scholarly journals Intimidation, harassment, and discrimination during family medicine residency training: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Olga Szafran ◽  
Wayne Woloschuk ◽  
Jacqueline M. I. Torti ◽  
Maria F. Palacios Mackay
Keyword(s):  
Mixed Methods ◽  
Family Medicine ◽  
Residency Training ◽  
Sleep Problems ◽  
Phase 1 ◽  
Qualitative Interviews ◽  
Hospital Setting ◽  
Mixed Methods Study ◽  
Family Medicine Residency ◽  
Negative Effect

Abstract Background The importance of wellbeing of family medicine residents is recognized in accreditation requirements which call for a supportive and respectful learning environment; however, concerns exist about learner mistreatment in the medical environment. The purpose of this study was to to describe family medicine graduates’ perceived experience with intimidation, harassment and discrimination (IHD) during residency training. Methods A mixed-methods study was conducted on a cohort of family medicine graduates who completed residency training during 2006–2011. Phase 1, the quantitative component, consisted of a retrospective survey of 651 graduates. Phase 2, the qualitative component, was comprised of 11 qualitative interviews. Both the survey and the interviews addressed graduates’ experience with IHD with respect to frequency and type, setting, perpetrator, perceived basis for IHD, and the effect of the IHD. Results The response rate to the survey was 47.2%, with 44.7% of respondents indicating that they experienced some form of mistreatment/IHD during residency training, and 69.9% noting that it occurred more than once. The primary sources of IHD were specialist physicians (75.7%), hospital nurses (47.8%), and family physicians (33.8%). Inappropriate verbal comments were the most frequent type of IHD (86.8%). Graduates perceived the basis of the IHD to be abuse of power (69.1%), personality conflict (36.8%), and family medicine as a career choice (30.1%), which interview participants also described. A significantly greater proportion IMGs than CMGs perceived the basis of IHD to be culture/ethnicity (47.2% vs 10.5%, respectively). The vast majority (77.3%) of graduates reported that the IHD experience had a negative effect on them, consisting of decreased self-esteem and confidence, increased anxiety, and sleep problems. As trainees, they felt angry, threatened, demoralized, discouraged, manipulated, and powerless. Some developed depression or burnout, took medication, or underwent counselling. Conclusions IHD continued to be prevalent during family medicine residency training, with it occurring most frequently in the hospital setting and specialty rotations. Educational institutions must work with hospital administrators to address issues of mistreatment in the workplace. Residency training programs and the medical establishment need to be cognizant that the effects of IHD are far-reaching and must continuously work to eradicate it.

scholarly journals Codeveloping a multibehavioural mobile phone app to enhance social and emotional well-being and reduce health risks among Aboriginal and Torres Strait Islander women during preconception and pregnancy: a three-phased mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e052545
Author(s):  
Michelle Kennedy ◽  
Ratika Kumar ◽  
Nicole M Ryan ◽  
Jessica Bennett ◽  
Gina La Hera Fuentes ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Mobile Phone ◽  
Phase 1 ◽  
Qualitative Interviews ◽  
Mixed Methods Study ◽  
Phase 2 ◽  
Community Members ◽  
Phase 3 ◽  
Aboriginal Community ◽  
Aboriginal Women

ObjectiveDescribe the development and pretest of a prototype multibehavioural change app MAMA-EMPOWER.DesignMixed-methods study reporting three phases: (1) contextual enquiry included stakeholder engagement and qualitative interviews with Aboriginal women, (2) value specification included user-workshop with an Aboriginal researcher, community members and experts, (3) codesign with Aboriginal researchers and community members, followed by a pretest of the app with Aboriginal women, and feedback from qualitative interviews and the user-Mobile Application Rating Scale (U-MARS) survey tool.SettingsAboriginal women and communities in urban and regional New South Wales, Australia.ParticipantsPhase 1: interviews, 8 Aboriginal women. Phase 2: workshop, 6 Aboriginal women. Phase 3: app trial, 16 Aboriginal women. U-MARS, 5 Aboriginal women.ResultsPhase 1 interviews revealed three themes: current app use, desired app characteristics and implementation. Phase 2 workshop provided guidance for the user experience. Phase 3 app trial assessed all content areas. The highest ratings were for information (mean score of 3.80 out of 5, SD=0.77) and aesthetics (mean score of 3.87 with SD of 0.74), while functionality, engagement and subjective quality had lower scores. Qualitative interviews revealed the acceptability of the app, however, functionality was problematic.ConclusionsDeveloping a mobile phone app, particularly in an Aboriginal community setting, requires extensive consultation, negotiation and design work. Using a strong theoretical foundation of behavioural change technique’s coupled with the consultative approach has added rigour to this process. Using phone apps to implement behavioural interventions in Aboriginal community settings remains a new area for investigation. In the next iteration of the app, we aim to find better ways to personalise the content to women’s needs, then ensure full functionality before conducting a larger trial. We predict the process of development will be of interest to other health researchers and practitioners.

scholarly journals How Effective Is Youth Volunteering as an Employment Strategy? A Mixed Methods Study of England

Sociology ◽  
2020 ◽  
Vol 54 (4) ◽  
pp. 763-781
Author(s):  
Bryony Hoskins ◽  
Pauline Leonard ◽  
Rachel Wilde
Keyword(s):  
Mixed Methods ◽  
Citizenship Education ◽  
Qualitative Interviews ◽  
Longitudinal Survey ◽  
Mixed Methods Study ◽  
Short Term ◽  
Mixed Methods Approach ◽  
Negative Effect ◽  
Support Policy ◽  
The Relationship

Volunteering is routinely advocated in British policy as a key mechanism for young people to gain employment, but with little evidence of its viability as a strategy. Indeed, the limited research in this area suggests the link is weak and that access to good quality volunteering is differentiated along class lines. This article draws on a mixed methods approach, using survey data from the Citizenship Education Longitudinal Survey and qualitative interviews, to analyse the relationship between youth volunteering and employment. It finds that volunteering is not unequivocally beneficial for employment, particularly if it does not offer career-related experience or is imposed rather than self-initiated. It can even have a negative effect on employment. Furthermore, social class mediates access to volunteering opportunities most likely to convert into employment. We conclude there is little evidence to support policy assumptions that, in the short term, volunteering has a positive relationship to paid employment.

scholarly journals Remote Health Care Provision in Care Homes in England: An Exploratory Mixed Methods Study of Yorkshire and the Humber

Technologies ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 24 ◽  
Author(s):  
Louise Newbould ◽  
Gail Mountain ◽  
Steven Ariss ◽  
Mark Hawley
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Urban Areas ◽  
Health Care Services ◽  
Qualitative Interviews ◽  
Care Home ◽  
Mixed Methods Study ◽  
Care Homes ◽  
Health Care Provision ◽  
Care Provision

An increasing demand for care homes in the UK, has necessitated the evaluation of innovative methods for delivering more effective health care. Videoconferencing may be one way to meet this demand. However, there is a lack of literature on the provision of videoconferencing in England. This mixed-methods study aimed to map current attitudes, knowledge and provision of videoconferencing in the Yorkshire and Humber region of England. Qualitative interviews with care home managers, a scoping review and field notes from a Special Interest Group (SIG) informed the development of a descriptive convenience survey which was sent out to care home managers in the Yorkshire and Humber region of England. The survey had a 14% (n = 124) response rate. Of those who responded, 10% (n = 12) reported using videoconferencing for health care; with over 78% (n = 97) of respondents’ care homes being based in urban areas. Approximately 62% (n = 77) of the 124 respondents had heard of videoconferencing for health care provision. Of those who reported not using videoconferencing (n = 112), 39% (n = 48) said they would consider it but would need to know more. The top ranked reason for not introducing videoconferencing was the belief that residents would not be comfortable using videoconferencing to consult with a healthcare professional. The main reason for implementation was the need for speedier access to services. Those already using videoconferencing rated videoconferencing overall as being very good (50%) (n = 6) or good (42%) (n = 5). Those who were not using it in practice appeared sceptical before implementing videoconferencing. The main driver of uptake was the home’s current access to and satisfaction with traditionally delivered health care services.

Bacterial resistance to fluoroquinolones and contributing factors in Addis Ababa, Ethiopia: a mixed methods study

2019 ◽  
Vol 34 (1) ◽  
pp. 61-72
Author(s):  
Banchirega Mekuria ◽  
Gebremedhin Beedemariam Gebretekle ◽  
Tamerat Bekele ◽  
Mesfin Negussie ◽  
Melaku Kifle ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mixed Methods ◽  
Nalidixic Acid ◽  
Bacterial Resistance ◽  
Addis Ababa ◽  
Qualitative Interviews ◽  
Mixed Methods Study ◽  
Bacterial Isolates ◽  
Contributing Factors ◽  
High Level

Fluoroquinolones are widely used globally and there is a growing trend of resistance to these agents. However, there is scanty information in Ethiopia and this study aimed to assess the level of bacterial resistance to fluoroquinolones and identify contributing factors in Addis Ababa, Ethiopia. Concurrent mixed methods study design was used. Records (January 2013 to December 2016) of the Microbiology Laboratory of International Clinical Laboratories were retrospectively reviewed. In addition, qualitative interviews were conducted with purposively selected 20 prescribers’ and dispensers’ to explore perceived contributing factors to resistance. Descriptive statistics was used to summarize the data and possible association was explored using multivariable logistic regression. Qualitative data was analyzed using thematic analysis. A total of 7,889 bacterial isolates were identified from 4,310 patients. The overall resistance of bacterial isolates to fluoroquinolones was 42.5% and the highest resistance was to nalidixic acid (63.3%). Enterococci and Escherichia coli developed high level of resistance to ciprofloxacin and norfloxacin; while Enterococci had higher resistant to nalidixic acid (77.8%). Resistance to fluoroquinolones was 5-times more likely in patients aged ≥ 60 years than those < 15 years old (AOR = 5.63, 95% CI: 4.71, 6.73). Resistance to fluoroquinolones increased from 40.4% in 2013 to 49.0% in 2015 but declined to 46.3% in 2016. Respondents of the qualitative interviews suggested that injudicious prescribing due to lack of institutional antibiogram and inadequate knowledge, nonprescription sales of antibiotics and/or patient hording and sharing practices contributed for the high level of fluoroquinolone resistance. The study showed a high level of bacterial resistance to fluoroquinolones. Patients’ age and year of testing were significantly associated with resistance. Moreover, inappropriate prescribing practice, illegal over-the-counter sales as well as their unreasonable use by patients were key drivers to the problem. This calls for the strict regulation of non-prescription sales of antibiotics, public awareness creation and development of local antibiogram to guide prescribing. Keywords: fluoroquinolones, bacterial resistance, qualitative interview, enterococci, Escherichia coli

scholarly journals Mental Health Competencies in Family Medicine Residency Training

2021 ◽  
Vol 44 (3) ◽  
pp. 116-127
Author(s):  
Shogo Kawada ◽  
Tadao Okada ◽  
Ryota Takahashi ◽  
Mamiko Ukai
Keyword(s):  
Mental Health ◽  
Family Medicine ◽  
Residency Training ◽  
Family Medicine Residency

scholarly journals The Role of Gender in Nurse-Resident Interactions: A Mixed-methods Study

2021 ◽  
Vol 22 (4) ◽  
pp. 919-930
Author(s):  
Emily Cleveland Manchanda ◽  
Anita Chary ◽  
Noor Zanial ◽  
Lauren Nadeau ◽  
Jennifer Verstreken ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Patient Care ◽  
Gender Bias ◽  
Clinical Judgment ◽  
Qualitative Interviews ◽  
Mixed Methods Study ◽  
Interprofessional Communication ◽  
Hospital Leadership

Introduction: The role of gender in interprofessional interactions is poorly understood. This mixed-methods study explored perceptions of gender bias in interactions between emergency medicine (EM) residents and nurses. Methods: We analyzed qualitative interviews and focus groups with residents and nurses from two hospitals for dominant themes. An electronic survey, developed through an inductive-deductive approach informed by qualitative data, was administered to EM residents and nurses. Quantitative analyses included descriptive statistics and between-group comparisons. Results: Six nurses and 14 residents participated in interviews and focus groups. Key qualitative themes included gender differences in interprofessional communication, specific examples of, and responses to, gender bias. Female nurses perceived female residents as more approachable and collaborative than male residents, while female residents perceived nurses’ questions as doubting their clinical judgment. A total of 134 individuals (32%) completed the survey. Females more frequently perceived interprofessional gender bias (mean 30.9; 95% confidence interval {CI}, 25.6, 36.2; vs 17.6 [95% CI, 10.3, 24.9). Residents reported witnessing interprofessional gender bias more frequently than nurses (58.7 (95% CI, 48.6, 68.7 vs 23.9 (95% CI, 19.4, 28.4). Residents reported that gender bias affected job satisfaction (P = 0.002), patient care (P = 0.001), wellness (P = 0.003), burnout (P = 0.002), and self-doubt (P = 0.017) more frequently than nurses. Conclusion: Perceived interprofessional gender bias negatively impacts personal wellbeing and workplace satisfaction, particularly among female residents. Key institutional stakeholders including residency, nursing, and hospital leadership should invest the resources necessary to develop and integrate evidence-based strategies to improve interprofessional relationships that will ultimately enhance residency training, work climate, and patient care.

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