scholarly journals What is clinician presence? A qualitative interview study comparing physician and non-physician insights about practices of human connection

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030831 ◽  
Author(s):  
Cati Brown-Johnson ◽  
Rachel Schwartz ◽  
Amrapali Maitra ◽  
Marie C Haverfield ◽  
Aaron Tierney ◽  
...  
Keyword(s):  
Social Services ◽  
Health Centre ◽  
Medical Professionals ◽  
Protective Services ◽  
Academic Medical Centre ◽  
Proactive Management ◽  
Academic Medical ◽  
Management Of Technology ◽  
Qualitative Interview Study ◽  
Definition Of

ObjectiveWe sought to investigate the concept and practices of ‘clinician presence’, exploring how physicians and professionals create connection, engage in interpersonal interaction, and build trust with individuals across different circumstances and contexts.DesignIn 2017–2018, we conducted qualitative semistructured interviews with 10 physicians and 30 non-medical professionals from the fields of protective services, business, management, education, art/design/entertainment, social services, and legal/personal services.SettingPhysicians were recruited from primary care clinics in an academic medical centre, a Veterans Affairs clinic, and a federally qualified health centre.ParticipantsParticipants were 55% men and 45% women; 40% were non-white.ResultsQualitative analyses yielded a definition of presence as a purposeful practice of awareness, focus, and attention with the intent to understand and connect with individuals/patients. For both medical and non-medical professionals, creating presence requires managing and considering time and environmental factors; for physicians in particular, this includes managing and integrating technology. Listening was described as central to creating the state of being present. Within a clinic, presence might manifest as a physician listening without interrupting, focusing intentionally on the patient, taking brief re-centering breaks throughout a clinic day, and informing patients when attention must be redirected to administrative or technological demands.ConclusionsClinician presence involves learning to step back, pause, and be prepared to receive a patient’s story. Building on strategies from physicians and non-medical professionals, clinician presence is best enacted through purposeful intention to connect, conscious navigation of time, and proactive management of technology and the environment to focus attention on the patient. Everyday practice or ritual supporting these strategies could support physician self-care as well as physician-patient connection.

scholarly journals Differences in burnout prevalence between clinical professionals and biomedical scientists in an academic medical centre: a cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023506 ◽  
Author(s):  
Erick Messias ◽  
Molly M Gathright ◽  
Emily S Freeman ◽  
Victoria Flynn ◽  
Timothy Atkinson ◽  
...  
Keyword(s):  
Health Centre ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Academic Medical Centre ◽  
Work Related ◽  
Academic Medical ◽  
Prevalence Estimates ◽  
Clinical Environments

ObjectiveTo determine the prevalence and associated factors for personal, work-related and patient/client-related burnout in clinical professionals and biomedical scientists in academic medicine.DesignPrevalence survey using the Copenhagen Burnout Inventory.SettingMid-size academic health centre.ParticipantsClinical providers (n=6489) and biomedical scientists (n=248) were invited to complete the survey. 1646 completed responses (response rate 24.4%) were analysed.Primary and Secondary outcome measuresPrevalence estimates and adjusted ORs (AOR) were stratified for gender, age and professional category.ResultsType of burnout varies across professional categories, with significant differences between clinicians and scientists. The prevalence of personal burnout was 52.7% (95%CI 50% to 55%), work-related burnout 47.5% (95%CI 45% to 49%) and patient/client-related burnout 20.3% (95%CI 18% to 22%). The prevalence of personal and work-related burnout was higher among women, while those aged 20–30 had a higher prevalence of all three burnout categories. Overall, clinical professionals had higher personal and work-related burnout, while biomedical scientists had higher client-related burnout. Accounting for the effects of gender and age, a significantly higher risk for personal burnout was found for physicians (AOR 1.64; 95%CI 1.3 to 2.1) and nurses (AOR 1.5; 95%CI 1.03 to 2.2). Significantly higher odds of work-related burnout were found for nurses (AOR 1.5; 95%CI 1.2 to 1.9) and residents (AOR 1.9; 95%CI 1.04 to 3.6). Basic scientists (AOR 10.0; 95%CI 5.7 to 17.6), physicians (AOR 2.8; 95%CI 1.9 to 4.1) and nurses (AOR 2.1; 95%CI 1.3 to 3.5) had higher odds of patient/client-related burnout.ConclusionsTypes of burnout are unevenly distributed in academic medical centres. Physicians have higher risk of personal and patient/client-related burnout, residents have higher risk of work-related burnout, basic scientists are at higher risk of client-related burnout and nurses have higher odds of all three types of burnout. Interventions addressing the problem of burnout in clinical environments may be inadequate to support biomedical scientists.

Attitudes of Medical Workers Toward Artificial Intelligence in Ophthalmology: A Comparative Survey (Preprint)

2020 ◽  
Author(s):  
Weihua Yang ◽  
Bo Zheng ◽  
Maonian Wu ◽  
Shaojun Zhu ◽  
Hongxia Zhou ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Medical Ethics ◽  
Online Survey ◽  
Medical Professionals ◽  
Medical Field ◽  
Acceptance Level ◽  
Professional Workers ◽  
Basic Understanding ◽  
Comparative Survey ◽  
Definition Of

BACKGROUND Artificial intelligence (AI) is widely applied in the medical field, especially in ophthalmology. In the development of ophthalmic artificial intelligence, some problems worthy of attention have gradually emerged, among which the ophthalmic AI-related recognition issues are particularly prominent. That is to say, currently, there is a lack of research into people's familiarity with and their attitudes toward ophthalmic AI. OBJECTIVE This survey aims to assess medical workers’ and other professional technicians’ familiarity with AI, as well as their attitudes toward and concerns of ophthalmic AI. METHODS An electronic questionnaire was designed through the Questionnaire Star APP, an online survey software and questionnaire tool, and was sent to relevant professional workers through Wechat, China’s version of Facebook or WhatsApp. The participation was based on a voluntary and anonymous principle. The questionnaire mainly consisted of four parts, namely the participant’s background, the participant's basic understanding of AI, the participant's attitude toward AI, and the participant's concerns about AI. A total of 562 participants were counted, with 562 valid questionnaires returned. The results of the questionnaires are displayed in an Excel 2003 form. RESULTS A total of 562 professional workers completed the questionnaire, of whom 291 were medical workers and 271 were other professional technicians. About 37.9% of the participants understood AI, and 31.67% understood ophthalmic AI. The percentages of people who understood ophthalmic AI among medical workers and other professional technicians were about 42.61% and 15.6%, respectively. About 66.01% of the participants thought that ophthalmic AI would partly replace doctors, with about 59.07% still having a relatively high acceptance level of ophthalmic AI. Meanwhile, among those with ophthalmic AI application experiences (30.6%), respectively about 84.25% of medical professionals and 73.33% of other professional technicians held a full acceptance attitude toward ophthalmic AI. The participants expressed concerns that ophthalmic AI might bring about issues such as the unclear definition of medical responsibilities, the difficulty of ensuring service quality, and the medical ethics risks. And among the medical workers and other professional technicians who understood ophthalmic AI, 98.39%, and 95.24%, respectively, said that there was a need to increase the study of medical ethics issues in the ophthalmic AI field. CONCLUSIONS Analysis of the questionnaire results shows that the medical workers have a higher understanding level of ophthalmic AI than other professional technicians, making it necessary to popularize ophthalmic AI education among other professional technicians. Most of the participants did not have any experience in ophthalmic AI, but generally had a relatively high acceptance level of ophthalmic AI, believing that doctors would partly be replaced by it and that there was a need to strengthen research into medical ethics issues of the field.

scholarly journals Impact of the COVID-19 pandemic on neuroimaging scan volumes at a teaching hospital

2021 ◽  
pp. 197140092098866
Author(s):  
Daniel Thomas Ginat ◽  
James Kenniff
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
The United States ◽  
Radiology Department ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Academic Medical Centre ◽  
Academic Medical ◽  
The Impact

Background The COVID-19 pandemic led to a widespread socioeconomic shutdown, including medical facilities in many parts of the world. The purpose of this study was to assess the impact on neuroimaging utilisation at an academic medical centre in the United States caused by this shutdown. Methods Exam volumes from 1 February 2020 to 11 August 2020 were calculated based on patient location, including outpatient, inpatient and emergency, as well as modality type, including computed tomography and magnetic resonance imaging. 13 March 2020 was designated as the beginning of the shutdown period for the radiology department and 1 May 2020 was designated as the reopening date. The scan volumes during the pre-shutdown, shutdown and post-shutdown periods were compared using t-tests. Results Overall, neuroimaging scan volumes declined significantly by 41% during the shutdown period and returned to 98% of the pre-shutdown period levels after the shutdown, with an estimated 3231 missed scans. Outpatient scan volumes were more greatly affected than inpatient scan volumes, while emergency scan volumes declined the least during the shutdown. In addition, the magnetic resonance imaging scan volumes declined to a greater degree than the computed tomography scan volumes during the shutdown. Conclusion The shutdown from the COVID-19 pandemic had a substantial but transient impact on neuroimaging utilisation overall, with variable magnitude depending on patient location and modality type.

scholarly journals Where is the leak in the pipeline? Investigating gender differences in academic promotion at an academic medical centre

2016 ◽  
Vol 5 (2) ◽  
pp. 125-128 ◽  
Author(s):  
Jessica K. Paulus ◽  
Karen M. Switkowski ◽  
Geneve M. Allison ◽  
Molly Connors ◽  
Rachel J. Buchsbaum ◽  
...  
Keyword(s):  
Gender Differences ◽  
Medical Centre ◽  
Academic Medical Centre ◽  
Academic Promotion ◽  
Academic Medical

scholarly journals Speaking up about care concerns in the ICU: patient and family experiences, attitudes and perceived barriers

2018 ◽  
Vol 27 (11) ◽  
pp. 928-936 ◽  
Author(s):  
Sigall K Bell ◽  
Stephanie D Roche ◽  
Ariel Mueller ◽  
Erica Dente ◽  
Kristin O’Reilly ◽  
...  
Keyword(s):  
Perceived Barriers ◽  
Family Education ◽  
Speaking Up ◽  
Academic Medical Centre ◽  
Know How ◽  
Family Attitudes ◽  
Conflicting Information ◽  
Academic Medical ◽  
Internet Sample ◽  
Speak Up

BackgroundLittle is known about patient/family comfort voicing care concerns in real time, especially in the intensive care unit (ICU) where stakes are high and time is compressed. Experts advocate patient and family engagement in safety, which will require that patients/families be able to voice concerns. Data on patient/family attitudes and experiences regarding speaking up are sparse, and mostly include reporting events retrospectively, rather than pre-emptively, to try to prevent harm. We aimed to (1) assess patient/family comfort speaking up about common ICU concerns; (2) identify patient/family-perceived barriers to speaking up; and (3) explore factors associated with patient/family comfort speaking up.MethodsIn collaboration with patients/families, we developed a survey to evaluate speaking up attitudes and behaviours. We surveyed current ICU families in person at an urban US academic medical centre, supplemented with a larger national internet sample of individuals with prior ICU experience.Results105/125 (84%) of current families and 1050 internet panel participants with ICU history completed the surveys. Among the current ICU families, 50%–70% expressed hesitancy to voice concerns about possible mistakes, mismatched care goals, confusing/conflicting information and inadequate hand hygiene. Results among prior ICU participants were similar. Half of all respondents reported at least one barrier to voicing concerns, most commonly not wanting to be a ‘troublemaker’, ‘team is too busy’ or ‘I don’t know how’. Older, female participants and those with personal or family employment in healthcare were more likely to report comfort speaking up.ConclusionSpeaking up may be challenging for ICU patients/families. Patient/family education about how to speak up and assurance that raising concerns will not create ‘trouble’ may help promote open discussions about care concerns and possible errors in the ICU.

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