scholarly journals High-Value, Cost-Conscious Care Attitudes in the Graduate Medical Education Learning Environment: Various Stakeholder Attitudes That Residents Misjudge

2020 ◽  
Author(s):  
Serge B. R. Mordang ◽  
Andrea N. Leep Hunderfund ◽  
Frank W. J. M. Smeenk ◽  
Laurents P. S. Stassen ◽  
Karen D. Könings
Keyword(s):  
Learning Environment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Attitudinal Differences ◽  
Resident Perceptions ◽  
Positive Attitudes ◽  
Academic Hospitals ◽  
Health Quality ◽  
Faculty And Administrators ◽  
Supportive Learning Environment

Abstract Background Training residents in delivering high-value, cost-conscious care (HVCCC) is crucial for a sustainable healthcare. A supportive learning environment is key. Yet, stakeholders’ attitudes toward HVCCC in residents’ learning environment are unknown. Objective We aimed to measure stakeholders’ HVCCC attitudes in residents’ learning environment, compare these with resident perceptions of their attitudes, and identify factors associated with attitudinal differences among each stakeholder group. Design We conducted a cross-sectional survey across the Netherlands between June 2017 and December 2018. Participants Participants were 312 residents, 305 faculty members, 53 administrators, and 1049 patients from 66 (non)academic hospitals. Main Measures Respondents completed the Maastricht HVCCC Attitude Questionnaire (MHAQ), containing three subscales: (1) high-value care, (2) cost incorporation, (3) perceived drawbacks. Additionally, resident respondents estimated the HVCCC attitudes of other stakeholders, and answered questions on job demands and resources. Univariate and multivariate analyses were used to analyze data. Key Results Attitudes differed on all subscales: faculty and administrators reported more positive HVCCC attitudes than residents (p ≤ 0.05), while the attitudes of patients were less positive (p ≤ 0.05). Residents underestimated faculty’s (p < 0.001) and overestimated patients’ HVCCC attitudes (p < 0.001). Increasing age was, among residents and faculty, associated with more positive attitudes toward HVCCC (p ≤ 0.05). Lower perceived health quality was associated with less positive attitudes among patients (p < 0.001). The more autonomy residents perceived, the more positive their HVCCC attitude (p ≤ 0.05). Conclusions Attitudes toward HVCCC vary among stakeholders in the residency learning environment, and residents misjudge the attitudes of both faculty and patients. Faculty and administrators might improve their support to residents by more explicitly sharing their thoughts and knowledge on HVCCC and granting residents autonomy in clinical practice.

scholarly journals 52 Cultivating Learner-centeredness in a Time of Rupture: Lessons from the Shift to Virtual Pediatric Academic Half Day during the COVID-19 Pandemic

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e36-e38
Author(s):  
Mia Remington ◽  
Brett Schrewe ◽  
Matt Carwana ◽  
Basil Kadoura
Keyword(s):  
Learning Environment ◽  
Subject Area ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Pediatric Residents ◽  
Resident Perceptions ◽  
Learner Centeredness ◽  
Uncertain Time ◽  
Survey Responses ◽  
Inductive Thematic Analysis

Abstract Primary Subject area Medical Education Background The COVID-19 pandemic has significantly disrupted the postgraduate learning environment. In light of public health recommendations and the need to offer safe learning environments, many programs have drawn upon virtual technologies to continue delivery of formal academic curricula. Despite widespread use, however, little is currently known as to how trainees view these changes. Objectives The authors sought to explore resident perceptions on the COVID-19-influenced shift from in-person to virtual academic half day (AHD) delivery. Design/Methods A cross-sectional survey was created and distributed to 51 pediatric residents who participated in virtual AHD at a university-affiliated Canadian program distributed across three sites, from March to June 2020. Survey responses were obtained confidentially through a secure, online platform (REDCap). Descriptive statistics and inductive thematic analysis were used to analyze responses to close-ended questions and narrative comments, respectively. Results Response rate was 60.8%. Residents reported statistically significant improvement in their attitudes towards virtual AHD across all metrics collected. Areas most strongly rated included increased trainee engagement and overall satisfaction with virtual delivery, in part due to increased relevance of content. Factors enabling participation included educationally safe interactions and a more comfortable and flexible learning environment. Conclusion These results suggest that the transition to virtual AHD was generally well received. During an uncertain time, when trainee vulnerability is heightened, the need to explicitly attend to educational issues of relevance, engagement, safety, and comfort are crucial. Further, given the rapid and reactive pivots to new curricular strategies in the wake of COVID-19, it is incumbent upon programs to incorporate resident feedback to ensure a learner-centred environment is maintained.

scholarly journals The Medical Education Environment at the University of Nairobi, Kenya: An Assessment with the DREEM Tool

2021 ◽  
Vol 18 (2) ◽  
pp. 96-102
Author(s):  
Daniel Ojuka ◽  
Faith Aseta ◽  
Beth Githambo ◽  
Brian Wambua
Keyword(s):  
Medical Students ◽  
Learning Environment ◽  
Educational Environment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Knowledge And Skills ◽  
School Of Medicine ◽  
Education Environment ◽  
The University ◽  
Supportive Learning Environment

Background: The supportive learning environment can enhance impartating of knowledge and skills. Objective: To assess the learning environment at the School of Medicine of the University of Nairobi using the Dundee Ready Educational Environment Measure(DREEM) tool. Methods: A cross-sectional survey carried in 2019 out among medical students during their clinical years to obtain their perceptions about the learning environment at the School of Medicine of the University of Nairobi. The DREEM tool was used for the survey. Data were entered and analyzed in SPSS version19. Comparisons were performed using analysis of variance (ANOVA). p≤0.05 was consideredstatistically significant. Results: We obtained 619 responses (77.4%) from 800 tools distributed. The total mean score of DREEM was 93.3/200. This is a 46.7%score overall indicating a poor perception of the learning environment. Year IV was the class with the poorest perception with a p<0.05. Conclusion: The DREEM score shows numerous problems, with perception of learning and social support being the areas requiring themost improvement. Although teachers are knowledgeable, students are wary of their ability to transfer knowledge and skills. Keywords: Learning environment, DREEM, Medical students

Malaria Prevention and Mothers: Sudan

2021 ◽  
Author(s):  
Yousif Elmosaad ◽  
Ahmed Al Rajeh ◽  
Asif khan ◽  
Elfatih Malik ◽  
Ilias Mahmud
Keyword(s):  
Formal Education ◽  
Effective Means ◽  
Malaria Prevention ◽  
Good Knowledge ◽  
Bed Nets ◽  
Cluster Sampling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Positive Attitudes

This study assessed the knowledge, attitudes, and practices (KAP) in malaria prevention using insecticide-treated bed nets (ITNs) among mothers of children under five years of age in White Nile State, Sudan. Multistage cluster sampling was used to select 761 mothers for this cross-sectional survey. There were gaps in the KAP in malaria prevention. Only 46.3% of the mothers stated personal protective measures (PPMs) as the best malaria prevention strategy; 54.9% considered ITNs as an effective means; and only 18.7% reported sleeping under an ITN every day. Older mothers were less likely to have good knowledge (OR=0.96), attitudes (OR=0.98) and practices (OR=0.98). Having a Government employee as the head of the household was positively associated with knowledge (OR=2.16) and attitudes (OR=1.96). The mother having a formal education was also positively associated with good knowledge (OR=1.55) and positive attitudes (OR=1.69). Mothers with a monthly household income of <491 Sudanese Pound were more likely to have good knowledge (OR=1.43). Mothers who had good knowledge (OR=4.99) and positive attitudes towards PPMs (OR=2.60) in malaria prevention were found to be more likely to practice preventive measures. Therefore, we recommend focusing on raising mothers’ awareness of the different preventive activities to protect them and their family from malaria.

scholarly journals Assessing the Knowledge, Attitudes and Practices of COVID-19 among Quarantine Hotel Workers in China

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 772
Author(s):  
Yi-Man Teng ◽  
Kun-Shan Wu ◽  
Wen-Cheng Wang ◽  
Dan Xu
Keyword(s):  
Descriptive Analysis ◽  
Binary Logistic Regression ◽  
Sociodemographic Factors ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Positive Attitudes ◽  
Hotel Workers ◽  
Knowledge Attitudes And Practices

During the pandemic, quarantine hotel workers face a higher risk of infection while they host quarantine guests from overseas. This study’s aim is to gain an understanding of the knowledge, attitudes, and practices (KAP) of quarantine hotel workers in China. A total of 170 participants took part in a cross-sectional survey to assess the KAP of quarantine hotel workers in China, during the COVID-19 pandemic. The chi-square test, independent t-test, one-way analysis of variance (ANOVA), descriptive analysis, and binary logistic regression were used to examine the sociodemographic factors associated with KAP levels during the COVID-19 pandemic. The results show that 62.41% have good knowledge, 94.7% have a positive attitude towards COVID-19, but only 78.2% have good practices. Most quarantine hotel workers (95.3%) are confident that COVID-19 will be successfully controlled and that China is handling the COVID-19 crisis well (98.8%). Most quarantine hotel workers are also taking personal precautions, such as avoiding crowds (80.6%) and wearing facemasks (97.6%). The results evidence that quarantine hotel workers in China have acquired the necessary knowledge, positive attitudes and proactive practices in response to the COVID-19 pandemic. The results of this study can provide a reference for quarantine hotel workers and their targeted education and intervention.

scholarly journals US-based cross-sectional survey of clinicians’ knowledge and attitudes about shared decision-making across healthcare professions and specialties

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022730 ◽  
Author(s):  
Rachel C Forcino ◽  
Renata West Yen ◽  
Maya Aboumrad ◽  
Paul J Barr ◽  
Danielle Schubbe ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Shared Decision Making ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Knowledge And Attitudes ◽  
Positive Attitudes

ObjectiveIn this study, we aim to compare shared decision-making (SDM) knowledge and attitudes between US-based physician assistants (PAs), nurse practitioners (NPs) and physicians across surgical and family medicine specialties.SettingWe administered a cross-sectional, web-based survey between 20 September 2017 and 1 November 2017.Participants272 US-based NPs, PA and physicians completed the survey. 250 physicians were sent a generic email invitation to participate, of whom 100 completed the survey. 3300 NPs and PAs were invited, among whom 172 completed the survey. Individuals who met the following exclusion criteria were excluded from participation: (1) lack of English proficiency; (2) area of practice other than family medicine or surgery; (3) licensure other than physician, PA or NP; (4) practicing in a country other than the US.ResultsWe found few substantial differences in SDM knowledge and attitudes across clinician types, revealing positive attitudes across the sample paired with low to moderate knowledge. Family medicine professionals (PAs) were most knowledgeable on several items. Very few respondents (3%; 95% CI 1.5% to 6.2%) favoured a paternalistic approach to decision-making.ConclusionsRecent policy-level promotion of SDM may have influenced positive clinician attitudes towards SDM. Positive attitudes despite limited knowledge warrant SDM training across occupations and specialties, while encouraging all clinicians to promote SDM. Given positive attitudes and similar knowledge across clinician types, we recommend that SDM is not confined to the patient-physician dyad but instead advocated among other health professionals.

scholarly journals Perceptions and Attitudes towards Evidence Based Practice among Nurses and Nursing Students in Nepal

2017 ◽  
Vol 13 (4) ◽  
pp. 308-315 ◽  
Author(s):  
S. Karki ◽  
R. Acharya ◽  
H. Budhwani ◽  
P. Shrestha ◽  
P. Chalise ◽  
...  
Keyword(s):  
Nursing Students ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Study Objective ◽  
Knowledge And Skills ◽  
Professional Students ◽  
Positive Attitudes ◽  
Perceptions And Attitudes

Background As the evidence based practice (EBP) movement expands, there is a need for health leaders and educators in each country to assess the extent to which health professional students and practitioners are prepared to locate, evaluate, and apply evidence to guide their practice.Objective The study objective was to explore nurses’ and nursing students’ perceptions and attitudes towards EBP.Method This was a descriptive cross-sectional survey administered to all 273 nurses and nursing students from Nepal who attended an EBP conference. The survey instrument that was used by Majid in Singapore was adapted for use in this study with permission from the author.Result In total, 121 nurses participated in the study. The majority (93%) of respondents reported that they had no previous training in EBP. The respondents’ perceptions of their EBP knowledge and skills were variable, but most of them demonstrated positive attitudes toward EBP. Respondents identified a number of barriers that limit the implementation of EBP in Nepal. The greatest barriers were lack of time and resources, difficulty understanding research articles and translating the findings to practice, and limited autonomy to change practice based on evidence.Conclusion Although respondents had positive attitudes towards EBP, their knowledge and skills were limited and barriers to implementation existed. Nursing faculty can use the findings to guide implementation of EBP into curricula, and nursing administrators and clinicians can use the findings to guide practice to promote EBP.

scholarly journals Influence on attitudes and lifestyle due to lockdown amidst COVID-19 pandemic: a perception-based analysis among Bangladeshi residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Md. Saiful Islam ◽  
Md. Asad Ullah ◽  
Ummay Soumayia Islam ◽  
Sahadat Hossain ◽  
Yusha Araf ◽  
...  
Keyword(s):  
Associated Factors ◽  
Formal Education ◽  
Rural Residence ◽  
Regression Analyses ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Positive Attitudes ◽  
The Mean ◽  
Structured Questionnaire

Abstract Background Countrywide lockdown or stay-at-home order has been implemented to slow down the transmission of emergent coronavirus. However, the influence on attitudes and lifestyle due to lockdown amidst the coronavirus disease 2019 (COVID-19) pandemic has been poorly understood. The present study aimed to investigate the influence on attitudes and lifestyle due to lockdown amidst the COVID-19 pandemic among Bangladeshi residents. Methods A cross-sectional survey carried out involving 1635 community dwellers across eight divisions in Bangladesh conducted from April 15, 2020 to May 10, 2020. A structured questionnaire incorporating socio-demographic, attitudes towards lockdown and adverse lifestyle amidst lockdown measures was employed to collect data using the Google Forms. Multiple regression analyses were executed to determine the associated factors of positive attitudes towards lockdown and adverse lifestyle. Results The mean scores of attitudes towards lockdown were 67.9 (SD = 8.4) out of 85 with an overall correct rate (positive attitudes) of 79.9%; whereas the mean scores of adverse lifestyle amidst lockdown were 16.1 (SD = 4.8) out of 34 with an overall rate of 47.4%. The factors associated with more positive attitudes towards lockdown included being female, divorced, higher educated, and students. Conversely, being male, having no formal education, and rural residence were associated factors of adverse lifestyle amidst the COVID-19 pandemic. Conclusions The findings reflect how the COVID-19 lockdown has preciously impacted the attitudes, and lifestyle of Bangladeshi citizens, which will contribute to promoting appropriate measures during a subsequent zonal or complete lockdown.

scholarly journals Community Pharmacists’ Perceptions, Barriers, and Willingness for Offering Sexual and Reproductive Health Services

2021 ◽  
Vol 18 (20) ◽  
pp. 10735
Author(s):  
Ali Mofleh Alshahrani ◽  
Mona Y. Alsheikh
Keyword(s):  
Reproductive Health ◽  
Sex Education ◽  
Professional Education ◽  
Sexual And Reproductive Health ◽  
Community Pharmacists ◽  
Reproductive Health Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Positive Attitudes ◽  
Patient Health

The role of community pharmacists is crucial for promoting health and providing consultation related to sexual and reproductive health. This study measured the perception of community pharmacists in the Kingdom of Saudi Arabia (KSA) towards the provision of counselling services on sex education and reproductive health, including barriers to and proficiency in the delivery of services. A cross-sectional survey was developed and distributed electronically to pharmacists, and responses were analyzed using SPSS version 26. Graphical representations for various opinions on perception, proficiency and barriers were created. More than 80% of pharmacists placed a high value on counselling patients on sex and reproductive health, about 90% counselled their patients very often (74.6%) or often (22.2%), and 3.2% of pharmacists did not counsel patients. Most respondents believed counselling was very important (65.3%) or important (15.1%), with only 19.6% of respondents indicating it was not important. Barriers to offering services included fear from responsibility and liability (M = 4.8), lack of information about patient health (M = 4.7), gender differences (M = 4.7), and lack of social acceptability (M = 4.6). Community pharmacists in KSA possessed positive attitudes, professional education, and willingness to provide counselling to patients on sex education and reproductive health. Apart from the existing barriers that require augmented community pharmacists’ soft skills, clear policies and authorization for offering this type of service are also needed.

Community knowledge of and attitudes to palliative care: A descriptive study

2019 ◽  
Vol 34 (2) ◽  
pp. 245-252 ◽  
Author(s):  
Anna Collins ◽  
Sue-Anne McLachlan ◽  
Jennifer Philip
Keyword(s):  
Palliative Care ◽  
Tertiary Education ◽  
Quality Care ◽  
Multiple Regression Model ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Engagement Strategies ◽  
Positive Attitudes ◽  
English Speaking

Background: Palliative care is predominantly accessed late in the course of an illness, despite evidence to suggest the benefits of early engagement. Strategies are required to reduce the barriers to the delivery of palliative care. Aim: To describe community understandings of and attitudes to palliative care and explore characteristics significantly associated with favourable attitudes towards palliative care. Design: Cross-sectional survey data were collected including several sociodemographic characteristics, knowledge of palliative care and attitudes to palliative care. Correlational analyses identified factors related to positive attitudes to palliative care. Those of significance ( p ⩽ 0.01) were examined using a multiple regression model to determine their predictive value. Setting/participants: A community-based sample of consecutive English-speaking adults who volunteered their participation in response to a study advertisement distributed online through established community groups. Results: A total of 421 participants (75% female, mean age: 51 ± 15.1) reported a median of at least three misperceptions of palliative care. Older age, previously undertaking a caregiving role, knowing someone who had received palliative care and reporting more accurate knowledge of palliative care significantly predicted favourable attitudes to palliative care (adjusted R2 = 0.24, F(8, 333) = 13.2, p < 0.001). Other factors typically associated with health literacy such as tertiary education, working at a medical facility and speaking a language other than English at home were not predictive. Conclusion: Gaps in knowledge about palliative care exist in community, which may limit citizen’s potential access to quality care in the event of serious illness. These results point to a role for public education programmes, which may, in turn, also shift attitudes to palliative care.

scholarly journals Analysing actual prices of medical products: a cross-sectional survey of Dutch hospitals

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e035174 ◽  
Author(s):  
Anouk den Ambtman ◽  
Joris Knoben ◽  
Dana van den Hurk ◽  
Mark Van Houdenhoven
Keyword(s):  
Value Added ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Electronic Survey ◽  
Medical Products ◽  
Total Spending ◽  
Academic Hospitals ◽  
Average Coefficient ◽  
Actual Price

ObjectivesTo assess whether there is a difference between the net prices of medical products used by Dutch hospitals and, if there is, how this difference can be explained.DesignCross-sectional self-administered electronic survey.SettingWe surveyed the prices paid for 17 commonly used medical products, such as pacemakers, gloves and stents in 38 Dutch hospitals (including general, specialised and academic hospitals) in 2017. Hospitals voluntarily and anonymously provided these data and received a personalised free benchmark tool in return. This tool provides information about the variance in prices of the medical products they buy.Participants38 out of 79 hospitals entered and completed the study.Primary and secondary outcome measuresActual price paid excluding Value Added Tax (VAT) per item, the order size per year, total spending for an assortment group and total spending for all products purchased from a specific supplier were measured.ResultsWe found large price variations for the medical products surveyed (average coefficient of variation of 71%). In general, these differences were hard to explain (average R2of 26%). Only purchasing volume (for 8 out of 17 products) was significantly associated with the net price paid by a hospital. Total spending for an assortment group (in euros with a specific supplier) and total spending (for all products in euros with a specific supplier) were not related to the net price paid.ConclusionsWe conclude that only purchasing volume is associated with lower prices paid. Total spending for an assortment group and total spending for all products purchased from a specific supplier are not. These results are in stark contrast to expectations based on economic theory. Other sources of differences in bargaining power might explain these findings. Further research might involve comparing prices across countries.

Sign in / Sign up

Export Citation Format

Share Document