Browsing by Subject "Attitude of Health Personnel"
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Item COVID-19 in long term care facilities(2020-12-04) Gangavati, AnupamaItem Cultivating a culture of safety in academic medical centers(2021-10-15) Wootton, TaylorItem Development of Video and Simulation-Based Communication Skills Learning: Responding to Emotions(2021-05-01T05:00:00.000Z) Nguyen, Trung Tan; Siropaides, Caitlin; Sendelbach, Dorothy; Abraham, ReeniPROBLEM: Responding appropriately to patients’ emotions and concerns is vital for excellent patient care and outcomes. There is a lack of training in this area, with the need to educate healthcare providers about how to appropriately respond to emotions. While communication skills training programs exist for undergraduate medical education, medical students often feel unprepared in responding to patients’ emotions INTERVENTION: A 90-minute small group exercise was developed for second-year pre-clinical students at a large United States medical school in Texas. The exercise consisted of faculty-facilitated small group discussion of two video examples of a patient encounter, comparing clinician responses to patient emotions. The exercise utilized a framework for identifying skills and patient impact of verbal expressions of empathy to different patient emotions. CONTEXT: This curriculum sought to demonstrate examples of strong patient emotions for preclerkship students, and introduce a framework of concrete communication skills that can positively impact a clinical encounter. Data was collected by questionnaires delivered immediately pre-session and post-session, as well as 3 months post-session. Survey questions assessed student perception of effectiveness of the exercise, student-reported preparedness and feeling equipped to perform various communication skills during clinical visits. Paired t-tests were performed and data analyzed for qualitative responses. OUTCOMES: The process evaluation yielded a positive subjective learner response to the exercise which was sustained at 3-month follow-up. The students (N=161 paired for the immediate pre- and post-survey) reported significant increases in knowledge and preparedness to recognize and appropriately respond to different patients’ emotions (P= 0.001). Qualitative data were also captured in the surveys. LESSONS LEARNED: This video-based small group discussion of skills to express verbal empathy is perceived by pre-clinical medical students to be beneficial, and to improve their knowledge and preparedness for using empathic skills in the future. There is a need for further investigation whether this type of communication skills training results in behavior change and is sustained long-term.Item Discordance in OR Safety Attitudes: Does Safety Lie in the Eye of the Beholder?(2013-01-22) Clayton, Joshua; Bernstein, Ira H.; Chen, Li ErnBACKGROUND: Efforts to improve operating room (OR) safety can be optimized if we understand the safety attitudes of those who work in the OR. We sought to describe the safety attitudes of current OR personnel. METHODS: Survey: The Safety Attitudes Questionnaire (OR Version) was modified to develop a shorter, 23-item anonymous electronic survey to measure attitudes toward OR safety. Respondents were also asked to rate the quality of their communication with other providers who care for surgical patients. Participants: Surgeons and proceduralists, anesthesia providers, and nurses who worked in perioperative services and on the surgical wards. Data: Respondents' demographic information was collected. Survey responses were on a 5-point Likert scale, where a higher score reflected a better safety attitude or higher quality communication, as appropriate. Analysis: Classical test theory and factor analysis. ANOVA was used to compare responses between surgeons/proceduralists, anesthesia providers and nurses. Results are reported as mean (SD). RESULTS: Survey: The 23 survey items reliably measured attitudes toward OR safety (α=0.92). Respondents: 170 staff responded to the survey (55 surgeons, 29 anesthesia providers, and 86 nurses). Mean age of respondents was 40.1 (10.9) years. Median duration of experience was 8 years (range: <1 to 42). Attitudes toward OR safety culture: The mean score on the 23-item survey for all respondents was 3.95(0.68). Scores differed significantly among provider groups (p=0.0009). Surgeons' mean score was 0.57 higher than anesthesia providers' (p<0.05), and 0.33 higher than nurses' (p<0.05). Quality of communication: The surgeons' perception of the quality of their communication with nurses was higher than the nurses' perception of the quality of their communication with surgeons (3.95 vs. 3.05, p<0.0001). Similarly, surgeons' perception of the quality of their communication with anesthesia providers was higher than the anesthesia providers' perception of their communication with surgeons (4.43 vs. 3.81, p=0.0015). However, the anesthesia providers' perception of the quality of their communication with nurses did not differ from the nurses' perception of the quality of their communication with anesthesia providers (3.62 vs. 3.68, p=0.77). CONCLUSION: The abbreviated questionnaire is a reliable measure of OR safety attitudes. Surgeons had the most positive OR safety attitude, but there was consistent discrepancy in the way surgeons rated their communication with other provider groups - surgeons reported that the quality of their communication with anesthesia providers and nurses was better than how these other groups rated their communication with surgeons. This finding calls to question the validity of the surgeons' survey scores, and whether they truly had the best safety attitude.Item Does diversity in medicine REALLY enhance quality?: a multiple-choice quiz(2021-02-26) Capers, Quinn, IVItem Erosion of empathy in medical trainees(2015-10-02) Abraham, ReeniItem The ethics of defibrillators and end of life care: the patient, not the device(2014-07-25) Sulistio, MelanieItem Exploring the untapped nexus of ethics and health facility design(2023-01-10) Anderson, Diana C.; Hercules, William J.; Teti, Stowe Locke; Deemer, David A.Architecture inherently reflects the normative preferences of its time. This certainly applies to healthcare architecture, where design concepts have intentional and decades-long effects on patients, families, and staff. Employing healthcare architecture to alter behaviors, mediate interpersonal interactions, and affect patient outcomes make it an ethical matter. We propose that advances in design science and our understanding of its powerful effects warrant a shift in how we think about space, and that the built environment in healthcare is analogous to a medical intervention. As such, all responsible stakeholders should openly discuss and thoroughly scrutinize the intentional use of the built environment to affect perceptions and change behaviors of patients, residents to a similar standard as conventional medical therapies. We highlight prominent examples of such architectural interventions, analyze their implementation, and offer perspective on how medicine and architecture can create ethically responsible spaces.Item Family presence during procedures and resuscitation(2016-12-13) Marco, Catherine A.Invasive procedures and resuscitative efforts are commonly performed in the Emergency Department environment. Traditionally, family members were not invited into the room for invasive procedures and resuscitative efforts. Ethical guidelines and evidence from medical literature support family presence as helpful to patients and families, and does not interfere with resuscitative efforts or training. This presentation will discuss evidence from medical literature, ethical arguments for supporting and opposing family presence, and perspectives of families, physicians, and nurses. Practical guidelines inform best practices when inviting family to be present during invasive procedures and resuscitative efforts.Item Healthcare Provider and Community Adult Knowledge and Beliefs about Adolescent Sexual and Reproductive Health(2018-07-20) McDonald, Wade Compton; Stewart, Sunita M.; Faith, Melissa A.; Bordes Edgar, Veronica; LePage, James; Hughes, Jennifer L.Sexual and gender minority (SGM) youth face discrimination and health/healthcare disparities in American society (Mustanski, Birkett, Greene, Hatzenbuehler, & Newcomb, 2014a). Researchers have demonstrated connections between discriminatory beliefs (e.g., homophobia), beliefs about environmental etiology of SGM, and SGM moral condemnation among United States adults (Wood & Bartkowski, 2004). Previous research has not established whether pediatric healthcare providers share attitudes and beliefs with other U.S. adults. To address SGM youth’s healthcare disparities, one important step is to understand pediatric healthcare providers’ SGM-specific attitudes and beliefs, what factors influence providers’ beliefs, and how providers’ beliefs differ from the greater community. Our study surveyed a national sample of community adults (n=258) and a sample of pediatric healthcare providers (n=103). The primary aim was to validate three novel measures in both samples: a measure assessing knowledge about sexual minority health risks, a measure assessing SGM etiology beliefs, and a measure assessing moral condemnation of SGM identities. We expected etiology beliefs and moral condemnation to contain separate sexual minority (SM) and gender minority (GM) factors when subjected to exploratory and confirmatory factor analyses. This study’s secondary and tertiary aims examined associations between SM knowledge, SGM etiology beliefs, moral condemnation, and homophobia in our community adult and pediatric healthcare provider samples. We anticipated healthcare providers would demonstrate more SM health risk knowledge, more biological etiology beliefs, and less moral condemnation. Our measures demonstrated good psychometric properties. Contrary to expectations, the etiology and moral condemnation measures were unidimensional for all SGM behaviors and identities. Providers demonstrated more SM health risk knowledge than community adults, but this knowledge was not statistically explained by the quantity of participants’ self-reported SGM-specific prior training. Providers and community adults demonstrated similar etiology beliefs, which were associated with moral condemnation and self-reported religiosity. Moral condemnation was lower in the provider sample, and was associated with spirituality, religiosity, previous interaction with SM individuals, and the presence of a SGM friend or family member. This study lays groundwork for future research designed to better understand pediatric healthcare providers’ SGM-specific knowledge and beliefs and to, ultimately, improve healthcare provision for at-risk SGM youth.Item The internist's role in the firearm public health crisis(2018-02-23) Brinker, StephanieItem Love it? hate it? it's complicated: electronic medical record user experience(2020-02-14) Chu, LingItem Medicine in this day and age: addressing ageism in healthcare(2023-12-15) Voit, Jessica H.Item Moral distress in healthcare professionals: what is it and how should we respond?(2019-02-12) Hamric, Ann B.[Note: The slide presentation and video are not available from this event.] Over the past 20 years, the study of moral distress has garnered great interest among healthcare professionals, philosophers, and researchers due to the ubiquity and dangers of the phenomenon. The intersections of exponential growth of scientific knowledge, the availability of medical information to the public through the internet, the increasing complexity of healthcare delivery through formal and informal teams, and shifting notions of professionalism fuel the sustained relevance of moral distress. This presentation will explore moral distress and advance strategies for dealing with it. Healthcare professional data from a large multi-site study (N=706) will be presented showing the importance of team- and system-level causes of moral distress. Relationships between moral distress levels and key variables such as ethical climate and practice setting will be presented. Discussion of the sources of moral distress will assist participants to target interventions in their settings that can minimize this problem and its negative consequences.Item The Perceptions of Shared Medical Appointments among Health Care Workers at Parkland Hospital's Community Oriented Primary Care Clinics(2014-05-22) Murthy, Neil C.; Gimpel, Nora; Pagels, Patti; Kindratt, TiffanyINTRODUCTION: Shared Medical Appointments (SMAs) are a novel way of delivering health care to patients in a group setting. Past research regarding SMA quality improvement have always been patient focused. There is a great deal in the literature that shows that patients perceive SMAs favorably and that patients experience better health outcomes through the SMA format. There is a paucity in the literature regarding providers’ perceptions regarding SMA efficacy and implementation, and whether or not these provider perceptions could affect care. The specific aims of this study were to determine the SMA team’s perceptions on 1) the quality of care delivered through an SMA, and 2) the feasibility of implementing an SMA in a primary care setting. This study was conducted at all eight of the Parkland Community Oriented Primary Care (COPC) clinics located in the Dallas, TX area. METHODS: This cross-sectional study recruited 72 participants who were employees at the Parkland COPCs. The 72 participants had to fill out a survey that covered a wide variety of topics, ranging from their perceptions regarding SMA job training, SMA facilitation, SMA implementation, and SMA quality of care. RESULTS: Quantitative analysis was conducted using SAS, and qualitative analysis was conducted on all subjective answers. We found that most SMA team members harbored positive perceptions regarding SMA format and structure, and SMA quality of care. SMA protocols and curricula were not standardized, and language assistants were most likely to be not trained for their roles on the SMA team. DISCUSSION: Non-standardized protocols/curricula and a lack of training for language assistants could affect the quality of care being delivered to patients. SMAs need to have standardized protocols/curricula, and all SMA team members are due for a refresher training course for their job roles.Item Preparing physicians for an evolving demographic landscape(2018-12-14) Nesbitt, Shawna D.Item Reclaiming our voices: activism as antidote(2023-09-22) Bornstein, Sue S.Item Reflections on race and racism in bioethics: Is there a way forward? (The Daniel W. Foster, M.D., Visiting Lectureship in Medical Ethics)(2017-10-12) King, Patricia A.[Note: The slide presentation is not available from this event.] The concept of race emerged in the United States to explain observable differences among human beings. Physicians, scientists and others used this concept to support beliefs about inherent biological differences between Americans, who trace their ancestry to African slaves, and whites and the "inherent superiority" of whites over blacks. These beliefs provided support for slavery and segregation, continue to reinforce negative stereotypes, and foster implicit bias about blacks and black health down to the present. Nonetheless, the field of bioethics has tended in its deliberations about issues in health care, health science and health policy to ignore the implications of persistent racism embedded in the norms, practices and institutional structures of these fields. What are possible explanations for this failure? Is there a way forward?Item The short history and tenuous future of "professionalism"(2022-12-13) Wynia, Matthew[Note: The slide presentation is not available from this event.] The concept of professionalism in health care is both newer and more fragile than many assume. The history, strengths, risks, and alternatives to professionalism should be understood if we hope to create a future in which health professionals work well together in teams to effectively and ethically serve our patients and communities.