Needs assessment for a curriculum for difficult conversations in a neurology residency training program in China

Abstract Background Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in which neurology programs in China teach residents about difficult conversations and determine whether there is a perceived need for a formalized educational curriculum in this field.Method An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China.Results A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n=168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence(P=0.003)and were under lower pressure(P=0.037) in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training.Conclusion This survey provides a contemporary assessment of the current status of education on the topic of difficult conversations in neurology residency training. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Targeted communication curriculum in difficult conversation should be further developed and implemented for the neurological residents in China.

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Needs assessment for a curriculum for difficult conversations -a survey from 5 Chinese accredited neurology residency training programs

BMC Medical Education ◽

10.1186/s12909-020-02246-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Lixin Zhou ◽

Bo Wu ◽

Liyong Wu ◽

Xin Cheng ◽

Bo Hu ◽

...

Keyword(s):

Residency Training ◽

Online Survey ◽

Training Programs ◽

Unmet Need ◽

Skills Training ◽

Current Status ◽

Teaching Hospitals ◽

Cross Sectional ◽

Difficult Conversations ◽

Previous Training

Abstract Background Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in teaching residents about difficult conversations in 5 Chinese accredited neurology residency training programs and determine whether there is a perceived need for a formalized curriculum in this field. Methods An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China. Results A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n = 168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence (P = 0.003) and were under lower pressure (P = 0.037) in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training. Conclusion This survey provides a preliminary assessment of the current status of education on the topic of difficult conversations in five accredited Chinese neurology residency training programs. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Future efforts should be made to establish and promote a standard and targeted communication curriculum in difficult conversation for Chinese neurological residents.

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Needs assessment for a curriculum for difficult conversations -A survey from 5 Chinese accredited neurology residency training programs

10.21203/rs.2.17438/v2 ◽

2020 ◽

Author(s):

Lixin Zhou ◽

Bo Wu ◽

Liyong Wu ◽

Xin Cheng ◽

Bo Hu ◽

...

Keyword(s):

Residency Training ◽

Online Survey ◽

Training Programs ◽

Unmet Need ◽

Skills Training ◽

Current Status ◽

Teaching Hospitals ◽

Cross Sectional ◽

Difficult Conversations ◽

Previous Training

Abstract Background: Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in teaching residents about difficult conversations in 5 Chinese accredit neurology residency training programs and determine whether there is a perceived need for a formalized curriculum in this field. Methods: An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China. Results: A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n=168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence（P=0.003）and were under lower pressure（P=0.037）in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training. Conclusion: This survey provides a preliminary assessment of the current status of education on the topic of difficult conversations in five accredit Chinese neurology residency training programs. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Future efforts should be made to establish and promote standard and targeted communication curriculum in difficult conversation for Chinese neurological residents.

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Needs assessment for a curriculum for difficult conversations -A survey from 5 Chinese accredited neurology residency training programs

10.21203/rs.2.17438/v3 ◽

2020 ◽

Author(s):

Lixin Zhou ◽

Bo Wu ◽

Liyong Wu ◽

Xin Cheng ◽

Bo Hu ◽

...

Keyword(s):

Residency Training ◽

Online Survey ◽

Training Programs ◽

Unmet Need ◽

Skills Training ◽

Current Status ◽

Teaching Hospitals ◽

Cross Sectional ◽

Difficult Conversations ◽

Previous Training

Abstract Background: Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in teaching residents about difficult conversations in 5 Chinese accredited neurology residency training programs and determine whether there is a perceived need for a formalized curriculum in this field.Methods: An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China.Results: A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n=168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence（P=0.003）and were under lower pressure（P=0.037）in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training.Conclusion: This survey provides a preliminary assessment of the current status of education on the topic of difficult conversations in five accredited Chinese neurology residency training programs. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Future efforts should be made to establish and promote a standard and targeted communication curriculum in difficult conversation for Chinese neurological residents.

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Education Research: Difficult conversations in neurology

Neurology ◽

10.1212/wnl.0000000000004794 ◽

2018 ◽

Vol 90 (2) ◽

pp. 93-97 ◽

Cited By ~ 5

Author(s):

Monica E. Lemmon ◽

Charlene Gamaldo ◽

Rachel Marie E. Salas ◽

Ankita Saxena ◽

Tiana E. Cruz ◽

...

Keyword(s):

Focus Groups ◽

Communication Skills ◽

Poor Prognosis ◽

Skills Training ◽

Communication Skills Training ◽

Cross Sectional ◽

Difficult Conversations ◽

Perceived Preparedness ◽

Terminal Diagnosis ◽

Prognostic Uncertainty

ObjectiveTo characterize features of medical student exposure to difficult conversations during a neurology core clerkship.MethodsThis was a cross-sectional concurrent nested mixed methods study, and all students rotating through a required neurology clerkship between 2014 and 2015 were enrolled. Data collection included an electronic communication tracker, baseline and end-of-clerkship surveys, and 4 facilitated focus groups. Students were asked to log exposure to patient–clinician conversations about (1) new disability, (2) poor prognosis, (3) prognostic uncertainty (4), terminal diagnosis, and (5) end-of-life care.ResultsA total of 159 students were enrolled and 276 conversations were tracked. Most (70%) students observed at least 1 difficult conversation, and conversations about poor prognosis, new disability, and prognostic uncertainty were most commonly logged. At clerkship end, most students (87%) desired additional bedside training in communication skills. Exposure to one of the predefined conversation types did not improve student perceived preparedness to lead difficult conversations in the future. In focus groups, students noted that the educational value of observation of a difficult conversation could be optimized with preconversation planning and postconversation debriefing.ConclusionsDifficult conversations are common in neurology, and represent a valuable opportunity to provide communication skills training on the wards. Future curricula should consider ways to leverage these existing opportunities to enhance communication skills training.

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Why Do Data Users Say Health Care Data Are Difficult to Use? A Cross-Sectional Survey Study (Preprint)

10.2196/preprints.14126 ◽

2019 ◽

Author(s):

Ho Heon Kim ◽

Bora Kim ◽

Segyeong Joo ◽

Soo-Yong Shin ◽

Hyo Soung Cha ◽

...

Keyword(s):

Health Care ◽

Access To Health Care ◽

Online Survey ◽

Data Use ◽

Survey Study ◽

Current Status ◽

Sensitive Information ◽

Cross Sectional ◽

Health Care Data ◽

Public Data

BACKGROUND There has been significant effort in attempting to use health care data. However, laws that protect patients’ privacy have restricted data use because health care data contain sensitive information. Thus, discussions on privacy laws now focus on the active use of health care data beyond protection. However, current literature does not clarify the obstacles that make data usage and deidentification processes difficult or elaborate on users’ needs for data linking from practical perspectives. OBJECTIVE The objective of this study is to investigate (1) the current status of data use in each medical area, (2) institutional efforts and difficulties in deidentification processes, and (3) users’ data linking needs. METHODS We conducted a cross-sectional online survey. To recruit people who have used health care data, we publicized the promotion campaign and sent official documents to an academic society encouraging participation in the online survey. RESULTS In total, 128 participants responded to the online survey; 10 participants were excluded for either inconsistent responses or lack of demand for health care data. Finally, 118 participants’ responses were analyzed. The majority of participants worked in general hospitals or universities (62/118, 52.5% and 51/118, 43.2%, respectively, multiple-choice answers). More than half of participants responded that they have a need for clinical data (82/118, 69.5%) and public data (76/118, 64.4%). Furthermore, 85.6% (101/118) of respondents conducted deidentification measures when using data, and they considered rigid social culture as an obstacle for deidentification (28/101, 27.7%). In addition, they required data linking (98/118, 83.1%), and they noted deregulation and data standardization to allow access to health care data linking (33/98, 33.7% and 38/98, 38.8%, respectively). There were no significant differences in the proportion of responded data needs and linking in groups that used health care data for either public purposes or commercial purposes. CONCLUSIONS This study provides a cross-sectional view from a practical, user-oriented perspective on the kinds of data users want to utilize, efforts and difficulties in deidentification processes, and the needs for data linking. Most users want to use clinical and public data, and most participants conduct deidentification processes and express a desire to conduct data linking. Our study confirmed that they noted regulation as a primary obstacle whether their purpose is commercial or public. A legal system based on both data utilization and data protection needs is required.

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How the COVID-19 pandemic affects specialty training: An analysis of a nationwide survey among otolaryngology residents in Chile

Medwave ◽

10.5867/medwave.2021.01.8097 ◽

2021 ◽

Vol 21 (01) ◽

pp. e8097-e8097

Author(s):

Matías L Álvarez ◽

Sofia Waissbluth ◽

Claudia González ◽

Carla Napolitano ◽

Mariela Torrente ◽

...

Keyword(s):

Residency Training ◽

Online Survey ◽

Negative Impact ◽

Nationwide Survey ◽

Peritonsillar Abscess ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Journal Clubs ◽

Surgical Data ◽

The Impact

Introduction Coronavirus disease 2019, or COVID-19, has become a global pandemic. Given that the highest viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is found in the airway, otolaryngologists are at high risk of infection. As a result, multiple recommendations have emerged regarding protective measures for surgical teams, including suspending non-urgent procedures and surgeries. Objectives To evaluate the impact of the COVID-19 pandemic on otolaryngology residency training programs nationwide. Methods A cross-sectional survey-based study was completed in April 2020. The participants were recruited through an online survey, sent by email to all Chilean otolaryngology residents. Demographics, clinical activities, on-call shifts, COVID-19 infection status, exposure to COVID-19 patients, deployment to other specialties, diagnostic/therapeutic procedures, and surgeries performed were analyzed. Self-reported surgical data logs from previous years were used to compare results. Results Forty-seven residents completed the survey (84% response rate); 64% of residents refer seeing patients ten days or less during April 2020. Commonly performed procedures such as flexible nasolaryngoscopy, rigid nasal endoscopy, and peritonsillar abscess drainage were not performed by over 40% of the residents in that month. Only 38% participated in surgeries, with an average of 0.6 surgeries as a first surgeon, a dramatic decrease in surgical exposure when comparing the data logs from previous years. Most residents refer the following measures taken by their residency program to improve residency training: bibliographic videoconferences (87%), online clinical case seminars (60%), weekly journal clubs (38%), among others. Conclusions Clinical and surgical opportunities decreased dramatically during April 2020. Adjustments to the regular academic curricula should be considered to decrease the negative impact of this pandemic on residency training.

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Public’s Knowledge and Beliefs towards Universal Safety Precautions during COVID-19 Pandemic in Nepal: A web-based Cross-Sectional Study

Journal of Drug Delivery and Therapeutics ◽

10.22270/jddt.v10i3-s.4175 ◽

2020 ◽

Vol 10 (3-s) ◽

pp. 133-141

Author(s):

Deependra Prasad Sarraf ◽

Pramendra Prasad Gupta ◽

Shashi Keshwar

Keyword(s):

Online Survey ◽

Unmet Need ◽

Knowledge Score ◽

Educational Interventions ◽

Cross Sectional Study ◽

Average Score ◽

Cross Sectional ◽

Web Based ◽

The Public ◽

Knowledge And Beliefs

Background: Coronavirus disease (COVID-19) has been declared as a global pandemic. In the absence of vaccines or specific drugs for COVID-19, a better understanding and implementation of universal safety precautions is essential for the prevention of COVID-19 virus infection globally. People’s adherence to the universal precautions safety measures against COVID-19 is essential which is largely affected by their knowledge and belief. Objectives: To assess the public’s knowledge and belief toward the universal safety precautions during COVID-19 pandemic. Materials and Methods: A cross-sectional web-based online survey was conducted in general public in Nepal during April, 2020. A self-designed questionnaire was prepared using Google forms via docs.google.com/forms for the collection of the data. The study participants were grouped into two categories according to their level of knowledge: excellent (score 80% and above) and average (score less than 80%). Descriptive statistics mean, frequency and percentage were used to analyze the data. Results: Out of 228, majority were male (90.4%) and aged 36-45 years (36%). Mean knowledge score was 4.68±1.41. Most of them (57.9%) had average knowledge. Average of the correct responses in the knowledge and belief domain were found to be 66.9% and 71.2% respectively. Majority of the public (55.3%) believed that home-made alcohol-based hand sanitizer is equally effective to factory-made standard sanitizer against COVID-19 virus. Conclusion: Knowledge toward universal safety precautions against COVID-19 were average among the majority of the public. There was gap between knowledge and belief domain. There is an unmet need for long term educational interventions among the public regarding the preventive methods against COVID-19. Keywords: Knowledge; Belief; COVID-19; Nepal; Public; Universal safety precautions.

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Is care of stillborn babies and their parents respectful? Results from an international online survey

10.22541/au.163530097.77946066/v1 ◽

2021 ◽

Author(s):

Bethany Atkins ◽

Hannah Blencowe ◽

Fran Boyle ◽

Emma Sacks ◽

Dell Horey ◽

...

Keyword(s):

Online Survey ◽

Unmet Need ◽

Care Quality ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Disrespectful Care ◽

Geographical Regions ◽

Respectful Care

Objective To quantify parents’ experiences of respectful care around stillbirth globally. Design Multi-country, online, cross-sectional survey. Setting and Population Self-identified bereaved parents (n=3769) of stillborn babies from 44 high- and middle-income countries. Methods Parents’ perspectives of 7 aspects of care quality, factors associated with respectful care, and 7 bereavement care practices were compared across geographical regions using descriptive statistics. Respectful care was compared between country income groups using multivariable logistic regression. Main Outcome Measures Self-reported experience of care around the time of stillbirth Results A quarter (25.4%) of 3769 respondents reported disrespectful care after stillbirth and 23.5% reported disrespectful care of their baby. Gestation <30 weeks, and primiparity were associated with disrespect. Reported respectful care was lower in middle-income countries (MICs) than in high-income countries (HICs) (aOR=0.35, 95%CI (0.29-0.42), p <0.01). In many countries, aspects of care quality need improvement, such as ensuring families have enough time with providers. Participating respondents from Latin America and Southern Europe reported lower satisfaction across all aspects of care quality compared to Northern Europe. Unmet need for memory-making activities in MICs is high. Conclusions Despite improvements, many parents still experience disrespectful care around stillbirth. The gap between parents’ access to memory-making activities in MICs and HICs needs urgent attention. Tweetable abstract A quarter of parents of stillborn babies experience disrespectful care. There is global unmet need for memory-making activities

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Stressful experiences impact on pain, fatigue and mental health in people with endometriosis: a questionnaire study during the COVID-19 pandemic

10.22541/au.162500834.44230862/v1 ◽

2021 ◽

Author(s):

Lysia Demetriou ◽

Christian Becker ◽

Beatriz Martínez-Burgo ◽

Adriana Invitti ◽

Marina Kvaskoff ◽

...

Keyword(s):

Mental Health ◽

Effect Size ◽

Online Survey ◽

Current Status ◽

Physical And Mental Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Holistic Management ◽

Stressful Experiences ◽

The Impact

Objective To explore the impact of the COVID-19 pandemic on pain and fatigue symptoms and their interactions with the impact on mental health in people with endometriosis. Design Global cross-sectional survey. Setting Online survey. Sample A total of 4717 adults with a surgical or radiological diagnosis of endometriosis. Methods An online global study collected data in 5 languages between 11th May to 8th June 2020. The survey included questions on current-status and changes of endometriosis-symptoms, mental health, demographics, and the impact of the COVID-19 pandemic on the respondents’ lives. Main Outcome Measures Self-reported changes to endometriosis-associated symptoms (pelvic pain, tiredness/fatigue, bleeding) and to mental health during the early stages of the COVID-19 pandemic. Results Respondents reported a marked worsening of their endometriosis symptoms (endo-associated pain (39.3%; 95% CI [37.7, 40.5]), tiredness/fatigue (49.9%; 95% CI [48.4, 51.2]) and bleeding (39.6%; 95% CI [38.2, 41])) and mental health (38.6%; 95% CI [37.2, 39.9]). Those with a pre-existing mental health diagnosis (38.8%) were more negatively impacted. The worsening of pain and TF were significantly correlated with worsening of mental health (p<0.001) and these relationships were found to be weakly mediated by pain catastrophising scores (pain: effect size: 0.071, LLCI= 0.060, ULCI= 0.082, TF: effect size: 0.050, LLCI= 0.040, ULCI= 0.060). Conclusions This study demonstrates that stressful experiences impact the physical and mental health of people with endometriosis. The findings highlight the need to consider psychological approaches in the holistic management of people with endometriosis.

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Resuscitation orders in the perioperative setting: A survey of knowledge, practices and perceptions among consultant and trainee anaesthesiologists

Journal of Perioperative Practice ◽

10.1177/17504589211022310 ◽

2021 ◽

pp. 175045892110223

Author(s):

Ann-Marie Crowe ◽

Brian Marsh

Keyword(s):

Online Survey ◽

Perioperative Period ◽

Teaching Hospitals ◽

Local Hospital ◽

Hospital Policy ◽

Resuscitation Orders ◽

Cross Sectional ◽

State Legislation ◽

Knowledge Practices

Background As advance healthcare directives gain clarity in state legislation in Ireland, anaesthesiologists will come across patients with resuscitation orders that will demand interpretation when encountered perioperatively. Studies show variable perceptions among anaesthesiologists towards the binding nature of resuscitation orders in the context of anaesthesia provision. Currently, knowledge, perceptions and practices of anaesthesiologists in Ireland towards such orders are not known. Methods A cross-sectional online survey was distributed to anaesthesiologists in adult teaching hospitals. Results In this cohort, 65.9% of those surveyed did not know if there was a local hospital policy advance healthcare directive containing, do not attempt resuscitation, decisions in the perioperative period in their current hospital; 57.7% did not know if there was a policy for not for resuscitation orders; 74.8% did not know if there are guidelines for the management of patients with resuscitation orders. Irrespective of the presence of an order stating otherwise, 43.9% would initiate resuscitation in the event of any arrest occurring in theatre, with 66.7% initiating resuscitation if secondary to iatrogenesis. Conclusions By uncovering low self-perceived levels of knowledge and mixed perceptions towards resuscitation orders, the authors hope that the study initiates much-needed conversations on the topic, particularly at a time when advance healthcare directives find a more firm legal footing in Ireland.

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