25/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND The effectiveness of simulation-based training for skill acquisition is widely recognized. However, the impact of simulation-based procedural training (SBPT) on pre-clerkship medical students and the retention of procedural skills learned through this modality are rarely investigated. METHODS A prospective cohort study was conducted among pre-clerkship medical students. Learners underwent SBPT in venipuncture in the skills laboratory. Assessments were conducted at two main points: 1) immediate assessment following the training and 2) delayed assessment one year after training. Learner self-assessments, independent assessor assessments for procedural competency, and communication skills assessments were conducted in both instances. The students were assessed for their competency in performing venipuncture by an independent assessor immediately following the training in the simulated setting and one-year post-training in the clinical setting, using the Integrated Procedural Protocol Instrument (IPPI). The student's communication skills were assessed by standardized patients (SP) and actual patients in the simulated and clinical settings, respectively, using the Communication Assessment Tool (CAT). RESULTS Fifty-five pre-clerkship medical students were recruited for the study. A significant increase was observed in self-confidence [mean: 2.89 SD (Standard Deviation) (0.69)] and self-perceived competency [mean: 2.42 SD (0.57)] in performing venipuncture, which further improved at the delayed assessment conducted in the clinical setting (p < 0.001). Similarly, the IPPI ratings showed an improvement [immediate assessment: mean: 2.25 SD (1.62); delayed assessment: mean: 2.78 SD (0.53); p < 0.01] in venipuncture skills when assessed by an independent assessor blinded to the study design. A significant difference (p < 0.01) was also observed in doctor-patient communication when evaluated by SPs [mean: 2.49 SD (0.57)] and patients [mean: 3.76 SD (0.74)]. CONCLUSION Simulation-based venipuncture training enabled students to perform the procedure with confidence and technical accuracy. Improved rating scores received at a one-year interval denote the impact of clinical training on skills acquisition. The durability of skills learned via SBPT needs to be further investigated.
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Affiliation(s)
- Kaumudee Kodikara
- Department of Medical Education, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
| | - Thilanka Seneviratne
- Department of Pharmacology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Ranjan Premaratna
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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Berglund L, von Knorring J, McGrath A. When theory meets reality- a mismatch in communication: a qualitative study of clinical transition from communication skills training to the surgical ward. BMC Med Educ 2023; 23:728. [PMID: 37794444 PMCID: PMC10552412 DOI: 10.1186/s12909-023-04633-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/30/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Communication skills training in patient centered communication is an integral part of the medical undergraduate education and has been shown to improve various components of communication. While the effects of different educational interventions have been investigated, little is known about the transfer from theoretical settings to clinical practice in the context of communication skills courses not integrated in the clinical curriculum. Most studies focus on single factors affecting transfer without considering the comprehensive perspective of the students themselves. The aim of this study is to explore how the students experience the transition to clinical practice and what they perceive as challenges in using patient centered communication. METHODS Fifteen 4th year medical students were interviewed 3 weeks after the transition from an advanced communication skills course to surgical internship using semi-structured interviews. Qualitative content analysis was used to analyze the interviews. RESULTS The analysis resulted in a theme 'When theory meets reality- a mismatch in communication'. It was comprised of four categories that encompassed the transfer process, from theoretical education, practical communication training and surgical internship to students' wishes and perceived needs. CONCLUSIONS We concluded that preparing the students through theoretical and practical training should reflect the reality they will face when entering clinical practice. When educating medical students as a group, their proclivity for perfectionism, high performance environment and achievement-related stress should be taken into consideration. The role of tutors being role models, offering guidance, giving feedback and providing support plays a major part in facilitating transfer of communication skills. To enable transfer to a larger extent, the environment needs to promote patient centeredness and students need more opportunities to practice communication with their patients.
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Affiliation(s)
- Leif Berglund
- Department of Clinical Sciences, Umeå- University, Umeå, Sweden
| | | | - Aleksandra McGrath
- Department of Clinical Sciences, Umeå- University, Umeå, Sweden.
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
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27
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Ruba E, Reeves C, Khan A, Pelaez EC, Heaberlin S. Communication skills in practice vs. communication in the real world: Insights from an international medical student symposium. Patient Educ Couns 2023; 115:107848. [PMID: 37406472 DOI: 10.1016/j.pec.2023.107848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE To explore and compare medical students' experiences with communication skills training (CST) in medical education. METHOD Five medical students from the U.S., U.K., and Ireland shared their experiences with CST at a 90-minute symposium held at the 2022 International Conference on Communication in Healthcare (ICCH). RESULTS Students identified two areas of CST that may affect their preparedness for real-world clinical practice: 1) the impact of the COVID-19 pandemic on communication teaching and learning, and 2) the need to effectively communicate with diverse patient populations. CONCLUSION The COVID-19 pandemic brought major changes to CST, and though training programs varied in their approach, students found that they were able to successfully adapt while gaining valuable skills needed to navigate communicating with patients on virtual platforms. When learning to communicate with patients from diverse backgrounds, students perceived generalized strategies that equipped them with the skills needed to adapt to uncertainty to be the most valuable. PRACTICE IMPLICATIONS Collaboration between medical schools, both nationally and internationally, provides opportunity to share areas of strength and avenues for improvement in CST. Representation of learner perspectives is essential in order to better understand how well current educational methodologies prepare learners to enter real world clinical practice.
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Affiliation(s)
- Emily Ruba
- University of Iowa Carver College of Medicine, United States.
| | | | - Ahmad Khan
- Leicester Medical School, United Kingdom
| | | | - Sally Heaberlin
- University of Iowa Carver College of Medicine, United States
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Lathia T, Chittem M, Chawak S, Katdare P, Jayaram S, Selvan C. Experiences and expectations of physician communication: A focus group discussion with Indian patients with type 2 diabetes mellitus. Chronic Illn 2023:17423953231200683. [PMID: 37710965 DOI: 10.1177/17423953231200683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
OBJECTIVES This pilot study aimed to: (a) understand the experiences of Indian patients with type 2 diabetes mellitus and their expectations of their physicians during a medical consultation, (b) serve as a preliminary study to inform the development of a larger project exploring and improving patients' communication experiences, and (c) assess whether the pilot study findings indicate the viability of using the Relationship: Establishment, Development, and Engagement model of communication as the conceptual framework for the larger project. METHODS Using convenience sampling, 11 patients participated in a focus group discussion. Conventional content analysis was used. RESULTS Two themes were generated: (a) A plethora of negative feelings: experiences of the physician's verbal and nonverbal communication styles, and (b) 'I know what I want': Expectations of communication by patients from their physician. CONCLUSIONS The medical encounter with the physician elicited a range of negative experiences and clear expectations from the patients with type 2 diabetes mellitus. This pilot points to the need for (a) a mixed methods approach to comprehensively examine the communication needs of patients with type 2 diabetes mellitus from their physician, (b) understand physicians' communication practices, and (c) using these findings, culturally adapt and test the Relationship: Establishment, Development, and Engagement to improve physicians' communication skills in India.
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Affiliation(s)
- Tejal Lathia
- Apollo Hospitals, Navi Mumbai, Maharashtra, India
| | - Mahati Chittem
- Department of Liberal Arts, Indian Institute of Technology Hyderabad, Hyderabad, Telangana, India
| | - Shweta Chawak
- Jindal School of Psychology and Counselling, O.P. Jindal Global University, Haryana, India
| | - Praneeta Katdare
- Department of Liberal Arts, Indian Institute of Technology Hyderabad, Hyderabad, Telangana, India
| | | | - Chitra Selvan
- Department of Endocrinology, Ramaiah Medical College, Bengaluru, Karnataka, India
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Luthra M, Ohri P, Sharma U, Sharma A, Mohanty S, Maheshwari S. Assessment of Communication Skills in MBBS Interns with Objective Structured Video Examination (OSVE). Indian J Community Med 2023; 48:771-774. [PMID: 37970158 PMCID: PMC10637593 DOI: 10.4103/ijcm.ijcm_640_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 06/14/2023] [Indexed: 11/17/2023] Open
Abstract
Background Medical graduates enter work force with substantial knowledge but are they prepared for practice in diverse settings? To train medical interns in communication skills using Demonstration Observation Assistance and Performance (DOAP) and to assess communication skills in medical interns using objective structured video examination (OSVE). Methods and Materials DOAP sessions of all 27 interns posted in Community Medicine and Pediatrics departments during the duration of the study were conducted in six clinical scenarios followed by two OSVEs. Methods and Material Interns performed selected activity independently twice for assessments. Videos submitted by interns were assessed by Gap Kalamazoo assessment forms (OSVE). Data analysis was done by appropriate methods. Percentages and proportions and calculation of median scores with interquartile ranges. Results Seventy one point four percent of faculty and 96.3% of interns were satisfied with module implementation. More than = 57.8% marks were scored by 94.45% interns in self-assessment and faculty assessment and by 100% interns in patient assessment. Median scores of all second assessments were higher. Conclusions DOAP method is good for training of interns in communication skills. OSVE may be an appropriate assessment tool as it leads to progression in learning.
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Affiliation(s)
- Megha Luthra
- Department of Community Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Puneet Ohri
- Department of Community Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Utkarsh Sharma
- Department of Paediatrics, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Ashwani Sharma
- Department of Community Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Soumya Mohanty
- Department of Community Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Sonam Maheshwari
- Department of Community Medicine, Government Doon Medical College, Dehradun, Uttarakhand, India
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Nikkels A, Berns P, Neijenhuis K. Communication partner training for SLT students: Changes in communication skills, knowledge and confidence. J Commun Disord 2023; 105:106366. [PMID: 37541131 DOI: 10.1016/j.jcomdis.2023.106366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/06/2023]
Abstract
This paper describes the changes in communication skills, knowledge and confidence in Speech Language Therapy (SLT) students in conversations with People With Aphasia (PWA) after Training Con-tAct, a Dutch Communication Partner Training. METHODS On a voluntary basis, nine SLT students (2nd yr) completed Training Con-tAct, in which People With Aphasia (PWA) were involved as co-workers. A mixed method design with pre- and post-measures was used to analyze the students' communication skills, knowledge and confidence. A quantitative video analysis was used to measure changes in students' communication skills. Besides, a self-report questionnaire was used to measure the changes in students' knowledge and confidence regarding their communication with PWA. To evaluate the perspectives of the students on Training Con-tAct, additionally a focus group interview was held. RESULTS Regarding students' communication skills the outcomes revealed a significantly higher score on the 'supporting' competence in students who took part in Training Con-tAct. The mean scores for the 'acknowledging' and 'checking information' competences did not improve significantly. The outcomes of the questionnaire showed students gained more knowledge and confidence regarding communication with PWA. The focus group interview provided insights into: motivation for participating in Communication Partner Training, content and structure of the training, feedback in CPT, and learning experiences. CONCLUSION The present study suggests that SLT students may benefit from Training Con-tAct as the training leads to better skills, more knowledge about aphasia and more confidence in communicating with PWA. Training Con-tAct could be a valuable addition to the curricula of all healthcare disciplines, and eventually support interprofessional collaboration, resulting in improved access to health care, which is important for communication vulnerable people. Further research with a larger sample size and a control group is required.
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Affiliation(s)
- Alissa Nikkels
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Postbus 25035, Rotterdam, the Netherlands.
| | - Philine Berns
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Postbus 25035, Rotterdam, the Netherlands
| | - Karin Neijenhuis
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Postbus 25035, Rotterdam, the Netherlands
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Sullivan C, Doyle AJ, O'Toole M, Mulhall C, McNaughton N, Eppich W. 'How can we help the students learn?' A grounded theory study of simulated participants as educators. Med Teach 2023; 45:1047-1053. [PMID: 36726233 DOI: 10.1080/0142159x.2023.2171857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE Despite the demonstrated value of simulated participant (SP) feedback, we are only beginning to understand how to optimize SPs' feedback practices for communication skills and strengthen their role as educators. SPs portray roles and engage in feedback practices to support simulated-based learning for communication skills training. SPs come to their role with diverse experiences, knowledge, and training, such as (a) professional actors, (b) lay people, and (c) health professions educators. This study explored what factors influenced SPs' role as educators, including their preparation, training, and approach to role portrayal and feedback practices and how these aspects were influenced by SPs' backgrounds. METHODS Using grounded theory methodology, we collected and analysed data iteratively from 16 semi-structured in-depth interviews. We identified key concepts, using constant comparison and by exploring how concepts were related , to develop a conceptual model of SPs as educators. RESULTS The SP role as educator was shaped by several interrelated dualities which spanned both the SP and learner roles and contributed to the identity formation of both SP and learner: (a) building competence (SP competence as educator and learner competence as healthcare professional), (b) engaging in reflective practice (SPs prompting learner reflection and SPs reflecting on their own role), and (c) establishing a safe space (SP needing to feel safe in their role to create safety to support learner engagement). SPs' backgrounds influenced how they learned to portray roles and how they engaged in feedback practices, both in-action, through in-role prompts and cues, and on-action, through post-scenario feedback discussions. CONCLUSION Our conceptual model about SPs as educators informs SP selection and training. Further, this model enables practical suggestions for SP educators and faculty who involve SPs in teaching. Enhanced feedback practices have the potential to improve learning from simulated encounters.
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Affiliation(s)
- Clare Sullivan
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Andrea Jane Doyle
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Michelle O'Toole
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Mulhall
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Nancy McNaughton
- The Wilson Centre for Research in Education, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Walter Eppich
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Nambiar SS. Comparison of the Structured Consent Process Using Modified Delphi Technique with the Standard Process in Obtaining Informed Consent for Procedures in ENT by PHASE III MBBS Students. Indian J Otolaryngol Head Neck Surg 2023; 75:1557-1567. [PMID: 37636684 PMCID: PMC10447763 DOI: 10.1007/s12070-023-03546-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 01/30/2023] [Indexed: 03/17/2023] Open
Abstract
Communication skill is a core competency and the training must begin in the undergraduate period itself. The Phase III MBBS students during their ENT posting are required to obtain informed consent for procedures and surgeries in ENT which forms the basis for efficient communication skills in house-surgency (internship) and residency. Informed consent taking is an important aspect and in the clinical postings, the teaching of communication skills along with history taking and physical examination can go a long way in making a strong foundation to good doctor patient relationships. This study aimed to compare the structured consent process using modified Delphi technique with the standard process in obtaining informed consent for procedures in ENT by PHASE III MBBS students. The need to sensitise the MBBS students on appropriate consent taking procedures with familiarisation of the essential elements of the Kalamazoo consensus statement were raised, accepted and final OSCE assessment attributes decided by the modified Delphi technique. The Modified Delphi technique is a unique means to obtain opinions of experts across the field in various spheres so as to identify lacunae if any in the existing teaching with means to reach a valid and reliable consensus. Our study included Phase III MBBS students posted to the Department of ENT, Govt Medical College Kozhikode during Jan-Feb 2022 wherein one batch of 30 students were taught with 2 classes on informed consent taking by the structured process obtained after Modified Delphi technique and included as; "MD" group and another batch of 30 students from the entire batch taught by the standard process was included as; "T" group respectively. After completion of the clinical postings an assessment was carried out with OSCE stations in Mar 2022; wherein 10 students were evaluated for each of the 6 common ENT procedures, 5 students from "T" group and 5 students from "MD" group respectively. Median total score of MD group was 6.5 (3.25-8) and median score of T group was 4.5 (2.25-6.75). The difference in mean ranks of these scores was statistically significant, p < 0.0001. The feedback assessment using the questionnaire with Likert scale had all 30(100%) students recommend this method of structured consent taking for enhancement of communications skills. However 20% of the students were not satisfied with the teaching learning method expressing the need for more time allocation and demonstrations. Informed consent taking requires the appropriate training in the undergraduate period itself as seen by the improved OSCE scores on assessment after teaching by the structured consent taking process as well as from the feedback of the students.
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Almoghirah H, Illing J, Nazar M, Nazar H. A pilot study evaluating the feasibility of assessing undergraduate pharmacy and medical students interprofessional collaboration during an online interprofessional education intervention about hospital discharge. BMC Med Educ 2023; 23:589. [PMID: 37605168 PMCID: PMC10441699 DOI: 10.1186/s12909-023-04557-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 07/31/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Interprofessional education (IPE) has been identified as a strategy towards improving competence at interprofessional working and collaboration within teams. Entrustable professional activities (EPAs) provide a framework for translating competencies into elements of clinical practice, some of which in healthcare are inherently interprofessional. However, it is challenging to reconcile that entrustment decisions about student competence in an interprofessional activity are made about an individual without considering the dynamics and tensions between interprofessional team members and the task itself. This can influence students' development and demonstration of competence at interprofessional collaboration. METHODS In this study, undergraduate medical and pharmacy students worked in pairs online (Zoom) to undertake the hospital discharge process (a professional activity reliant on interprofessional collaboration) for a simulated patient, producing a hospital discharge letter and completing a consultation with the simulated patient. The online sessions were recorded and interprofessional behaviours were assessed using a validated scale completed by an interprofessional assessment team. Students undertook this IPE intervention three times after receiving feedback and a period of reflection each time. RESULTS Eighteen students participated across the entire intervention and 27 one-hour online IPE sessions were completed and recorded. Students demonstrated statistically significant improvements in interprofessional behaviours across the three iterations (p < 0.05 for all the sessions). The discharge letter students produced also improved over the three sessions (p = 0.01). Students found the educational sessions useful and relevant. CONCLUSION This online IPE intervention provided the students with an authentic opportunity to work collaboratively. At the end of each iteration, students received feedback about their work as a team and about the discharge letter, helping students to reflect and purposefully develop their performance. The IPE intervention with this assessment strategy is feasible and allows student development to be captured but has proved to be time and resource intensive.
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Affiliation(s)
- Hailah Almoghirah
- Newcastle University, Newcastle-upon-Tyne, UK
- King Saud University, Riyadh, Saudi Arabia
| | - Jan Illing
- Newcastle University, Newcastle-upon-Tyne, UK
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Hamde Nazar
- Newcastle University, Newcastle-upon-Tyne, UK.
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Ding N, Hu G, Wang X, Sun H, Song L, Chen Y, Zhang D, Xue H, Jin Z. Simulation video: a tool to evaluate communications skills in radiologist residents. BMC Med Educ 2023; 23:586. [PMID: 37596556 PMCID: PMC10439603 DOI: 10.1186/s12909-023-04582-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/10/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND Effective communication is a crucial component of radiology resident training, and many different aspects need to be explored when teaching and evaluating communication skills. To ensure that radiology residents' communication skill levels can be measured accurately, a standardized evaluation tool has been introduced. In twenty hospitals in Beijing, simulation videos have been developed as a way to assess the communication skills of radiology residents during their certification exams, to minimize evaluating biases. This study aims to assess the performance of a simulation video model in evaluating communications skills compared to the standard patient model. METHODS This is a retrospective observational study. The performance of standard patient and simulation video models was evaluated through an eight-year examination of communication skills in radiology residents. From 2014 to 2021, communications skill tests were administered to 1003 radiology residents in 20 hospitals in Beijing. The standardized patient (SP) model was applied in 2014, and simulation videos were used from 2015 to 2021. The difficulty and discrimination radio of the tests were evaluated. The subjective survey for candidates on two models of communication skills evaluation was performed and analyzed. RESULTS The simulation video model evaluation demonstrated stable difficulty (ranging from 0.92 to 0.98) and discrimination ratio (ranging from 0.37 to 0.49), except for minor exceptions of discrimination in 2019 (0.58) and 2020 (0.20). Furthermore, the Kruskal-Wallis H test revealed no significant differences in average scores between 2016 (93.9 ± 4.6) and 2018 (94.5 ± 4.2), 2016 and 2019 (97.3 ± 3.9), 2017 (97.0 ± 5.6) and 2019, 2017 and 2020 (97.7 ± 4.7), as well as 2019 and 2020 exams (all p ≥ 0.05). In addition, candidates who responded to the survey preferred the simulation video model (with a 77.2% response rate), with 62.7% choosing it over the SP model for communication skills evaluation. CONCLUSION The simulation video demonstrated a stable and better acceptable construct for assessing radiology residents' communication skills.
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Affiliation(s)
- Ning Ding
- Radiology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Shuai Fu Yuan 1#, Dongcheng Dist, Beijing, 100730, China
| | - Ge Hu
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xuan Wang
- Radiology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Shuai Fu Yuan 1#, Dongcheng Dist, Beijing, 100730, China
| | - Hao Sun
- Radiology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Shuai Fu Yuan 1#, Dongcheng Dist, Beijing, 100730, China
| | - Lan Song
- Radiology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Shuai Fu Yuan 1#, Dongcheng Dist, Beijing, 100730, China
| | - Yu Chen
- Radiology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Shuai Fu Yuan 1#, Dongcheng Dist, Beijing, 100730, China
| | - Daming Zhang
- Radiology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Shuai Fu Yuan 1#, Dongcheng Dist, Beijing, 100730, China.
| | - Huadan Xue
- Radiology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Shuai Fu Yuan 1#, Dongcheng Dist, Beijing, 100730, China.
| | - Zhengyu Jin
- Radiology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Shuai Fu Yuan 1#, Dongcheng Dist, Beijing, 100730, China.
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Gopaldas JA, Narayanaswamy N, Chandregowda NP. Communication Skill Training Levels among Critical Care Doctors in India. Indian J Crit Care Med 2023; 27:567-571. [PMID: 37636844 PMCID: PMC10452779 DOI: 10.5005/jp-journals-10071-24495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/27/2023] [Indexed: 08/29/2023] Open
Abstract
Medical training programs outline the necessity of communication skills but there is likely a dearth of teaching at the bedside in part due to prioritization of other skills over communication or due to lack of opportunity. In India, the majority of critical care units are open in nature, and communication lead is likely to be taken by the primary specialty rather than the critical care doctors themselves. In the majority of the cases, the root cause analysis shows a lack of clear communication as a barrier. The sicker the patient, the higher the chance for anxiety and miscommunication among healthcare professionals as well as the family. The current project aims to find the training levels in Indian critical care settings and draw conclusions to see if there are avenues to improve the process. This study was based on a web-based questionnaire that was sent out to 1,000 critical care doctors across India. Educational experience and learning of communication techniques/concepts were assessed using a modified educational experience and attitudes questionnaire. Baseline demographic data were obtained and results were tabulated across 193 complete responses, which consistently showed a disparity in perceived levels of competence across different mandatory aspects of communication. Further, we find that though communication is a trainable skill, the mode of training has been largely reactive and has remained so for the last 20 years hinting at poor training in communication. Our survey suggests an urgent need for improvement of the training processes to reduce the burden of ethical, clinical, and legal dilemmas in critical care. How to cite this article Gopaldas JA, Narayanaswamy N, Chandregowda NP. Communication Skill Training Levels among Critical Care Doctors in India. Indian J Crit Care Med 2023;27(8):567-571.
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Affiliation(s)
| | - Nikhil Narayanaswamy
- Department of Critical Care Medicine, Aster Whitefield Hospital, Bengaluru, Karnataka, India
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Alsubaie S, Grant D, Donyai P. An Applied Linguistics Study of How Students Prevent Embarrassments and Impositions During Interactive Examination OSCEs. Am J Pharm Educ 2023; 87:100103. [PMID: 37597917 DOI: 10.1016/j.ajpe.2023.100103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 08/21/2023]
Abstract
OBJECTIVE To assess the effectiveness of politeness strategies used by pharmacy students to avoid embarrassing or imposing on others during objective structured clinical examinations. METHODS A total of 19 objective structured clinical examinations video recordings of 10 students (participants) interacting with mock patients were examined using the framework of Politeness Theory (PT). All relevant participant acts (speech activities) were coded using PT into (1) type of face threatening acts (ie, potentially sensitive situations-as regarded by PT) and (2) politeness strategies used to mitigate them. Conversation Analysis was then used to examine the effectiveness of conversational strategies by judging the 'patient' responses to these strategies. RESULTS Most acts had the potential to impact patients' negative face needs (ie, desire to act autonomously, eg, upon the practitioner making a request), positive face needs (ie, desire to be liked, eg, upon the practitioner making a diagnosis), or both. Despite applying a variety of positive politeness strategies (eg, avoiding disagreement, or expressing understanding) to prevent embarrassment to the patient, and negative politeness strategies (eg, being indirect, using hedging, or minimizing the imposition) to avoid directly imposing on them, "dispreferred responses" showed participants mostly focused on avoiding impositions, corresponding to what they have been taught, rather embarrassments. CONCLUSION Participants were less aware that discussing sensitive topics could cause embarrassment to patients, with the potential to upset them. Developing teaching and evaluation methods to consider patients' face needs could help in assessing and improving pharmacy students' communication skills.
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Affiliation(s)
- Sarah Alsubaie
- University of Reading, School of Pharmacy, Whiteknights Campus, Reading, United Kingdom.
| | - Daniel Grant
- University of Reading, School of Pharmacy, Whiteknights Campus, Reading, United Kingdom
| | - Parastou Donyai
- University of Reading, School of Pharmacy, Whiteknights Campus, Reading, United Kingdom
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Menjot P, Bettahi L, Leclercq AL, Durieux N, Remacle A. Interventions That Target or Affect Voice or Speech Production During Public Speaking: A Scoping Review. J Voice 2023:S0892-1997(23)00203-5. [PMID: 37487795 DOI: 10.1016/j.jvoice.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVES Public speaking (PS) is frequently necessary in many professional, educational, and personal settings. Mastering this communication skill is particularly important in today's society. Training techniques for PS have been described in the literature. Given that PS anxiety affects performance, especially voice characteristics and speech fluency, the purpose of this scoping review is to examine, map, and narratively summarize the available evidence on PS interventions that target or affect voice or speech. METHODS An extensive literature search was conducted in three bibliographic databases: Medline ALL/Ovid, PsycINFO/Ovid, and Eric/Ovid. Of the 850 studies identified, 22 met the eligibility criteria, and one was added from the reference lists of the included studies. RESULTS A total of 23 studies were included. The interventions identified aim to improve speaking skills either by explicitly targeting the voice or speech (direct intervention, n = 15) or by targeting the cognitive, behavioral, psychological, or physical environment impacting the speaker's production (indirect intervention, n = 8). CONCLUSIONS This scoping review provides the first published methodological summary of the characteristics of existing PS interventions that target or affect voice and speech. Heterogeneous characteristics were observed. Further studies are needed to determine which interventions are most effective.
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Affiliation(s)
- Pauline Menjot
- Research Unit for a Life-Course Perspective on Health and Education, Faculty of Psychology, Speech Therapy and Education Sciences, University of Liège, Liège, Belgium.
| | - Lamia Bettahi
- Research Unit for a Life-Course Perspective on Health and Education, Faculty of Psychology, Speech Therapy and Education Sciences, University of Liège, Liège, Belgium
| | - Anne-Lise Leclercq
- Research Unit for a Life-Course Perspective on Health and Education, Faculty of Psychology, Speech Therapy and Education Sciences, University of Liège, Liège, Belgium
| | - Nancy Durieux
- Research Unit for a Life-Course Perspective on Health and Education, Faculty of Psychology, Speech Therapy and Education Sciences, University of Liège, Liège, Belgium
| | - Angélique Remacle
- Research Unit for a Life-Course Perspective on Health and Education, Faculty of Psychology, Speech Therapy and Education Sciences, University of Liège, Liège, Belgium
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Zeidani A, Soltanian M, Edraki M, Mirshah E. The effect of the communication skills training on the sensitivity and cultural competence of the nurses in the pediatric wards: A quasi-experimental study. J Educ Health Promot 2023; 12:212. [PMID: 37545997 PMCID: PMC10402802 DOI: 10.4103/jehp.jehp_898_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 09/01/2022] [Indexed: 08/08/2023]
Abstract
BACKGROUND This study aimed to investigate the effect of the communicative training skills on the sensitivity and cultural competence of the nurses in the pediatric wards. MATERIALS AND METHODS The participants included 54 nurses from the pediatric ward of Namazi Hospital affiliated with REDACTED. The sample members entered the study through voluntary registration in the in-service training system. RESULTS The results showed that cultural sensitivity score was 44.22±11.78 before the intervention, 48.51±13.34 immediately after the intervention, and 55.55±20.20 one month after the intervention. Cultural sensitivity score significantly increased immediately and one month after communication skills training for nurses compared to before the intervention (P < 0.001). The results also showed that cultural competency score was 51.68±9.43 before the intervention and increased significantly immediately after the communication skills training and one month after the intervention (57.64±10.43 and 62.56±11.53, respectively), showing significant improvement (P < 0.001). CONCLUSION The communication skills training promoted the nurses' cultural sensitivity and competence in childcare wards. Therefore, the implementation of the theoretical and practical methods of teaching communication skills is suggested to improve nurses' cultural competence and consequently, improve childcare quality in different cultures.
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Affiliation(s)
- Azin Zeidani
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Soltanian
- Community-Based Psychiatric Care Research Center, Nursing Department, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Edraki
- Community-Based Psychiatric Care Research Center, Nursing Department, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Mirshah
- Ph.D Student in Nursing, Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Yang A, Newhook D, Sutherland S, Moreau K, Eady K, Barrowman N, Writer H. Including patients and caregivers in assessment in the pediatric competence by design curriculum: A national consensus study. Med Teach 2023; 45:604-609. [PMID: 36508346 DOI: 10.1080/0142159x.2022.2152661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Although evidence supports diverse assessment strategies, including patient/caregiver involvement in Competency-Based Medical Education (CBME), few residency programs formally include patients/caregivers in assessment. We aimed to determine the milestones for which patient/caregiver inclusion would be valuable in the Canadian Pediatric Competence By Design (CBD) curriculum.Program directors from 17 Canadian pediatric residency programs were invited to participate in a Delphi study. This Delphi included 209 milestones selected by the study team from the 320 milestones of the draft pediatric CBD curriculum available at the time of the study. In round 1, 16 participants representing 13 institutions rated the value of including patients/caregivers in the assessment of each milestone using a 4-point scale. We obtained consensus for 150 milestones, leaving 59 for re-exposure. In round 2, 14/16 participants rated remaining items without consensus. Overall, 67 milestones met consensus for 'valuable,' of which 11 met consensus for 'extremely valuable.' The majority of these milestones related to communication skills.Patient/caregiver assessment is valuable for 21% of milestones in the draft pediatric CBD curriculum, predominantly those relating to communication skills. This confirms the perceived importance of patient/caregiver assessment of trainees in CBME curricula; formal inclusion may be considered. Future directions could include exploring patients/caregivers' perspectives of their roles in assessment in CBD.
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Affiliation(s)
- Ashlee Yang
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Dennis Newhook
- Clinical Research Unit, CHEO Research Institute, Ottawa, Canada
| | | | | | - Kaylee Eady
- Faculty of Education, University of Ottawa, Ottawa, Canada
| | - Nick Barrowman
- Clinical Research Unit, CHEO Research Institute, Ottawa, Canada
| | - Hilary Writer
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
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Erdogan O. The mediator's role of communication skills in the effect of social skills on digital game addiction. Acta Psychol (Amst) 2023; 237:103948. [PMID: 37267879 DOI: 10.1016/j.actpsy.2023.103948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 05/19/2023] [Accepted: 05/20/2023] [Indexed: 06/04/2023] Open
Abstract
This study aimed to investigate the mediating role of communication skills, which has a decisive role in people's healthy interaction with others, between social skills that enable the construction of social networks and digital game addiction. The study was conducted as a relational survey quantitative research model. A total of 474 university students, 232 of whom were female and 242 were male, comprised the participants of the study. The Social Skills Scale, the Communication Skills Scale, and the Digital Game Addiction Scales were used in this research. The data were analyzed using the AMOS-23 program. Results of the analysis showed that social and communication skills were strongly negatively related to digital game addiction, while communication skills were a solid mediator between social skills and digital game addiction. When the results are evaluated holistically, it is thought that digital games are an important escape area for individuals with low social and communication skills.
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Affiliation(s)
- Omer Erdogan
- Department of Psychology, Kastamonu University, Faculty of Humanities and Social Sciences, Turkey.
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Thuraisingham C, Abd Razak SS, Nadarajah VD, Mamat NH. Communication skills in primary care settings: aligning student and patient voices. Educ Prim Care 2023:1-8. [PMID: 37194600 DOI: 10.1080/14739879.2023.2210097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
INTRODUCTION Effective communication is essential for patient-centred relationships. Although medical graduates acquire communication skills during undergraduate training, these have been shown to be inadequate in early practice. Both students' and patients' perspectives are required to improve readiness for the workplace, patient satisfaction, and health outcomes. Our research question was: to what extent are medical students prepared with patient-centred communication skills in primary care settings? METHODS A qualitative descriptive research study using in-depth semi-structured interviews was conducted with Year 3 medical students and patients to study their experiences at a primary care clinic, over two weeks. Data were transcribed verbatim and analysed using Braun and Clark's thematic analysis. Both students' and patients' views on communication skills were obtained. RESULTS Three themes were established based on student-patient communication in primary care settings: socio-cultural elements in student-patient communication; cognitive and emotional challenges for effective communication; and enablers for effective student-patient communication. The themes and sub-themes describe both students and patients valuing each other as individuals with socio-cultural beliefs and needs. CONCLUSION The findings can be used to structure new approaches to communication skills education that is patient-centred, culturally sensitive, and informed by patients. Communication skills training should encourage students to prioritise and reflect more on patient perspectives while educators should engage patients to inform and assess the outcomes.
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Affiliation(s)
| | | | - Vishna Devi Nadarajah
- Education & Institutional Development Office, International Medical University, Kuala Lumpur, Malaysia
| | - Norul Hidayah Mamat
- IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
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Major AB, Zhou Y, Hatfield CL, Little KM, Mondragon NM, Gill AC. A comparison of medical and pharmacy student perspectives of a clinical interprofessional home-visit versus a virtual interprofessional workshop. MedEdPublish (2016) 2023; 13:27. [PMID: 37435138 PMCID: PMC10331847 DOI: 10.12688/mep.19510.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 07/13/2023] Open
Abstract
Background: No Place Like Home is a clinical interprofessional education (IPE) activity whereby pharmacy and medical students conduct home visits under the guidance and supervision of a clinical preceptor to homebound patients. Purpose: We examined pharmacy and medical student perceptions of mastery of interprofessional competencies during an in-person clinical home visit pre-COVID-19 pandemic versus a virtual IPE learning activity consisting of didactic and case discussions in response to the global COVID-19 pandemic. Methods: We administered the same modified Interprofessional Collaborative Competency Attainment Survey (ICCAS) instrument, which uses a five-point Likert scale, to both the in-person and the virtual IPE students following their learning activity. Results: We received a total of 459 completed survey responses with an overall response rate of 84%. For both groups of students, the in-person format was preferred, however, to our surprise, the results indicated that students in the virtual group reported greater perceived gain in interprofessional skills than students in the in-person group. In addition, pharmacy students perceived greater gain from the interprofessional activity and offered more thoughtful reflections about their experience. Conclusions: Even though both groups of students preferred the in-person visit, the IPE objectives were equally (for medical students) or better (for pharmacy students) absorbed in the virtual environment than the in-person clinical home visit.
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Affiliation(s)
- Anita B. Major
- Department of Medicine-Geriatrics, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Yuanyuan Zhou
- Evaluation, Assessment & Educational Research, Baylor College of Medicine, Houston, Texas, 77030, USA
| | | | - Kristina M. Little
- Department of Medicine-Geriatrics, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Natalie M. Mondragon
- Department of Medicine-Geriatrics, Baylor College of Medicine, Houston, Texas, 77030, USA
- Evaluation, Assessment & Educational Research, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Anne C. Gill
- Pediatrics, Baylor College of Medicine, Houston, Texas, 77040, USA
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Brown F, Sanders I, Watkins R, Grey E, Smith P, Springett D, Welsh T, Gillison F. "A disembodied voice over the telephone": a qualitative study of healthcare practitioners' experiences in geriatric medicine. BMC Geriatr 2023; 23:270. [PMID: 37142989 PMCID: PMC10159677 DOI: 10.1186/s12877-023-03909-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 03/20/2023] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVES This study explored the experience of delivering care remotely among practitioners in a UK geriatric medicine clinic. METHODS Nine semi-structured interviews were conducted with consultants (n = 5), nurses (n = 2), a speech and language and an occupational therapist, and thematically analysed. RESULTS Four themes developed; Challenges of remote consultations; Perceived advantages of remote consultations; Disruption of involvement of family members; Impact on care staff. Participants felt that rapport and trust had been more feasible to develop remotely than they had anticipated, although this was more challenging for new patients and those with cognitive or sensory impairments. While practitioners identified advantages of remote consultations, including involving relatives, saving time, and reducing anxiety, they also experienced disadvantages such as consultations feeling like a 'production line', missing visual cues and reduced privacy. Some participants felt their professional identity was threatened by the lack of face-to-face contact, linked to feeling that remote consultations are not suitable for frail older adults or those with cognitive deficits. DISCUSSION Staff perceived barriers to remote consultations that went beyond practical concerns, and suggest support for building rapport, involving families, and protecting clinician identity and job satisfaction may be warranted.
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Affiliation(s)
- Frankie Brown
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | | | - Ross Watkins
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - Elisabeth Grey
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - Paula Smith
- Department of Psychology, University of Bath, Bath, BA2 7AY, UK
| | | | - Tomas Welsh
- Research Institute for the Care of Older People, RICE, Royal United Hospitals Bath NHS Foundation Trust, Bath, BA1 3NG, UK
| | - Fiona Gillison
- Department for Health, University of Bath, Bath, BA2 7AY, UK.
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Antoun J, Saab B, Usta J, Romani M, Akl IB, El Mofti MF, Eter J, AlArab N, Itani H. Development of an assessment tool to measure communication skills among family medicine residents in the context of electronic medical record use. BMC Med Educ 2023; 23:245. [PMID: 37060046 PMCID: PMC10103454 DOI: 10.1186/s12909-023-04216-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/31/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The introduction of the electronic medical record (EMR) has led to new communication skills that need to be taught and assessed. There is scarce literature on validated instruments measuring electronic-specific communication skills. The aim is to develop an assessment checklist that assesses the general and EMR-specific communication skills and evaluates their content validity and reliability. METHODS Using the SEGUE theoretical framework for communication skills, the assessment checklist items were developed by the Communication Skills Working Group (CSWG) at the family medicine department using a literature review about the positive and negative aspects of EMR use on physician-patient communication. A group of faculty members rated real resident-patient encounters on two occasions, three weeks apart. Patients were asked to fill out the Communication Assessment Tool (CAT) at the end of the encounter. RESULTS A total of 8 residents agreed to participate in the research, with 21 clinical encounters recorded. The average total score was 65.2 ± 6.9 and 48.1 ± 9.5 for the developed scale and the CAT scale, respectively. The scale reliability was good, with a Cronbach alpha of 0.694. The test-retest reliability was 0.873, p < 0.0001. For the total score on the developed checklist, the intraclass correlation coefficient between raters (ICC) was 0.429 [0.030,0.665], p-value of 0.019. The level of agreement between any two raters on the cumulative score of the 5 subsections ranged from 0.506 (interpersonal skills) to 0.969 (end encounter). CONCLUSION This checklist is a reliable and valid instrument that combines basic and EMR-related communication skills.
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Affiliation(s)
- Jumana Antoun
- Department of Family Medicine, American University of Beirut, Lebanon, Lebanon.
| | - Bassem Saab
- Department of Family Medicine, American University of Beirut, Lebanon, Lebanon
| | - Jinan Usta
- Department of Family Medicine, American University of Beirut, Lebanon, Lebanon
| | - Maya Romani
- Department of Family Medicine, American University of Beirut, Lebanon, Lebanon
| | - Imad Bou Akl
- Department of Internal Medicine, American University of Beirut, Lebanon, Lebanon
| | | | - Joudy Eter
- Department of Family Medicine, American University of Beirut, Lebanon, Lebanon
| | - Natally AlArab
- Department of Family Medicine, American University of Beirut, Lebanon, Lebanon
| | - Hala Itani
- Department of Family Medicine, American University of Beirut, Lebanon, Lebanon
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Mariman A, Vermeir P, Csabai M, Weiland A, Stegers-Jager K, Vermeir R, Vogelaers D. Education on medically unexplained symptoms: a systematic review with a focus on cultural diversity and migrants. Eur J Med Res 2023; 28:145. [PMID: 37013665 PMCID: PMC10069028 DOI: 10.1186/s40001-023-01105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/20/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Health care providers often struggle with the management of patients with medically unexplained symptoms (MUS), especially in case of a different ethnicity and/or cultural background. These challenges are insufficiently addressed in their training. OBJECTIVES A systematic review on education in the field of MUS in a diverse context to improve MUS healthcare provider-patient interaction focused on intercultural communication. METHODS Screening of PubMed, Web of Science, Cinahl and Cochrane Library on the keywords 'Medical unexplained (physical) symptoms (MUS)', 'Somatoform disorder', 'Functional syndrome', 'Diversity', 'Migrants', 'Ethnicity', 'Care models', 'Medical education', 'Communication skills', 'Health literacy'. RESULTS MUS patients, especially with a different ethnic background, often feel not understood or neglected. Health care providers experience feelings of helplessness, which may provoke medical shopping and resource consumption. Attitudes and perceptions from undergraduate trainees to senior physicians tend to be negative, impacting on the quality of the patient/health care provider relationship and subsequently on health outcomes, patient satisfaction and therapeutic adherence. Current undergraduate, graduate and postgraduate education and training does not prepare health care providers for diagnosing and managing MUS patients in a diverse context. A continuum of training is necessary to achieve a long term and lasting change in attitudes towards these patients and trainers play a key role in this process. Hence, education should pay attention to MUS, requiring a specific competency profile and training, taken into account the variety in patients' cultural backgrounds. CONCLUSIONS This systematic review identified significant gaps and shortcomings in education on MUS in a diverse context. These need to be addressed to improve outcomes.
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Affiliation(s)
- An Mariman
- Faculty of Medicine and Healthcare Sciences, Ghent University, Ghent, Belgium
- Centre for Integrative Medicine, Ghent University Hospital, Ghent, Belgium
| | - Peter Vermeir
- Faculty of Medicine and Healthcare Sciences, Ghent University, Ghent, Belgium.
- Dean's Office of the Faculty of Medicine and Healthcare Sciences, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Marta Csabai
- Institute of Psychology, Károli Gáspár University of the Reformed Church, Budapest, Hungary
| | - Anne Weiland
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Karen Stegers-Jager
- Institute of Medical Education Research, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Ruben Vermeir
- Faculty of Medicine and Healthcare Sciences, Ghent University, Ghent, Belgium
| | - Dirk Vogelaers
- Faculty of Medicine and Healthcare Sciences, Ghent University, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium
- Department of General Internal Medicine, AZ Delta, Roeselare, Belgium
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Ortega P, Cisneros R, Park YS. Spanish medical jargon: A new metric for improving patient-centered communication with Spanish-speaking patients. Patient Educ Couns 2023; 109:107644. [PMID: 36689885 DOI: 10.1016/j.pec.2023.107644] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/16/2022] [Accepted: 01/18/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Reducing medical jargon improves patient-centered communication, which is a core objective of medical Spanish courses. We aimed to develop a reliable methodology for identifying and classifying Spanish medical jargon. METHODS Fourth-year medical students in a medical Spanish course recorded themselves explaining diagnosis, treatment, and follow-up care during ten clinical scenarios. We developed a stepwise process for identifying and classifying Spanish medical jargon in the recording transcripts. Two reviewers scored jargon, unexplained jargon, and non-Spanish (neologisms/English) word counts. We evaluated jargon metric correlations with other course performance data. RESULTS We identified 439 Spanish jargon words and 134 non-Spanish words across 480 transcripts. Mean Spanish jargon per minute was 6.57, and 30% was classified as unexplained. Overall inter-rater reliability was excellent (interclass correlation=0.88). Students with post-course Spanish proficiency of "very good" or higher had less unexplained jargon in follow-up care transcripts (P < 0.05); other course outcomes did not correlate with jargon findings. CONCLUSION A Spanish medical jargon metric can be reliably used to evaluate student communication skills in a medical Spanish course. Next steps include engaging patient perspectives and exploring strategies to automate jargon analysis. PRACTICE IMPLICATIONS Spanish medical jargon adds a previously unexplored dimension to the assessment of Spanish-language patient-centered communication.
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Affiliation(s)
- Pilar Ortega
- Department of Medical Education, University of Illinois College of Medicine, Chicago, IL, USA; Department of Emergency Medicine, University of Illinois College of Medicine, Chicago, IL, USA.
| | - Rafael Cisneros
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Yoon Soo Park
- Department of Medical Education, University of Illinois College of Medicine, Chicago, IL, USA
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Weir M. Understanding and Addressing Microaggressions in Medicine. Dermatol Clin 2023; 41:291-297. [PMID: 36933918 DOI: 10.1016/j.det.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Microaggressions are directed unconsciously to people of color or other minority groups, and the accumulated experience of multiple microaggressions over a lifetime have detrimental effects on mental health. In the clinical setting, both physicians and patients can commit microaggressions. Patients experiencing a microaggression from their provider suffer emotional distress and distrust resulting in decreased service utilization, reduced adherence, and poorer physical and mental health. Physicians and medical trainees, particularly those of color, women and LGBTQIA members, have increasingly experienced microaggressions committed by patients. Learning to recognize and address microaggressions in the clinical setting creates a more supportive and inclusive environment.
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Affiliation(s)
- Michelle Weir
- University of Pennsylvania, Perelman School of Medicine, 235 South 8th Street, Philadelphia, PA 19106, USA.
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McDarby M, Silverstein HI, Carpenter BD. Effects of a Patient Question Prompt List on Question Asking and Self-Efficacy During Outpatient Palliative Care Appointments. J Pain Symptom Manage 2023; 65:285-295. [PMID: 36565794 PMCID: PMC10023338 DOI: 10.1016/j.jpainsymman.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
CONTEXT Question prompt lists (QPLs) promote participation during medical appointments, including in the context of serious illness care. However, no studies have used parameters of a theoretical framework to examine the effects of QPL use in outpatient palliative care. OBJECTIVES The current pilot randomized controlled trial evaluated use of a 25-question QPL during initial outpatient palliative care appointments. We applied tenets of Self-Efficacy Theory to investigate how use of a QPL affected appointment participation and perceived self-efficacy. METHODS Participants were patients and care partners attending the patient's first palliative care appointment. Participants either received a QPL before the appointment (n = 29 appointments) or usual care (n = 30 appointments). Audio recordings of appointments were coded for total questions asked. Participants reported perceived self-efficacy in question asking pre- and postappointment. Analysis of variance was used to compare appointment participation between study conditions, and a linear mixed effects model was used to compare changes in ratings of perceived self-efficacy. RESULTS Participants who received the QPL did not ask significantly more questions compared to participants in usual-care appointments. There was a main effect of time on self-efficacy in question asking, such that self-efficacy increased from pre- to postappointment, but there was no effect of the intervention. CONCLUSION Despite their promise in previous studies, results of the current study suggest that QPLs may lack potency to shift patient and care partner question asking in palliative care appointments, and that other mechanisms outlined in Self-Efficacy Theory may characterize the relation between question asking and self-efficacy.
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Affiliation(s)
- Meghan McDarby
- Department of Psychiatry and Behavioral Sciences (M.M.), Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Psychological and Brain Sciences (H.I.S., B.D.C.), Washington University in St. Louis, St. Louis, Missouri, USA.
| | - Hannah I Silverstein
- Department of Psychiatry and Behavioral Sciences (M.M.), Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Psychological and Brain Sciences (H.I.S., B.D.C.), Washington University in St. Louis, St. Louis, Missouri, USA
| | - Brian D Carpenter
- Department of Psychiatry and Behavioral Sciences (M.M.), Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Psychological and Brain Sciences (H.I.S., B.D.C.), Washington University in St. Louis, St. Louis, Missouri, USA
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Borja K, Dieringer S. Telling My Story: Applying Storytelling to Complex Economic Data. East Econ J 2023; 49:328-348. [PMID: 37274304 PMCID: PMC10019412 DOI: 10.1057/s41302-023-00242-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Our experience with business and economic students indicates limited understanding and confidence when working with macroeconomic data such as unemployment rate, labor force participation rate, business cycles, and price indexes. To close this gap, the authors have developed and evaluated a college classroom experiential activity defined as the Storytelling Project (SP) conducted in nine principles of economics courses in a mid-size private university over a period of two years during the COVID-19 pandemic. In the SP, students wrote personal stories that assisted them in connecting with their audience and then visually presented complex economic data. A workbook supplemented the SP with learning objectives, tasks, multiple examples of data analysis, storytelling techniques, and videos. Participants completed a self-efficacy and attitude survey of perceived cognition, confidence, and motivation and took an assessment to evaluate cognitive competencies. The survey and assessment results were compared against students who did not complete the SP. Our results indicate that the SP and the workbook are effective experiential learning activities that improve data analysis and communication skills among college students. Students show more confidence and motivation in macroeconomics and data analysis at the end of the semester. Knowledge or cognitive competency is ranked higher among those completing the SP.
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Affiliation(s)
- Karla Borja
- Department of Economics, The University of Tampa, 401 W. Kennedy Blvd., Box O, Tampa, FL 33606 USA
| | - Suzanne Dieringer
- Department of Economics, The University of Tampa, 401 W. Kennedy Blvd., Box O, Tampa, FL 33606 USA
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Brown SM, Faw MH, Lucas-Thompson RG, Pettigrew J, Quirk K. Relations Between Stress-Adapted Communication Skills and Toxic Social Networks Among Young Adults with Childhood Adversity. Advers Resil Sci 2023; 4:1-13. [PMID: 37361563 PMCID: PMC10015516 DOI: 10.1007/s42844-023-00093-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/05/2023] [Indexed: 03/17/2023]
Abstract
Adverse childhood experiences are associated with deleterious outcomes across the lifespan. However, some individuals who grow up in adverse environments may develop stress-adapted skills or resilience factors that enable them to function in their current lived environments. This study explored whether communication is a stress-adapted skill among young adults with co-occurring forms of childhood adversity and the extent to which these communication skills are implicated in toxic social networks. This cross-sectional study included 384 young adults, ages 18-35 years, who completed an online survey. Mixture modeling was used to conduct latent class models estimating subgroups of young adults with co-occurring forms of early adversity; then, regression models estimated the association between communication skills and toxic social networks among subgroups. Four latent classes were identified: (1) high childhood adversity; (2) high to moderate household dysfunction and emotional abuse; (3) high emotional abuse and moderate physical abuse and emotional neglect; and (4) low or no childhood adversity. Results from regression models indicate that participants classified in the high emotional abuse and moderate physical abuse and emotional neglect class had more adaptive communication skills with friends than their counterparts in the low or no childhood adversity class, and participants in the high childhood adversity or low or no childhood adversity classes with higher communication skills were less likely to report toxic social networks. Findings suggest that stress-adapted communication skills may be one resilience factor that supports adaptation among young adults with early adversity exposures.
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Affiliation(s)
- Samantha M. Brown
- School of Social Work, Colorado State University, 1586 Campus Delivery, Fort Collins, CO 80523 USA
| | - Meara H. Faw
- Department of Communication Studies, Colorado State University, Fort Collins, CO USA
| | - Rachel G. Lucas-Thompson
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO USA
| | - Jessica Pettigrew
- School of Social Work, Colorado State University, Fort Collins, CO USA
| | - Kelley Quirk
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO USA
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