Implicit Bias and Caring for Diverse Populations: Pediatric Trainee Attitudes and Gaps in Training

2021 ◽  
pp. 000992282110352
Author(s):  
Hannah Barber Doucet ◽  
Valerie L. Ward ◽  
Tiffani J. Johnson ◽  
Lois K. Lee

The objective of this study was to determine the attitudes, skill level, and preferred educational interventions of pediatric residents related to implicit bias and caring for diverse patient populations. A cross-sectional survey of pediatric residents at a single, large urban residency program was utilized. Surveys were completed by 88 (55%) residents who were 69% female and 35% non-White or mixed race. Almost all residents felt that it was very or extremely important to receive training on health disparities, diverse patient populations, and implicit bias. Self-assessment of skill level revealed that residents felt confident in areas often covered by cultural competency curricula, such as interpreter use, but were less confident in other areas. The top 3 areas identified for further training included implicit bias, working with transgender and gender nonconforming patients, and weight bias. For the majority of diversity and bias-related skills, prior training was significantly correlated with higher skill level ( P < .05).

2015 ◽  
Vol 20 (3) ◽  
pp. 192-198 ◽  
Author(s):  
Kayloni Olson ◽  
Kathi J. Kemper ◽  
John D. Mahan

Burnout has high costs for pediatricians and their patients. There is increasing interest in educational interventions to promote resilience and minimize burnout among pediatric trainees. This study tested a conceptual model of factors that might promote resilience and protect against burnout, and which could serve as targets for addressing burnout in pediatric residents. Questionnaires were administered in a cross-sectional survey of (n = 45) first-year pediatric and medicine-pediatric residents. A minority (40%) of residents met one or more criteria for burnout. Physician empathy and emotional intelligence were not significantly correlated with burnout or resilience. Self-compassion and mindfulness were positively associated with resilience and inversely associated with burnout. Thus many residents in this sample endorsed burnout; mindfulness and self-compassion were associated with resilience and may promote resilience and protect against burnout in these trainees. Future studies should explore the impact of training in mindfulness and self-compassion in pediatric trainees.


Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 103
Author(s):  
Mst. Marium Begum ◽  
Sanzana Fareen Rivu ◽  
Md. Mahmud Al Hasan ◽  
Tasnova Tasnim Nova ◽  
Md. Motiar Rahman ◽  
...  

Background: This fact-finding study aimed to attain an overall idea and knowledge about medicine disposal practices in Dhaka Metropolitan households. Methods: This mixed study (both quantitative and qualitative) was orchestrated to inspect the household leftover medicine disposal pattern’s governing status. A cross-sectional survey was conducted following a structured questionnaire and key informant interview with a household person and in-depth interviews with the top pharmaceutical and government officials. Results: Findings disclose that, for most of the key informants, the terms “drug disposal” and “drug pollution” were unknown; more precisely, 67% and 74% of key informants even did not hear these two terms. Almost all (87%) households faced undesired incidents due to the insecure storage of medicines. People disposed of excess and expired medication in regular dustbins (47%), threw out of the window (19%), flushed within commode (4%), burnt in fire (2%), and reused (4%). A good percentage of people (21%) returned unexpired drugs to the pharmacy and bought other medicines on a need basis. A total of 72% wanted a medicine take-back program, and 100% agreed on mass education on this issue. Officials of pharmaceuticals conferred mixed opinion: top-ranked pharmaceuticals will adopt leftover medicine disposal practices; middle and low-ranked pharmaceutical companies are reluctant, merely denied mentioning the less important issue. Conclusions: The absence of mass awareness and standard laws and policies may explain these existing aberrant practices.


Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 154
Author(s):  
Sisira Donsamak ◽  
Marjorie C. Weiss ◽  
Dai N. John

In Thailand, antibiotics are available lawfully from community pharmacies without a prescription. Inappropriate supply of antibiotics from Thai community pharmacies to the public for common, self-limiting diseases has been reported. The study aimed to evaluate the appropriateness of antibiotics selected by community pharmacists in Thailand in response to vignettes. A cross-sectional survey of community pharmacists across Thailand was conducted using a self-administered questionnaire including nine case vignettes with three conditions, namely upper respiratory infections (URIs), acute diarrhoea and simple wounds. A total of 208 questionnaires were completed and analysed (20.8% response rate). In response to vignettes relating to URIs, 50.8% of pharmacist recommendations were not in accordance with antibiotic guidelines. Inappropriate recommendations for diarrhoea and wound cases were 20.8% and 16.7%, respectively. A higher proportion of younger pharmacists, those with less experience, Pharm. D. graduate pharmacists, employee pharmacists and those pharmacists who worked in a chain pharmacy were more likely to recommend appropriate antibiotic treatment in response to the vignettes (p < 0.05). These findings will be useful to promote educational interventions for community pharmacists regarding common infectious disease management in order to improve appropriate antibiotic use.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043421
Author(s):  
Rae Thomas ◽  
Hannah Greenwood ◽  
Zoe A Michaleff ◽  
Eman Abukmail ◽  
Tammy C Hoffmann ◽  
...  

ObjectivePublic cooperation to practise preventive health behaviours is essential to manage the transmission of infectious diseases such as COVID-19. We aimed to investigate beliefs about COVID-19 diagnosis, transmission and prevention that have the potential to impact the uptake of recommended public health strategies.DesignAn online cross-sectional survey.ParticipantsA national sample of 1500 Australian adults with representative quotas for age and gender provided by an online panel provider.Main outcome measureProportion of participants with correct/incorrect knowledge of COVID-19 preventive behaviours and reasons for misconceptions.ResultsOf the 1802 potential participants contacted, 289 did not qualify, 13 declined and 1500 participated in the survey (response rate 83%). Most participants correctly identified ‘washing your hands regularly with soap and water’ (92%) and ‘staying at least 1.5 m away from others’ (90%) could help prevent COVID-19. Over 40% (incorrectly) considered wearing gloves outside of the home would prevent them from contracting COVID-19. Views about face masks were divided. Only 66% of participants correctly identified that ‘regular use of antibiotics’ would not prevent COVID-19.Most participants (90%) identified ‘fever, fatigue and cough’ as indicators of COVID-19. However, 42% of participants thought that being unable to ‘hold your breath for 10 s without coughing’ was an indicator of having the virus. The most frequently reported sources of COVID-19 information were commercial television channels (56%), the Australian Broadcasting Corporation (43%) and the Australian Government COVID-19 information app (31%).ConclusionsPublic messaging about hand hygiene and physical distancing to prevent transmission appears to have been effective. However, there are clear, identified barriers for many individuals that have the potential to impede uptake or maintenance of these behaviours in the long term. We need to develop public health messages that harness these barriers to improve future cooperation. Ensuring adherence to these interventions is critical.


Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 311
Author(s):  
Nora A. Althumiri ◽  
Mada H. Basyouni ◽  
Norah AlMousa ◽  
Mohammed F. AlJuwaysim ◽  
Rasha A. Almubark ◽  
...  

The global prevalence of obesity is increasing. Obesity is associated with many chronic diseases and health conditions. This study aims to estimate the current prevalence of obesity in Saudi Arabia and described the current national-level status of the association between obesity and various health conditions. This study is a nationwide cross-sectional survey conducted over phone-interviews in June 2020. In this study, a proportional quota-sampling technique was used to obtain equal distributions of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. Weight and height were self-reported, and the obesity was determined as BMI ≥ 30. Logistic regression adjusted for age and gender was used for exploring current associations between obesity and health conditions. Of the 6239 participants contacted, 4709 participants responded and completed the interview with a response rate of 75.48%. Of them, 50.1% were female, the mean age was 36.4 ± 13.5 (Range: 18–90), and the median age was 36. The national weighted prevalence of obesity (BMI ≥ 30) was 24.7%, and the prevalence in the sample (unweighted) was 21.7%. Obesity was significantly associated with type 2 diabetes [Odd ratio, (OR) = 1.52], hypercholesterolemia (OR = 1.69), hypertension (OR = 1.61), lung diseases (OR = 1.69), rheumatoid arthritis (OR = 1.57), sleep apnea (OR = 1.82), colon diseases (OR = 1.31), and thyroid disorders (OR = 1.8). This study provides an update on the recent prevalence of obesity in Saudi Arabia. It also shows the variation in prevalence rates between different regions, which might be explored further. Although obesity shows a decreasing trend, almost one-quarter of this study sample were obese. Obesity is currently associated with many health conditions that can affect the individuals’ quality of life, impose stress on the healthcare system and impose an economic burden on the country. This evidence highlights the need for action to focus more on obesity in Saudi Arabia.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Vehko ◽  
E Lilja ◽  
S Parikka ◽  
A-M Aalto ◽  
H M Kuusio

Abstract Background Digital services are expected to improve the availability of public social and health care services in many European countries as well as in Finland. eHealth and eWelfare services often require strong electronic identification which may form barriers in the availability of care. This study focuses on recognising population groups who are vulnerable to exclusion either by not having access to web or by lacking a strong electronic identification. Methods The data were gathered from the cross-sectional survey on well-being among people aged 20-64 with foreign background (PFB) (FinMonik), conducted in Finland 2018-19 (N = 12 877; response rate 53%). The data from the National survey of health, well-being and service use (FinSote 2017-18) were used as reference data for the overall population, (N = 26 422, response rate 45%). Surveys asked respondents “Do you have at your disposal internet access at home, your workplace, library or some other place?” and 'Do you have at your disposal online banking codes or a mobile certificate for electronic identification online?”. PFB were defined by background country into seven country-groups. The age-standardized proportions with confidence intervals were examined by socio-demographic background variables. Results Almost all (98%) of the overall population reported access to internet, but the proportion was lower (92%) among PFB (p &lt; 0.001). Proportion of having a strong electronic identification was higher among general population (98%) than among PFB (88%) (p &lt; 0.001). In both populations, younger age increased the likelihood of having a strong electronic identification. PFB students reported lower level of strong electronic identification compared to the employed. Conclusions Although most had access to internet and a strong identification, there were statistically significant differences between country-groups and by employment status. Key messages Designing and developing of eHealth and eWelfare services must ensure that everyone has the opportunity to have a strong electronic identification. Development of digital services requires user guidance, which takes into account the varying needs and operating environments.


2016 ◽  
Vol 42 (12) ◽  
pp. 809-814 ◽  
Author(s):  
Jennifer C Kesselheim ◽  
Julie Najita ◽  
Debra Morley ◽  
Elizabeth Bair ◽  
Steven Joffe

ObjectiveTo evaluate the relationship between recently trained paediatricians' ethics knowledge and exposure to a formal ethics or professionalism curriculum during residency.MethodsWe conducted a cross-sectional survey of recently trained paediatricians which included a validated 23-item instrument called the Test of Residents' Ethics Knowledge for Pediatrics. The sample included paediatricians who completed medical school in 2006–2008, whose primary specialty was paediatrics or a paediatric subspecialty, and who completed paediatric residency training in 2010–2011. This sample was stratified based on residency programme variables: presence of a formal curriculum in ethics or professionalism, programme size and American Board of Pediatrics certifying exam passage rate. Paediatricians were randomly selected from each stratum for survey participation.ResultsAmong the 370 responding paediatricians (55%), the mean knowledge score was 17.3 (SD 2.2) out of a possible 23. Presence of a formal curriculum in ethics and/or professionalism was not significantly associated with knowledge. Knowledge was lowest on items about parental requests for a child to undergo genetic testing (2 items, 44% and 85% incorrect), preserving patient confidentiality over email (55% incorrect), decision-making regarding life-sustaining technologies (61% incorrect), and decision-making principles such as assent and parental permission (2 items, 47% and 49% incorrect).ConclusionsThis study highlights several areas in which paediatricians' knowledge may be low and that are amenable to targeted educational interventions. These findings should prompt discussion and research among ethicists and educators about how ethics and professionalism curricula can more consistently influence paediatricians' knowledge.


2021 ◽  
Author(s):  
Patrick L.S. van Dun ◽  
Lorenzo Arcuri ◽  
Johan Verbeeck ◽  
Jorge E. Esteves ◽  
Francesco Cerritelli

Abstract Background: Since the previous survey of the osteopathic profession in Austria was almost a decade ago, an update was necessary. The Osteopathic Practitioners Estimates and RAtes (OPERA) project was developed as a Europe-based survey, whereby an updated profile of the profession not only provides new data for Austria, but also allows for a clear comparison with other European countries. Methods: A voluntary, online-based, closed-ended survey was distributed across Austria in the period between April and August 2020. The original English OPERA-questionnaire, composed of 52 questions in seven sections, was formally translated in German and adapted to the Austrian situation. Recruitment was performed through social-media and an e-based campaign.Results: The survey was completed by 338 individuals, of which 239 (71%) were female, and the median age was 40-49 years. Almost all respondents had preliminary healthcare training, mainly in physiotherapy (72%). The majority of respondents were self-employed (88%) and working as sole practitioners (54%). The median number of consultations per week was 21-25 and the majority of respondents scheduled 46-60 minutes for each consultation (69%). The most commonly used diagnostic techniques were: palpation of position/structure, palpation of tenderness and visual inspection. The most commonly used treatment techniques were cranial, visceral and articulatory/mobilisation techniques. The majority of patients estimated by respondents consulted an osteopath for musculoskeletal complaints mainly localised in the lumbar and cervical region. Although the majority of respondents experience a strong osteopathic identity, only a small proportion (17%) advertise themselves exclusively as osteopaths. Conclusions: This study represents the first published document to determine the characteristics of the osteopathic practitioners in Austria using large, national data. It provides new information on where, how, and by whom osteopathic care is delivered. The information provided may contribute to the evidence used by stakeholders and policy makers for the future regulation of the profession in Austria.


2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Muhammad Faheem Afzal ◽  
Muhammad Haroon Hamid ◽  
Azra Parveen ◽  
Asif Hanif

Objectives: To assess the improvement in the knowledge of hand hygiene in Pediatric residents and nurses after theoretical and hands-on educational intervention Methods: This study was a questionnaire‑based cross‑sectional survey carried out in the department of Pediatrics, King Edward Medical University/ Mayo hospital Lahore in two weeks period. Total 41 Pediatrics residents and nurses, participated in the study. Initially a pretest questionnaire was given to each participant, followed by an educational intervention: a day’s worth of didactic lectures and practical training of practices for infection control. After two weeks, an identical post-test questionnaire was sent to the participants via email. Data were statistically analyzed through SPSS 22. Z test was applied to see the normality of data while paired t test was applied to compare the pretest score with posttest score. Results: Of 41 participants who attended the workshop, 34 participants responded to post‑test giving an overall response rate of 83%. Out of 34, there were 27(80%) doctors and 7(20%) nurses, who participated in workshop. Each item of the questionnaire was analyzed, showing that pretest score for questions related to indication for hand washing, minimum timings required for hand rub, and spread of infection from unclean hands was quite low, as compared to post-test score, indicating statistically significant increment (p value 0.000, 0.001and 0.046 respectively). Mean pre-test score for doctors was 3.22 while for nurses, it was 3.14, whereas post-test score was 4.51 and 4.00 for doctors and nurses respectively. Overall, there was statistically significant increase in knowledge after educational intervention. Conclusion: There is statistically significant impact of educational intervention on improving the knowledge of Pediatric residents and nurses with respect to hand hygiene practices. doi: https://doi.org/10.12669/pjms.35.3.388 How to cite this:Afzal MF, Hamid MH, Parveen A, Hanif A. Educational intervention to improve the knowledge of hand hygiene in pediatric residents and nurses. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.388 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2018 ◽  
Vol 07 (04) ◽  
pp. 215-218 ◽  
Author(s):  
Vijay Kumar Chattu ◽  
Soosanna Kumary ◽  
Akshaya Srikanth Bhagavathula

Abstract Background: In Oman, a higher proportion of patients presented with breast cancer are relatively young age and with an advanced stage. This could be due to lack of awareness and knowledge about breast cancer among young women. Aim: To assess the breast cancer knowledge, awareness and factors associated with the practice of breast self-examination (BSE) among females in Buraimi, Oman. Methods: A cross-sectional survey was conducted among females attending the two days health exhibition event at a polyclinc, in Al-Buraimi, governorate. A pretested questionnaire to assess their knowledge, awareness and practices concerned to breast cancer was used. The collected data was categorized, analyzed using descriptive statistics and logistic regression model. All the statistical analysis was performed using SPSS 21.0 version. Results: Out of the total of one hundred and eighty nine (189) participants, 80% had information of breast cancer. Participants had better knowledge of symptoms but less knowledge about risk factors. When probed about BSE, only 43% performed it and only 21% of them do it monthly on regular basis. The main reasons for regular monthly BSE is mainly because of fear of breast cancer (9%), doctor's advice (6%) and awareness through media (5%). Conclusion: Our study participants showed insufficient knowledge in some areas related to sign and symptoms and risk factors of breast cancer and identified a negative influence of low knowledge on the practice of BSE. Thus, educational interventions need to be emphasized to provide comprehensive information of breast cancer.


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