Are we training our fellows adequately in delivering bad news to patients? A survey of hematology/oncology program directors

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9023-9023
Author(s):  
H. D. Hebert ◽  
J. Butera ◽  
A. Mega
Keyword(s):  
United States ◽  
Skill Development ◽  
Institutional Support ◽  
Program Directors ◽  
The United States ◽  
Urban Setting ◽  
Bad News ◽  
Formal Training ◽  
Delivering Bad News ◽  
E Mail

9023 Background: Medical Oncologists are often in a situation of delivering bad news (dbn). We were interested in the extent of formal training in dbn in Hematology/Oncology fellowships in the United States. Methods: An e-mail survey was conducted of all Hematology/Oncology Program Directors (PDs) in the United States to elicit subjective responses as to the degree of formal training fellows receive in dbn, the adequacy, perceived necessity and quality of this training as well as institutional support provided. The surveys were e- mailed to 124 PDs and responses were received either via e-mail or regular mail. Results: 49 surveys were completed and returned (40% response rate). The majority of programs, 82%, are in an urban setting and 96% of the primary teaching hospitals are considered tertiary care centers. 45% of programs carry an NCI designation; the median number of fellows in a training program is 6, with the range being 3 to 42. 90% of PDs reported that they received little to no formal training in dbn. In contrast, they report that 31% of current fellows receive little to no formal training with 43% receiving some training and additional 26% receiving moderate to extensive training. 36% of PDs felt that formal training is important for skill development in dbn while only 4% did not feel so and an additional 31% felt that some training is useful. 50% of PDs would like to see some improvements in how their fellows are trained and 28% would like to see moderate to extensive improvement. 44% reported little to no institutional support for training while 22% reported moderate to full support. Conclusions: Of the Hematology/Oncology Program Directors who responded to our survey, a large majority did not have formal training in dbn. Despite this lack of training, most PDs felt that some training was useful for skill development in dbn and the majority of today's fellows do receive training in delivering bad news. However, there was still a significant percentage of PDs who reported little or no formal training for fellows and most PDs would still like to see some improvements in how fellows are trained. Specific institutional support for training fellows in dbn remains lacking. No significant financial relationships to disclose.

scholarly journals Postinterview Communication between Obstetrics and Gynecology Residency Programs and Candidates

2012 ◽  
Vol 4 (2) ◽  
pp. 165-169 ◽  
Author(s):  
Diana S. Curran ◽  
Pamela B. Andreatta ◽  
Xiao Xu ◽  
Clark E. Nugent ◽  
Samantha R. Dewald ◽  
...  
Keyword(s):  
United States ◽  
Response Rate ◽  
Educational Leaders ◽  
Program Directors ◽  
The United States ◽  
Obstetrics And Gynecology ◽  
Residency Programs ◽  
Ethical Conflicts ◽  
Communication Practices ◽  
E Mail

Abstract Introduction Residency programs seek to match the best candidates with their positions. To avoid ethical conflicts in this process, the National Residency Matching Program (NRMP or Match) has rules regarding appropriate conduct, including guidelines on contact between candidates and programs. Our study examined communication between obstetrics and gynecology (Ob-Gyn) programs and residency candidates after interviewing and prior to ranking. Methods Ob-Gyn program directors in the United States were sent a self-administered survey via e-mail. Data were collected and analyzed using descriptive methods to examine communication practices of these programs. Results The response rate was 40%. The findings showed that respondents had variable interpretations of the NRMP rules and suggest that programs may be communicating their match intentions especially to favored candidates. Respondents' open text comments highlighted program directors' frustrations with current NRMP rules. Discussion NRMP communication rules are intended to minimize pressure on residency candidates. Our findings suggest they may be leading to unforeseen stresses on program directors and candidates. Conclusions As educational leaders in medicine, we must consider what professional communications are acceptable without increasing the pressure on candidates during the ranking and match process.

Validation of Institutional Support Survey for Anesthesiology Training Programs in the United States

2006 ◽  
Vol 102 (2) ◽  
pp. 644 ◽  
Author(s):  
Kevin K. Tremper ◽  
Amy Shanks ◽  
Michelle Morris ◽  
Dave A. Burnett
Keyword(s):  
United States ◽  
Training Programs ◽  
Institutional Support ◽  
The United States

Serious Games as a Complementary Tool for Social Skill Development in Young People: A Systematic Review of the Literature

2021 ◽  
pp. 104687812110312
Author(s):  
Lucy R. Zheng ◽  
Catherine M. Oberle ◽  
W. A. Hawkes-Robinson ◽  
Stéphane Daniau
Keyword(s):  
United States ◽  
Systematic Review ◽  
Social Skills ◽  
Young People ◽  
Social Skill ◽  
Serious Games ◽  
Skill Development ◽  
The United States ◽  
Serious Game ◽  
Social Skill Development

Background The use of games for social skill development in the classroom is accelerating at a tremendous rate. At the same time, the research surrounding games designed for teaching social skills remains fragmented. This systematic review summarizes the current existing literature on social skill serious games for young people ages 5 to 19 and is the first review of serious games to note the demographic and geographic component of these studies. Method This review included papers that: evaluated a game designed to teach social skills; included measurable, quantitative outcomes; have a translation or be published in English; were peer-reviewed; date from January 2010 to May 2020; and have a nonclinical study population between ages of 5 to 19. Keywords were obtained from the CASEL 5 framework. Results Our findings are mixed but suggest that serious games may improve social skills when used alongside in-person discussion. We also found potential effects of the length of time of gameplay, intervention, and follow-up on social skill serious game effectiveness. Although this review found promising research conducted in East Asian countries and with minority samples in the United States, the majority of social skill serious game research takes place in the United States and Australia, with unreported demographic information and white-majority samples. Conclusions Due to the limited number of published studies in this area and studies lacking methodological rigor, the effectiveness of using games to teach social skills and the impact of background on social skill learning require further discussion.

Physical therapy research and researchers in the United States: good news and bad news

1997 ◽  
Vol 2 (3) ◽  
pp. 173-178 ◽  
Author(s):  
Lynn Snyder-Mackler ◽  
Stuart Binder-Macleod ◽  
Paul F. Mettler
Keyword(s):  
United States ◽  
Physical Therapy ◽  
The United States ◽  
Bad News ◽  
Good News

Resources Used and Innovations in Teaching Vegetarian and Vegan Nutrition in Accredited Dietetics Programs in the United States

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Irana W Hawkins ◽  
A. Reed Mangels
Keyword(s):  
United States ◽  
Program Directors ◽  
The United States ◽  
Cross Sectional ◽  
Innovative Teaching ◽  
Survey Question ◽  
Dietetics Education ◽  
Instructional Methodologies ◽  
Vegetarian Nutrition ◽  
Nutrition And Dietetics

Background: Vegetarian and vegan diets effectively reduce morbidity and mortality from many chronic diseases and are associated with reduced environmental impact. However, little is known about the role of teaching vegetarian and vegan nutrition in dietetics education in the United States. Thus, we examined the resources and methods used in teaching vegetarian/vegan nutrition in accredited dietetics programs in the United States. Methods: A cross-sectional, internet-based survey was sent to all Accreditation Council for Education in Nutrition and Dietetics (ACEND) program directors in the United States (N = 574). Questions included queries about where vegetarian/vegan nutrition is taught in the curriculum (if at all), instructional methodologies, and the resourcesutilized. Overall, 205 program directors responded to our survey. Results: Vegetarian/vegan nutrition was taught in a variety of courses, most commonly in introductory nutrition courses. The evidence-based resources used most often included the Academy of Nutrition and Dietetics (AND) Position Paper on Vegetarian Nutrition, the AND Evidence Analysis Library, and peer-reviewed studies. Hands-onfood preparation activities were commonly cited as a useful means for teaching vegetarian and vegan nutrition. Nearly 60% of 183 respondents to the relevant survey question indicated that their programs reviewed flexitarian/semi-vegetarian/low-meat diets. Innovative teaching techniques included stand-alone vegetarian nutrition courses, cu-linary experiences including recipe development and sensory evaluation, student presentations to the community, and asking students to follow vegetarian/vegan diets and then evaluate those experiences. Conclusions: Many dietetics educators used innovative strategies to teach vegetarian/vegan nutrition. These methods offer novel experiences for students to increase self-efficacy in vegetarian/vegan nutrition that can ultimately improve public and planetary health outcomes in practice.

Abstract 180: What is the Potential Capacity for Increasing Cardiac Rehabilitation Utilization in the United States?

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Quinn R Pack ◽  
Ray W Squires ◽  
Steven W Lichtman ◽  
Francisco Lopez-Jimenez ◽  
Juan Pablo Rodriguez-Escudero ◽  
...  
Keyword(s):  
United States ◽  
Cardiac Rehabilitation ◽  
Program Directors ◽  
The United States ◽  
Service Needs ◽  
Full Time ◽  
Potential Growth ◽  
Related Factors ◽  
Potential Capacity ◽  
Program Capacity

Introduction: Cardiac rehabilitation (CR) is an effective but highly underutilized therapy for heart disease. Efforts are underway to increase CR referral and enrollment, but little is known about the potential capacity for growth in CR utilization in the United States. To address this concern, we estimated the current national capacity of CR programs across the United States and assessed obstacles to potential growth. Methods: We surveyed all CR Program Directors listed in the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) database in November of 2012. Respondents reported current enrollment levels, current program capacity, program capacity given reasonable expansion, and obstacles to growth. Results: Of 812 Program Directors in the AACVPR database, 290 (36%) completed the full survey. Respondents represented somewhat larger programs compared to non-respondents (4.0 vs. 4.6 full time employees, p = 0.01), but were otherwise similar. Current enrollment levels demonstrated a median [IQ range] of 140 [75,232] patients per year and a current estimated capacity of 192 [100,300] patient per year. Respondents estimated that programs could expand services by 25% to 240 [141,380] patients annually, assuming a significant increase in patient demand and a feasible increase in resources. We estimate that if programs filled to their current capacity, national CR utilization rates would increase from 34.7% to 46.4% (95% CI, 43.9 to 48.9) of eligible US patients each year. Given feasible program expansion, utilization could increase to a maximum of 58.4% (95% CI, 55.2 to 61.6) of qualifying patients. Capacity projections based upon absolute patient numbers and national statistics revealed concordant results. The most commonly cited obstacles to increasing patient participation are shown in the figure. As seen, the majority (88%) are controllable system-related factors unrelated to patient behavior. Conclusions: Even with substantial expansion of all existing CR programs, there is currently insufficient capacity in current CR programs to meet national service needs. Solutions to this problem will likely include the creation of new CR programs, and new policies that improve reimbursement for CR and also embrace new models of CR delivery.

Issues in Using Web-Based Course Resources

2010 ◽  
pp. 1771-1779
Author(s):  
Karen S. Nantz ◽  
Norman A. Garrett
Keyword(s):  
United States ◽  
Online Courses ◽  
The United States ◽  
The Internet ◽  
Web Based ◽  
Course Materials ◽  
Socially Isolated ◽  
Rss Feeds ◽  
E Mail ◽  
The Web

Education over the Internet is going to be so big it is going to make e-mail usage look like a rounding error. John Chambers, Cisco Systems, New York Times, November 17, 1990 Web-based courses (Mesher, 1999) are defined as those where the entire course is taken on the Internet. In some courses, there may be an initial meeting for orientation. Proctored exams may also be given, either from the source of the Web-based course or off-site at a testing facility. The Internet-based course becomes a virtual classroom with a syllabus, course materials, chat space, discussion list, and e-mail services (Resmer, 1999). Navarro (2000) provides a further definition: a fully interactive, multimedia approach. Current figures indicate that 12% of Internet users in the United States use the Internet to take an online course for credit toward a degree of some kind (Horrigan, 2006). That number is indicative of the rapid proliferation of online courses over the past several years. The Web-enhanced course is a blend with the components of the traditional class while making some course materials available on a Web site, such as course syllabi, assignments, data files, and test reviews. Additional elements of a Web-enhanced course can include online testing, a course listserver, instructor-student e-mail, collaborative activities using RSS feeds and related technologies, and other activities on the Internet. One of the biggest concerns about Web-based courses is that users will become socially isolated. The Pew Internet and America Life Project found that online communities provide a vibrant social community (Horrigan, Rainie, & Fox, 2001). Clearly, students are not concerned or feel that other benefits outweigh the potential drawbacks. According to government research (Waits and Lewis, 2003), during the 2000-2001 academic year alone, an estimated 118,100 different credit courses were offered via distance education (with the bulk of that using Internet-based methods) by 2- and 4-year institutions in the United States. Over 3 million students were registered in these courses. Navarro (2000) suggests that faculty members are far more likely to start by incorporating Internet components into a traditional course rather than directly offering Web-based courses. These Web-enhanced courses might be considered the transition phase to the new paradigm of Internet-based courses. Rich learning environments are being created, with a shift from single tools to the use of multiple online tools, both to enhance traditional courses and to better facilitate online courses (Teles, 2002).

An International Comparative Study of the Roles, Rules, Norms, and Values That Predict Email use

2011 ◽  
pp. 177-204
Author(s):  
Mark F. Peterson ◽  
Stephanie J. Thomason ◽  
Norm Althouse ◽  
Nicholas Athanassiou ◽  
Gudrun Curri ◽  
...  
Keyword(s):  
United States ◽  
Technology Use ◽  
The United States ◽  
Norms And Values ◽  
The Social ◽  
Cultural Contingencies ◽  
International Comparative ◽  
Communication And Technology ◽  
Further Development ◽  
E Mail

This chapter extends communication and technology use theories about factors that predict e-mail use by explaining the reasons for cultural contingencies in the effects of managers’ personal values and the social structures (roles, rules and norms) that are most used in their work context. Results from a survey of 576 managers from Canada, the English-speaking Caribbean, Nigeria, and the United States indicate that e-mail use may support participative and lateral decision making, as it is positively associated with work contexts that show high reliance on staff specialists especially in the U.S., subordinates, and unwritten rules especially in Nigeria and Canada. The personal value of self-direction is positively related to e-mail use in Canada, while security is negatively related to e-mail use in the United States. The results have implications for further development of TAM and media characteristic theories as well as for training about media use in different cultural contexts.

Duke and the Disciples

2020 ◽  
pp. 144-163
Author(s):  
Rodney A. Smolla
Keyword(s):  
United States ◽  
Presidential Election ◽  
The United States ◽  
Bad News ◽  
Good News ◽  
Information Warfare ◽  
Modern History ◽  
History Of ◽  
The Right ◽  
Political Election

This chapter draws attention to David Duke as one of the celebrity headliners of the Charlottesville Unite the Right rally. It details how Duke presaged and inspired the alt-right and describes his influence on the modern history of nationalist and supremacist movements in America. It also notes Duke's influence on alt-right leaders and Donald Trump during the presidential election of the United States. The chapter analyzes how a perennial political election loser can turn losses into ideological and cultural gains. It discusses how all bad news is really good news in the eyes of a guerrilla information warfare insurrectionist in order to understand the influence of David Duke.

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