FP1-2 Implementation of duty of candor regulation within neurosurgery: a national cross-sectional survey

ObjectivesStatutory Duty of Candor was introduced in 2014 for NHS bodies in England. Contained within the regulation were definitions regarding the threshold for what constitutes a notifiable patient safety incident. The aim of this survey was to evaluate the interpretation of these definitions by British neurosurgeons.MethodsFull members of the SBNS were electronically invited to participate in an online survey. Surgeons were presented with 15 cases and asked to decide in each one whether they would trigger the process of Duty of Candor. Cases were stratified according to their likelihood and severity.ResultsIn all, 106/357 (29.7%) members participated in the survey. Responses varied widely with almost no members triggering the process of Duty of Candor in cases where adverse events were likely (>10% likelihood) and required only outpatient follow up (7/106; 6.6%), and almost all members doing so in cases where adverse events were rare (<0.1% likelihood) and resulted in death (102/106; 96.2%). However, there was clear equipoise in triggering the process of Duty of Candor in cases where adverse events were unlikely (0.1%–10% likelihood) and resulted in moderate harm (38/106; 35.8%), severe harm (57/106; 53.8%), or death (49/106; 46.2%).ConclusionsThere is considerable nationwide variation in the interpretation of definitions regarding the threshold for Duty of Candor; this has important implications with some providers at risk of penalties, and others unduly burdened by the associated administrative processes.

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Implementation of duty of candour within neurosurgery: a national survey and framework for improved application in clinical practice

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0124 ◽

2020 ◽

Vol 102 (2) ◽

pp. 144-148

Author(s):

S Basu ◽

HJ Marcus ◽

P Sayal ◽

N Kitchen ◽

R Ley ◽

...

Keyword(s):

Patient Safety ◽

Clinical Practice ◽

Adverse Events ◽

Online Survey ◽

Statutory Duty ◽

Safety Incident ◽

Patient Safety Incident ◽

Survey Responses ◽

Almost All

Introduction Statutory duty of candour was introduced in November 2014 for NHS bodies in England. Contained within the regulation were definitions regarding the threshold for what constitutes a notifiable patient safety incident. However, it can be difficult to determine when the process should be implemented. The aim of this survey was to evaluate the interpretation of these definitions by British neurosurgeons. Materials and methods All full (consultant) members of the Society of British Neurological Surgeons were electronically invited to participate in an online survey. Surgeons were presented with 15 cases and asked to decide in the case of each one whether they would trigger the process of duty of candour. Cases were stratified according to their likelihood and severity. Results In all, 106/357 (29.7%) members participated in the survey. Responses varied widely, with almost no members triggering the process of duty of candour in cases where adverse events were common (greater than 10% likelihood) and required only outpatient follow-up (7/106; 6.6%), and almost all members doing so in cases where adverse events were rare (less than 0.1% likelihood) and resulted in death (102/106; 96.2%). However, there was clear equipoise in triggering the process of duty of candour in cases where adverse events were uncommon (0.1–10% likelihood) and resulted in moderate harm (38/106; 35.8%), severe harm (57/106; 53.8%) or death (49/106; 46.2%). Conclusion There is considerable nationwide variation in the interpretation of definitions regarding the threshold for duty of candour. To this end, we propose a framework for the improved application of duty of candour in clinical practice.

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Medical Students’ Attitudes Towards Cardiothoracic Surgery in the United Kingdom: A Cross-Sectional Survey of 1675 Students

Journal of Medical Education and Curricular Development ◽

10.1177/23821205211072722 ◽

2022 ◽

Vol 9 ◽

pp. 238212052110727

Author(s):

Samiullah Dost ◽

Lana Al-Nusair ◽

Mai Shehab ◽

Arwa Hagana ◽

Aleena Hossain ◽

...

Keyword(s):

Medical Students ◽

Extracurricular Activities ◽

Online Survey ◽

Negative Relationship ◽

Medical Schools ◽

Cardiothoracic Surgery ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Students Attitudes ◽

Survey Responses

Objectives The objectives of this study were the following: (i) assess interest levels in cardiothoracic surgery (CTS) among UK-based medical students, (ii) identify potential motivators and barriers to pursuing CTS training, (iii) explore the influence of gender on interest in CTS in greater depth. Methods Medical students from all year groups across UK medical schools were invited to participate in a cross-sectional, national online survey. Responses were collected from 02/12/2019 to 08/12/2019. Results 1675 medical students from 31 UK medical schools responded, with an estimated 5.3% response rate. Of the respondents, 33.7% respondents reported having exposure to CTS, primarily through their medical school or through extracurricular activities (48.4% and 38.8%, respectively). When assessing interest in CTS, 31.4% were interested in undertaking a career in CTS, with a larger proportion of students expressing interest with no exposure to CTS than those with exposure. However, interest in pursuing CTS decreased with exposure as medical students transitioned from pre-clinical to clinical stages. Additionally, male participants were more interested in seeking a CTS post than their female counterparts (38% vs. 27.6%). The length of training ( p = 0.0009) and competitive nature ( p < 0.0001) of gaining a CTS post were the primary deterring factor for female participants, compared to their male counterparts. Conclusions This study shows the importance of quality of exposure and its impact on students’ interests in pursuing a career in CTS. The negative relationship between exposure and interest in CTS can be associated with the realisation of the challenges that come with pursuing CTS.

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Suitability of Video Consultations During the COVID-19 Pandemic Lockdown: Cross-sectional Survey Among Norwegian General Practitioners

Journal of Medical Internet Research ◽

10.2196/26433 ◽

2021 ◽

Vol 23 (2) ◽

pp. e26433

Author(s):

Tor Magne Johnsen ◽

Børge Lønnebakke Norberg ◽

Eli Kristiansen ◽

Paolo Zanaboni ◽

Bjarne Austad ◽

...

Keyword(s):

General Practitioners ◽

Life Stress ◽

Large Scale ◽

Online Survey ◽

Health Care Planning ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Face To Face ◽

Relational Continuity

Background The COVID-19 pandemic imposed an acute, sharp rise in the use of video consultations (VCs) by general practitioners (GPs) in Norway. Objective This study aims to document GPs’ experiences with the large-scale uptake of VCs in the natural experiment context of the pandemic. Methods A nationwide, cross-sectional online survey was conducted among Norwegian GPs during the pandemic lockdown (April 14-May 3, 2020). Each respondent was asked to evaluate up to 10 VCs. Basic demographic characteristics of the GPs and their practices were collected. The associations between GPs’ perceived suitability of the VCs, the nature of the patients’ main problems, prior knowledge of the patients (relational continuity), and follow-up of previously presented problems (episodic continuity) were explored using descriptive statistics, diagrams, and chi-square tests. Results In total, 1237 GPs (26% of the target group) responded to the survey. Among these, 1000 GPs offered VCs, and 855 GPs evaluated a total of 3484 VCs. Most GPs who offered VCs (1000/1237; 81%) had no experience with VCs before the pandemic. Overall, 51% (1766/3476) of the evaluated VCs were considered to have similar or even better suitability to assess the main reason for contact, compared to face-to-face consultations. In the presence of relational continuity, VCs were considered equal to or better than face-to-face consultations in 57% (1011/1785) of cases, as opposed to 32% (87/274) when the patient was unknown. The suitability rate for follow-up consultations (episodic continuity) was 61% (1165/1919), compared to 35% (544/1556) for new patient problems. Suitability varied considerably across clinical contact reasons. VCs were found most suitable for anxiety and life stress, depression, and administrative purposes, as well as for longstanding or complex problems that normally require multiple follow-up consultations. The GPs estimate that they will conduct about 20% of their consultations by video in a future, nonpandemic setting. Conclusions Our study of VCs performed in general practice during the pandemic lockdown indicates a clear future role for VCs in nonpandemic settings. The strong and consistent association between continuity of care and GPs’ perceptions of the suitability of VCs is a new and important finding with considerable relevance for future primary health care planning.

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Community education and health promotion activities of naturopathic practitioners: results of an international cross-sectional survey

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-021-03467-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Amie Steel ◽

Iva Lloyd

Keyword(s):

Health Promotion ◽

Patient Education ◽

Online Survey ◽

Community Education ◽

Stakeholder Involvement ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Convenience Sample ◽

Wide Range ◽

Almost All

Abstract Background Health promotion and patient education are crucial to improved population health and are also among the core principles that define naturopathy. Yet, the activities of naturopathic practitioners (NPs) with regards to health promotion and community education have not been widely studied. Methods A cross-sectional online survey of an international convenience sample of NPs was conducted through disseminating a 15-item questionnaire prepared in five languages. Correlates of most frequently mentioned NP activities were studied. Results The survey was completed by 813 NPs representing all world regions. Almost all participants (98%) reported at least one health promotion activity. Most reported were information sheets and handouts (92.7%) or social and professional network communications (91.8%) and information talks presented to community members (84.9%). The majority of NPs (79.5%) indicated that the ‘health issues individuals in NPs’ community have said they need help with’ were a ‘very important’ consideration when they designed health promotion activities. NP characteristics associated with the likelihood of engaging in specific health promotion activities varied between activities but include gender, time since first qualification, factors considered to identify need when designing an activity, and stakeholder involvement in activity design. Conclusions Health promotion is a key activity of the global naturopathic profession. There are a wide range of patient education tools utilized by NPs.

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The collateral impact of COVID19 among surgeons and residents: Second cross-sectional survey about the Colombian perspective

Revista Colombiana de Cirugía ◽

10.30944/20117582.877 ◽

2021 ◽

Vol 36 (2) ◽

pp. 312-323

Author(s):

Carlos Eduardo Díaz-Castrillón ◽

Natalia Cortés ◽

Juan Felipe Díaz-Castrillón ◽

Manuela Pineda ◽

Sara Sierra Tobón

Keyword(s):

Healthcare Providers ◽

Cross Sectional Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Private Hospitals ◽

Electronic Survey ◽

General Surgeons ◽

Almost All ◽

The Impact

Introduction. The COVID-19 pandemic has led health services to adapt, surgical training has had to restructure, and personal life has had to thrive hardships. We aimed to describe the evolution of surgeons' and residents' perceptions about the impact COVID-19 has had on Colombia's surgical practice. Methods. Descriptive cross-sectional study using a structured electronic survey among general surgery residents, and graduated surgeons who have a clinical practice in Colombia. Results. 355 participants were included, with a median age of 37 years (IQR 30, 51), and 32.1% female. There were 28.7% residents, 43.3% general surgeons, and 27.8% subespecialist in surgery. Overall, 48.7% of respondents were from Bogotá, and 38.8% worked at academic private hospitals. Although almost all participants reported having used telemedicine platforms during the pandemic, 58% of the respondents did not view telemedicine as sufficient for follow-up consults. More than 80% of surgeons surveyed reported that their monthly incomes had been reduced. Discussion. The second survey showed a better-perceived adherence to safety protocols at their institutions than at the beginning of the pandemic. However, the toll on economic and academic domains are substantial among the surgical community. As the pandemic's effects are expected to last longer in our region, telemedicine services acceptance and healthcare providers' job stability need to be improved in Colombia.

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A mixed-methods survey of physiotherapists who practice acupuncture and dry needling in Ontario, Canada: practice characteristics, motivations, and professional outcomes

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-021-03440-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nadine Ijaz ◽

Sandy Welsh ◽

Heather Boon

Keyword(s):

Online Survey ◽

Survey Design ◽

Clinical Results ◽

Evidence Base ◽

Dry Needling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Practice Characteristics ◽

Professional Outcomes ◽

Almost All

Abstract Background Physiotherapists (PTs) across the globe are increasingly incorporating filiform needling techniques (e.g., acupuncture, dry needling) into their clinical toolkits; and, the evidence base for these complementary therapies is becoming progressively more robust. However, to date, little is known about needling PTs themselves. Methods Using a cross-sectional survey design, PTs authorized to perform needling therapies in Ontario, Canada were recruited for anonymous participation (n = 2061) in an online survey. The survey asked providers about their demographics and practice characteristics, rationale for and views about therapeutic needling, and their related clinical and professional outcomes. The response rate was 20.7% (n = 426), and 22.3% (n = 95) of respondents provided textual responses to an open-ended qualitative question. Results While study respondents’ demographic features appear similar to their broader professional population, Ontario’s needling PTs are less likely to work in public sector settings. Most completed training in medical acupuncture rather than dry needling, and typically used needling in over one-third of patient visits. Almost all endorsed needling as an effective musculoskeletal treatment, the primary factor informing their adoption of the practice. While many viewed traditional Chinese medical theories as a useful explanatory framework, most relied on biomedical epistemology to drive their needling work. A majority of respondents reported that the inclusion of needling within their clinical toolkits had improved their likelihood of achieving excellent clinical results, helped support patient recruitment and retention, and heightened their professional satisfaction. While a few reported earning a higher income as a result, most reported that their clinical use of needling in addition to other PT modalities reduced their physical fatigue after a day’s work. Conclusions This study represents a first scholarly investigation into the motivations, training backgrounds and practice patterns of PTs who use acupuncture or dry needling. Additional research from other jurisdictions is needed to evaluate the transferability of study findings.

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Self-reported confidence in patient safety competencies among Chinese nursing students: a multi-site cross-sectional survey

10.21203/rs.2.13067/v1 ◽

2019 ◽

Author(s):

fei fei huang ◽

xiaoying shen ◽

Xue Lei Chen ◽

liping he ◽

Sufen Huang ◽

...

Keyword(s):

Patient Safety ◽

Nursing Students ◽

Adverse Events ◽

Professional Education ◽

Online Survey ◽

Safety Skills ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Undergraduate Nursing Students ◽

Undergraduate Nursing

Abstract Background Nursing interns are an important backup force for nursing professionals, so efforts to strengthen their patient safety (PS) competencies are a major priority. To do so requires assessing the strengths and weaknesses of Chinese nursing students’ PS competence and identifying the influencing factors. Methods This was a multi-site, cross-sectional, web-based study that was carried out between September 2018 and January 2019. Participants A national online survey was completed by 732 Chinese undergraduate nursing students. Main outcome measures Our primary outcome factor was the Health Professional Education in Patient Safety Survey score. We also collected socio-demographic and clinical practice-related characteristics as independent variables. Results Chinese undergraduate nursing students were fairly confident in their clinical safety skills but less confident in what they learned about sociocultural or context-dependent aspects of PS and speaking up about PS, including effective communication and understanding human and environmental factors. Less than half of the students felt that they could approach someone engaging in unsafe practice and were reluctant to voice concern about adverse events. We observed significant differences in PS competence between students from different regions, across different PS learning styles (self-study and classroom theoretical study), with different self-assessed PS competence levels, and with experiences of adverse events( p <0.05). These factors accounted for almost 15% of the total variance in PS competence scores (adjusted R 2 =0.15， p =0.00). Conclusions The results of this study provide a better understanding of PS competence among final-year nursing students. Our findings may help nursing educators or healthcare organizations to cultivate and improve PS competence by establishing documented policies or by improving the efficacy of intervention.

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Suitability of Video Consultations During the COVID-19 Pandemic Lockdown: Cross-sectional Survey Among Norwegian General Practitioners (Preprint)

10.2196/preprints.26433 ◽

2020 ◽

Author(s):

Tor Magne Johnsen ◽

Børge Lønnebakke Norberg ◽

Eli Kristiansen ◽

Paolo Zanaboni ◽

Bjarne Austad ◽

...

Keyword(s):

General Practitioners ◽

Life Stress ◽

Large Scale ◽

Online Survey ◽

Health Care Planning ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Face To Face ◽

Relational Continuity

BACKGROUND The COVID-19 pandemic imposed an acute, sharp rise in the use of video consultations (VCs) by general practitioners (GPs) in Norway. OBJECTIVE This study aims to document GPs’ experiences with the large-scale uptake of VCs in the natural experiment context of the pandemic. METHODS A nationwide, cross-sectional online survey was conducted among Norwegian GPs during the pandemic lockdown (April 14-May 3, 2020). Each respondent was asked to evaluate up to 10 VCs. Basic demographic characteristics of the GPs and their practices were collected. The associations between GPs’ perceived suitability of the VCs, the nature of the patients’ main problems, prior knowledge of the patients (relational continuity), and follow-up of previously presented problems (episodic continuity) were explored using descriptive statistics, diagrams, and chi-square tests. RESULTS In total, 1237 GPs (26% of the target group) responded to the survey. Among these, 1000 GPs offered VCs, and 855 GPs evaluated a total of 3484 VCs. Most GPs who offered VCs (1000/1237; 81%) had no experience with VCs before the pandemic. Overall, 51% (1766/3476) of the evaluated VCs were considered to have similar or even better suitability to assess the main reason for contact, compared to face-to-face consultations. In the presence of relational continuity, VCs were considered equal to or better than face-to-face consultations in 57% (1011/1785) of cases, as opposed to 32% (87/274) when the patient was unknown. The suitability rate for follow-up consultations (episodic continuity) was 61% (1165/1919), compared to 35% (544/1556) for new patient problems. Suitability varied considerably across clinical contact reasons. VCs were found most suitable for anxiety and life stress, depression, and administrative purposes, as well as for longstanding or complex problems that normally require multiple follow-up consultations. The GPs estimate that they will conduct about 20% of their consultations by video in a future, nonpandemic setting. CONCLUSIONS Our study of VCs performed in general practice during the pandemic lockdown indicates a clear future role for VCs in nonpandemic settings. The strong and consistent association between continuity of care and GPs’ perceptions of the suitability of VCs is a new and important finding with considerable relevance for future primary health care planning.

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Self-reported confidence in patient safety competencies among Chinese nursing students: a multi-site cross-sectional survey

10.21203/rs.2.13067/v2 ◽

2019 ◽

Author(s):

fei fei huang ◽

xiaoying shen ◽

Xue Lei Chen ◽

liping he ◽

Sufen Huang ◽

...

Keyword(s):

Patient Safety ◽

Nursing Students ◽

Adverse Events ◽

Professional Education ◽

Online Survey ◽

Safety Skills ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Undergraduate Nursing Students ◽

Undergraduate Nursing

Abstract Background Nursing interns are an important backup force for nursing professionals, so efforts to strengthen their patient safety (PS) competencies are a major priority. To do so requires assessing the strengths and weaknesses of Chinese nursing students’ PS competence and identifying the influencing factors. Methods This was a multi-site, cross-sectional, web-based study that was carried out between September 2018 and January 2019. A national online survey was completed by 732 Chinese undergraduate nursing students. Our primary outcome factor was the Health Professional Education in Patient Safety Survey score. We also collected socio-demographic and clinical practice-related characteristics as independent variables. Multiple stepwise linear regression was performed to identify predictors of PS competence. Results Chinese undergraduate nursing students were fairly confident in their clinical safety skills but less confident in what they learned about sociocultural or context-dependent aspects of PS and speaking up about PS, including effective communication and understanding human and environmental factors. Less than half of the students felt that they could approach someone engaging in unsafe practice and were reluctant to voice concern about adverse events. We observed significant differences in PS competence between students from different regions, across different PS learning styles (self-study and classroom theoretical study), with different self-assessed PS competence levels, and with experiences of adverse events(p<0.05). These factors accounted for almost 15% of the total variance in PS competence scores (adjusted R2=0.15，p=0.00). Conclusions The results of this study provide a better understanding of PS competence among final-year nursing students in China. Our findings may help nursing educators or healthcare organizations to cultivate and improve PS competence by establishing documented policies or by improving the efficacy of intervention.

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Views and experiences of the female condom in Australia: An exploratory cross-sectional survey of cisgender women

PLoS ONE ◽

10.1371/journal.pone.0246664 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246664

Author(s):

Sarah E. Fenwick ◽

Jessica R. Botfield ◽

Prudence Kidman ◽

Kevin McGeechan ◽

Deborah Bateson

Keyword(s):

Female Condom ◽

Cross Sectional Study ◽

Future Research ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Sti Prevention ◽

Health Promotion And Education ◽

Sexually Transmissible Infections ◽

Survey Responses

Background The female condom is the only female-initiated form of protection against unintended pregnancy and sexually transmissible infections (STIs). However, use of this method in Australia is low. To better understand women’s views and experiences of the female condom, we conducted an interventional cross-sectional study. Methods Cisgender women ≥16 years, heterosexually active and living in New South Wales were recruited through social media advertisements and email invitations to clients of a family planning service. Eligible participants were provided with three female condoms and invited to complete a follow-up survey. Survey responses for women who attempted to use at least one female condom were summarised using counts and proportions. Results We recruited 556 women; few (30/556) had used the female condom before the study. There were 284 women who used, or attempted to use, a female condom during the study and completed the follow-up survey. Fifty-one percent (104/205) reported experiencing some difficulty in insertion, although only 46% (130/284) had seen an instructional demonstration. Approximately half (105/204) of women rated the sensation and comfort of the female condom as the same or better than the male condom, and 66% (137/204) reported that it provided the same or better lubrication. Approximately half of women said they would consider using the female condom again for STI prevention (51% (133/260)) or contraception (40% (103/260)), or would recommend to others (43% (112/260)). Conclusion Findings highlight the need for increased health promotion and education regarding use of the female condom. To increase access it will be important to address method cost and availability in Australia. Future research should explore other perspectives of this method, including among the LGBTIQ+ community.

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