scholarly journals A survey of Irish psychiatric trainees attitudes to balint groups

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S259-S259
Author(s):  
Sudha Jain ◽  
Emma Adams ◽  
Alyson Lee
Keyword(s):  
Thematic Analysis ◽  
Online Survey ◽  
Psychological Needs ◽  
Free Text ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Cross Sectional Survey ◽  
Online Groups ◽  
Face To Face ◽  
Balint Groups

Aims1. To compare the experience of psychiatric trainees in Ireland of online Balint Groups (BG) in contrast to face to face groups.2. To assess the general attitudes of trainees to BG using the Psychological Medical Inventory (PMI) (Ireton and Sherman, 1988) scale.MethodAn online survey comprising two sections: 1. A questionnaire exploring participants experience, effectiveness and obstacles to attending the two formats of BG with a free text box response. 2. General attitude of trainees towards BG using PMI scale.An online cross-sectional survey using Survey Monkey. An invitation to participate in the survey was emailed to all trainees by the College of Psychiatrists in Ireland. All data were anonymised, and all data processing was conducted in line with GDPR. Statistical analysis was undertaken using Microsoft Excel. Thematic analysis was applied to the free-text box responses.Result16.49% (64/388) responded to the survey. Responses were uniform across all stages of training. 97% of respondents attended BG; 72% attended both formats, 25% attended only face-to-face and 3% online only. 65% of respondents preferred face to face compared to 18% online, whilst 11% stated no preference.On thematic analysis, trainees asserted a preference for face-to-face, describing better group cohesion, feeling safer to share, increased ease of interpreting non-verbal communication, and that conversation was more fluid. They described greater ease of engagement with the group/facilitator and preferred direct social interaction with peers.Conversely, most trainees acknowledged that online groups were convenient to attend, less time consuming & mitigated COVID risk associated with face-to-face meetings. Common themes against the use of online groups were: less psychotherapeutic in nature, technical issues, silences, unable to see participants faces and as though speaking “into the void”.Regarding trainees' attitudes to attending BG, most of the trainees found BG had been beneficial in developing more interest and confidence in dealing with the psychological aspects of patient care. Trainees agreed that skills improved in developing an excellent doctor-patient relationship, recognising patients under stress/ in distress, systemically obtaining psychological information and making treatment decisions based upon psychological needs and psychotherapeutic engagement. They agreed that they could better understand the influence of doctors' emotions on the doctor-patient relationship.ConclusionThis survey showed that most trainees find BG beneficial in developing better doctor-patient relationships, preferring face-to-face rather than online BG. However, they found online more convenient. A blended learning approach could provide trainees with the benefits of both formats of BG.

A comparative study of teleconsultations versus face-to-face consultations

2001 ◽  
Vol 7 (5) ◽  
pp. 257-265 ◽  
Author(s):  
E J Nordal ◽  
D Moseng ◽  
B Kvammen ◽  
M-L Løchen
Keyword(s):  
General Practitioner ◽  
Comparative Study ◽  
Complete Agreement ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Partial Agreement ◽  
Face To Face ◽  
High Degree ◽  
Made In

We compared the diagnoses made by one dermatologist via telemedicine with those of another dermatologist made in a face-to-face consultation. The patients first underwent a teledermatology consultation and then a face-to-face consultation. A general practitioner was present with the patient in the videoconference studio. Videoconferencing equipment connected at 384 kbit/s was used. The doctor-patient relationship and the satisfaction of the patients and dermatologists in the two settings were assessed, as well as technical conditions during the videoconferences. There were 121 patients, with a mean age of 40 years (range 17-82 years). There was a high degree of concordance between the two sets of diagnoses, with 72% complete agreement and 14% partial agreement between the two dermatologists. A total of 116 patients (96% of those included) completed a questionnaire. Both the patients and the dermatologists were in general satisfied with the videoconferences. Videoconferencing with a participating general practitioner may be useful in dermatology, but the technique should be used only for selected patients.

scholarly journals Balint style case-based discussion group for medical students in Bassetlaw Hospital

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S342-S342
Author(s):  
Anu Priya ◽  
Hardev Bhogal
Keyword(s):  
Medical Students ◽  
Discussion Group ◽  
Discussion Groups ◽  
Written Feedback ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Balint Groups ◽  
Balint Group ◽  
Learning Points ◽  
Case Based

AimsTo evaluate feedback from Balint style case based discussion groups and to reflect on learning points.We have three medical students from Sheffield University on six week psychiatry placements at Bassetlaw Hospital and we get eighteen students in a year. In order to further develop their approach towards reflection and their understanding towards the doctor patient relationship we developed the Balint style case based discussion group, and each group of students attend three sessions during their placement.MethodThe groups are held on a weekly basis and consist of the three medical students and 1-2 facilitators. As the group is small one of the facilitators may participate with the students for the Balint process and to help encourage the students. Following completion of the third session of the discussion group we gain written feedback from the students. A total of 17 feedbacks have been reviewed over the period of November 2018 -November 2019.Result16 students stated that this was their first experience at Balint Group and all except one student felt that they were given a good introduction about Balint groups before starting. When asked about the most significant thing that they have learnt in the group, the majority of students marked reflecting feelings to improve relationships with patients, exploring why they feel a certain way with patients and that the doctor patient relationship can affect the consultation.One student stated that they would not recommend it to colleagues as they felt it was relevant more to doctors rather than medical students. Another student recommended having more people in a group.ConclusionOverall, it has been a positive experience with the medical students during the groups and with feedbacks. We have reflected on difficult topics like bereavement, fantasized about the purpose of a patient's delusion and shared the joy of a patient who was discharged after a long stay. While we think we have been able to teach the students some tips on reflection, we ourselves have been able to reflect on certain topics we would not have if not raised by the students. Some medical students have contacted the larger Balint Group in Sheffield for further sessions. Considering our experience, we will continue with the sessions at Bassetlaw Hospital.

Benefits and Challenges of Using Virtual Primary Care During the COVID-19 Pandemic: An International Cross-sectional Survey Study (Preprint)

2021 ◽  
Author(s):  
Edmond Li ◽  
Rosy Tsopra ◽  
Geronimo Jimenez ◽  
Alice Serafini ◽  
Gustavo Gusso ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Delivery ◽  
Lessons Learned ◽  
Survey Study ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Face To Face ◽  
Remote Care

BACKGROUND With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. OBJECTIVE We explored GPs’ perspectives on the main benefits and challenges of using digital remote care. METHODS GPs across 20 countries completed an online questionnaire between June – September 2020. GPs’ perceptions on main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data. RESULTS A total of 1,605 respondents participated in our survey. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and accompanying legal frameworks. Main challenges included patient’s preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital remote care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues, and regulatory weaknesses. CONCLUSIONS At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how during the pandemic. Lessons learned can be used to inform the adoption of improved virtual care solutions, and support the long-term development of platforms that are more technologically robust, secure. INTERNATIONAL REGISTERED REPORT RR2-10.2196/30099

The characteristics of Queensland private physiotherapy practitioners’ interprofessional interactions: a cross-sectional survey study

2020 ◽  
Vol 26 (6) ◽  
pp. 500
Author(s):  
Jack A. Seaton ◽  
Anne L. Jones ◽  
Catherine L. Johnston ◽  
Karen L. Francis
Keyword(s):  
Private Practice ◽  
Online Survey ◽  
Interprofessional Collaboration ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Face To Face ◽  
Level Of Satisfaction ◽  
Cost Efficient ◽  
High Level

Effective interprofessional collaboration (IPC) contributes to superior patient outcomes, facilitates cost-efficient health care, and increases patient and practitioner satisfaction. However, there is concern that IPC may be difficult to implement in clinical settings that do not conform to formal team-based processes, such as mono-professional physiotherapy private practice facilities. The aim of this study was to describe the characteristics of private physiotherapy practitioners’ interprofessional interactions, including their experiences and perceptions regarding IPC. A custom developed cross-sectional online survey instrument was used to collect data from physiotherapists employed in private practice facilities in Queensland, Australia. In all, 49 (20% response rate) physiotherapists completed the survey. Only a small proportion (14%) indicated that their interprofessional interactions were a daily occurrence, and less than one-third of all respondents (31%) participated in formal, multi-professional face-to-face planned meetings. Most participants (76%) reported a moderate-to-high level of satisfaction regarding their interprofessional interactions. Despite low self-reported levels of interprofessional activity and other data indicating that IPC is necessary for holistic patient care, this study shows that physiotherapists were predominately satisfied when interacting with health practitioners from various professional backgrounds. Further research is required to inform the implementation of robust strategies that will support sustainable models of IPC in physiotherapy private practice.

Balint groups: psychosocial nonsense or a real insight into the doctor-patient relationship?

BMJ ◽  
2004 ◽  
Vol 328 (Suppl S4) ◽  
pp. 0404172
Author(s):  
Bruno Rushforth ◽  
Wendy Brown
Keyword(s):  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Balint Groups ◽  
Insight Into

Patients' Influence on Doctors' Behavior: A Case Study of Patient Strategies in Somatization

1995 ◽  
Vol 25 (4) ◽  
pp. 319-329 ◽  
Author(s):  
Peter Salmon ◽  
Carl R. May
Keyword(s):  
Empirical Data ◽  
Single Case ◽  
Psychological Needs ◽  
Biomedical Model ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Social Distress ◽  
Powerful Explanation

Objective: Extensive empirical data and theory describe the inequality of power in relations between doctors and their patients. However, the focus has been on the ways in which doctors control the doctor-patient relationship. This has meant that the extent to which patients influence the consultation, and the ways in which they do this, have been neglected. Methods: In this article, we use a single case to identify and illustrate distinct ways in which patients exert power to determine the outcome of consultations. Conclusion: This analysis leads to a more powerful explanation than is presently available to understand the somatization of psychological needs. According to this, the patient organizes strategies, which include the presentation of emotional and social distress, around a biomedical model. Because of their prior decisions as to their role, doctors permit themselves to be trapped in this model.

scholarly journals Post-COVID-19 Adaptations; the Shifts Towards Online Learning, Hybrid Course Delivery and the Implications for Biosciences Courses in the Higher Education Setting

2021 ◽  
Vol 6 ◽  
Author(s):  
Amreen Bashir ◽  
Shahreen Bashir ◽  
Karan Rana ◽  
Peter Lambert ◽  
Ann Vernallis
Keyword(s):  
Higher Education ◽  
Online Survey ◽  
Course Delivery ◽  
Space Environment ◽  
Mental Wellbeing ◽  
Free Text ◽  
Hybrid Course ◽  
Face To Face ◽  
Working Space ◽  
The Impact

The Covid-19 pandemic has created challenges and caused disruption across the Higher Education sector; university campuses closed, and face-to-face teaching and assessment shifted to an online format. Learning from our students’ experience during this period will help us shape future hybrid delivery so that it best fits Bioscience students. This pedagogical study explored Aston University’s Bioscience students’ experiences of studying from home, and the impact of the lockdown on mental wellbeing and quality of life. 151 students completed an online survey during August 2020, which included open and closed questions. Analysis of survey data revealed that a majority of students reported positive experiences of online open-book assessments and most would welcome this format in the future. The majority of students faced no technical issues, predominantly stating that they also had good internet connectivity. Shifting to remote learning and online classrooms uncovered conflicting preferences; despite wanting more interactive lectures, only half of the students were comfortable interacting using video cameras. Free text responses provided an insight into how some students reported an inadequate home working space/environment and lacked necessary items such as a desk, highlighting how remote working may intensify social and digital inequality - particularly for students from more deprived households. Wider detrimental experiences of lockdown included dissatisfaction with access to healthcare, decreased concentration, sleeping difficulties and a decline in mental wellbeing. Education strategies going forward will need to address the mental health needs of students who have suffered during the pandemic. Our university, amongst others, is embracing hybrid course delivery, which could offer a solution to ensuring Bioscience students receive hands-on laboratory experience and face-to-face contact to remain motivated and benefit from the on-campus facilities and support, whilst allowing students some of the flexibility afforded by remote study. In the current competitive higher education market where student retention is key, it is important to consider student demographics and digital equity to ensure an appropriate approach is applied to cater for all students.

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

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.

scholarly journals Paramedic confidence in estimating external blood loss

2017 ◽  
Vol 14 (3) ◽  
Author(s):  
Wayne Harris ◽  
Auston Rotheram ◽  
Sue Pearson ◽  
Peter Lucas ◽  
Dale Edwards ◽  
...  
Keyword(s):  
Blood Loss ◽  
Online Survey ◽  
Response Rate ◽  
Assessment Tools ◽  
Free Text ◽  
Visual Estimation ◽  
Demographic Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Relationship

IntroductionStudies have identified that visual estimation of blood loss is highly inaccurate, however no research has investigated the relationship between this practice and the confidence of estimation by paramedics.The aim of this study was to determine paramedic confidence in the estimation of, and reporting of external blood loss due to medical or trauma aetiology, within an Australasian paramedic context.MethodsBetween July and September 2015, a cross-sectional survey was distributed through Australasian paramedic professional bodies to determine confidence in estimating and documentation of external blood loss. Using Likert scale and free text responses, participants provided demographic information and their self-perceived confidence in estimating and documenting external blood loss.ResultsFive thousand six hundred paramedics were invited to participate in an online survey. Two hundred and eight responses were received (3.8% response rate). A total of 86.6% of participants reported documenting blood loss in clinical reports, however only 47.8% of participants believed their estimation of external blood loss was accurate with 13% reporting underestimation and 33.5% reporting overestimation of blood loss. Additionally, only 51.6% of participants agreed to strongly agreed that they were confident in their estimation of blood loss.ConclusionThis research demonstrates the majority of paramedics estimate and document external blood loss, yet nearly half do not feel confident in doing so, despite indicating its importance. Educational and organisational changes are recommended to reflect the clear evidence against this practice. Further research is recommended to identify appropriate physiological parameters and practical assessment tools to replace this inaccurate form of clinical assessment.

Implementation and evaluation of clinical supervision for support workers in a paediatric palliative care setting

2021 ◽  
pp. 135910452110555
Author(s):  
Jonathan Beavis ◽  
Sian McKenzie ◽  
Lucy Davis ◽  
Nell Ellison
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Clinical Supervision ◽  
Thematic Analysis ◽  
Online Survey ◽  
Care Setting ◽  
Peer Supervision ◽  
Face To Face ◽  
Paediatric Palliative Care ◽  
Palliative Care Setting

Support workers represent a large proportion of the NHS workforce and yet their supervisory needs are often overlooked. This study focused specifically on a cohort of support workers in a community paediatric palliative care setting. Peer supervision was implemented for this group, initially face to face and then virtually. The experiences of clinical supervision for this group were investigated through responses to an online survey ( n = 25) and two focus groups ( n = 7). Survey data were analysed concurrently with a thematic analysis. The following themes and sub-themes were developed from transcribed focus groups: (1) Barriers to engagement (2) Being Listened to (3) What Worked Well: Logistics. Overall, delivery of supervision was effective to a mixed degree – though support workers appreciated a space to be listened to, their distrust of colleagues and other barriers impeded the capacity of supervision to achieve more than support and catharsis for this group. Future projects should focus on introducing more preliminary interventions to promote reflection and peer support for these groups as well as continue to consider the supervisory needs of support workers.

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