scholarly journals Group assessment of residents’ clinical skills using Case-based Discussions is feasible, highly valued and moreover fosters learning

2020 ◽  
Author(s):  
Rakel Fuglsang Johansen ◽  
René Buch Nielsen ◽  
Bente Malling ◽  
Hanne Storm
Keyword(s):  
Clinical Skills ◽  
Assessment Process ◽  
Structured Interviews ◽  
Medical Department ◽  
Group Assessment ◽  
Individual Assessment ◽  
New Knowledge ◽  
One To One ◽  
The Individual ◽  
Case Based

Abstract Background Assessment of residents’ clinical skills using Case-based Discussion traditionally involves a one-to-one discussion with a supervisor. This entails a subjective, and maybe unequal, assessment of the resident, which can only be overcome with the use of multiple assessors. The purpose of this study was to explore residents’ and assessors’ perception of a group-assessment concept.Methods Eleven to fifteen residents in a medical department met 4 times (every 3rd month) over 1 year for 5 hours each time. The residents took turns presenting clinical cases within a predefined topic and discussed it with peers and assessors (diagnosis, differential diagnosis, ethical considerations etc.). Four assessors (specialists in internal medicine) participated in the discussion and together assessed the residents` clinical skills. An external consultant observed the group-assessment several times and conducted semi-structured interviews with the residents as well as the assessors. Notes from the observations and transcribed interviews were analyzed using an inductive approach looking for participants’ perceptions of the concept.Results Both residents and assessors preferred the group-assessment to the individual assessment. Since there were several assessors, the group-assessments were more consistent and regarded more resource-efficient and manageable than one-to-one assessments. The level of discussion was perceived to be higher in the group discussions compared to one-to-one discussions. All residents gained new knowledge during their assessment and in addition, also reported having learned from listening to the assessment of their peers. Assessors reported gaining new knowledge as well.Conclusions Group-assessment through Case-based Discussions is a good way to structure assessment of residents` clinical skills. The quality of the assessment process seems to be increased and is likely to be more objective than individual assessment. Group-assessment is feasible and acceptable, and additionally fosters learning for all participating doctors in the department.

A Structured Psychiatric Interview for Use in Epidemiological Studies of Mental Disorder

1970 ◽  
Vol 1 (4) ◽  
pp. 339-348 ◽  
Author(s):  
John Warder
Keyword(s):  
Mental Disorder ◽  
Clinical Skills ◽  
Individual Case ◽  
Epidemiological Studies ◽  
Medical Patients ◽  
Structured Interviews ◽  
Individual Subject ◽  
Psychiatric Interview ◽  
Additional Information ◽  
The Individual

The Structured Psychiatric Interview is intended for use in surveys of population subgroups defined in terms of nonpsychiatric criteria including, for example, general medical patients. Its purpose is to elicit evidence of current mental pathology, utilizing the essential clinical skills of the examiner within the context of a structured situation. No diagnostic inferences are made at this stage. (Such inferences would be both inappropriate and unwise without additional information about the individual subject.) Unlike some existing structured interviews, it does not purport to be a “psychological test for psychopathology,” thus avoiding questionable assumptions about the propriety of summating molecular behaviors to arrive at a “quantitative evaluation of the individual for psychopathology.” Insofar as it represents an organized phenomenological examination, it will be of value in the individual case, but it remains primarily an epidemiological instrument for economic measurements of mental disorder within and between populations.

scholarly journals A Multiple Stakeholder Perspective for Evaluating Community-Based Dementia Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 60-61
Author(s):  
Johan Suen
Keyword(s):  
Dementia Care ◽  
Structural Constraints ◽  
Care Provision ◽  
Care Providers ◽  
Structured Interviews ◽  
Community Based ◽  
Relational Factors ◽  
Care Relationships ◽  
The Individual ◽  
The Impact

Abstract For holistic interventions and research on dementia, it is fundamental to understand care experiences from the perspectives of carers, care recipients, and care professionals. While research on care dyads and triads have highlighted the effects of communication and interactional aspects on care relationships, there is a lack of knowledge on how individual-contextual and relational factors shape the provision and receipt of care in terms of decision-making processes, resource allocation, and expectations of care outcomes. Thus, this paper sheds light on (i) how carers negotiate care provision with other important life domains such as employment, household/family roles and conflicts, as well as their own health problems, life goals, values, and aspirations for ageing; (ii) how older adults with dementia perceive support and those who provide it; (iii) the structural constraints faced by care professionals in delivering a team-based mode of dementia care; and, taken together, (iv) how community-based dementia care is impeded by barriers at the individual, relational, and institutional levels. Findings were derived from semi-structured interviews and observational data from fieldwork conducted with 20 persons with dementia (median age = 82), 20 of their carers (median age = 60), and 4 professional care providers. All respondents were clients and staff of a multidisciplinary and community-based dementia care system in Singapore. Our analysis indicates the impact of dementia care is strongly mediated by the interplay between institutional/familial contexts of care provision and the various ‘orientations’ to cognitive impairment and seeking support, which we characterised as ‘denial/acceptance’, ‘obligated’, ‘overprotective’, and ‘precariously vulnerable’.

scholarly journals Developing HIV assisted partner notification services tailored to Mexican key populations: a qualitative approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heleen Vermandere ◽  
Santiago Aguilera-Mijares ◽  
Liliane Martínez-Vargas ◽  
M. Arantxa Colchero ◽  
Sergio Bautista-Arredondo
Keyword(s):  
Partner Notification ◽  
Key Populations ◽  
Structured Interviews ◽  
Hiv Diagnosis ◽  
Serostatus Disclosure ◽  
Hiv Epidemic ◽  
Contact Information ◽  
Hiv Awareness ◽  
Sex With Men ◽  
The Individual

Abstract Background Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). This study aimed to explore the awareness of and need for HIV partner notification, as well as to outline potential strategies for APNS based on identified barriers and facilitators. Methods We conducted semi-structured interviews to explore partner notification with MSM, TW, and counselors. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS. Results Most participants reported experiences with informal partner notification and serostatus disclosure, but not with APNS. Only one counselor indicated assisting notification systematically. The main barriers for notifying or disclosing mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier to inform a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counselors or peers to mitigate potential rejection or violent reactions. Conclusions While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS could potentially enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.

A Qualitative Study of Developing Competency in Thyroid Surgery: A Resident’s Perspective With 5 Year Follow Up

2021 ◽  
pp. 000348942199691
Author(s):  
Gabriela DeVries ◽  
Megan Rudolph ◽  
Howard David Reines ◽  
Philip E. Zapanta
Keyword(s):  
Qualitative Study ◽  
Learning Strategies ◽  
Thyroid Surgery ◽  
Washington Dc ◽  
Structured Interviews ◽  
Self Directed Learning ◽  
Surgical Specialty ◽  
Long Term Follow Up ◽  
The Individual

Objectives: The Accreditation Council for Graduate Medical Education has guidelines on assessing surgical qualifications based on experience. Attending surgeons have various assumptions on how their trainees learn and acquire surgical skills. This study primarily investigates the resident’s perspective on gaining experience and achieving competency in thyroid surgical procedures. Methods: A qualitative study using semi-structured interviews was designed to derive themes that discuss the acquisition of competency in thyroid surgery. After IRB approval, data was collected from 2012 to 2014 at 4 academic centers in the Washington, DC area. Fourteen chief residents specializing in either general surgery or otolaryngology were interviewed until saturation was achieved. These semi-structured interviews were transcribed and broken up into codes utilizing Moustakas’ analysis. A comprehensive list of master themes in regards to achieving competency in thyroid surgery was developed. A follow up survey of the surgeons was undertaken at 5 years to determine if the perceptions during residency persisted in practice. Results: Surgical specialty residents experience and learn thyroid surgery in 5 learning themes: 1. Self—directed learning is significant during residency. 2. Repetition with graduated autonomy is key. 3. Effective mentors are competent surgeons who challenge residents and use positive teaching techniques. 4. Residents employ active learning through the “see one, do one, teach one” philosophy. 5. Learning from complexity is of importance to residency training. After several years in practice, the most important theme in learning after residency was repetition of cases. Conclusions: This study demonstrates how residents progress in approaching competency in thyroid surgery. Adult learning strategies are preferred, and programs should incorporate tailored techniques to meet the individual needs of the residents. Perceptions of what is most important shifted in long-term follow up. Further study is needed to assure competency in residency and in practice.

scholarly journals The value of domiciliary medication reviews: a thematic analysis of patient views

2021 ◽  
Author(s):  
Patricia McCormick ◽  
Bridget Coleman ◽  
Ian Bates
Keyword(s):  
Thematic Analysis ◽  
Outcome Measure ◽  
Service Users ◽  
Structured Interviews ◽  
Main Outcome Measure ◽  
Healthcare Settings ◽  
Medication Reviews ◽  
Informal Carers ◽  
The Individual ◽  
Patient Centric

AbstractBackground Medication reviews are recognised as essential to tackling problematic polypharmacy. Domiciliary medication reviews (DMRs) have become more prevalent in recent years. They are proclaimed as being patient-centric but published literature mainly focuses on clinical outcomes. However, it is not known where the value of DMRs lies for patients who participate in them. Objective To determine the value of domiciliary medication reviews to service users. Setting Interviews took place with recipients of domiciliary medication reviews residing in the London boroughs of Islington and Haringey. Method Semi-structured interviews analysed using thematic analysis. Main outcome measure Themes and sub-themes identified from interview transcripts. Results Five themes were identified: advantages over traditional settings, attributes of the professional, adherence, levels of engagement and knowledge. Conclusion For many patients, the domiciliary setting is preferred to traditional healthcare settings. Patients appreciated the time spent with them during a DMR and felt listened to. Informal carers felt reassured that the individual medication needs of their relative had been reviewed by an expert.

scholarly journals Testing for SARS-CoV-2 seroprevalence: experiences of a tertiary eye centre

2021 ◽  
Vol 6 (1) ◽  
pp. e000688
Author(s):  
Focke Ziemssen ◽  
You-Shan Feng ◽  
Sven Schnichels ◽  
Tarek Bayyoud ◽  
Marius Ueffing ◽  
...  
Keyword(s):  
Point Of Care ◽  
Kappa Statistics ◽  
Antibody Testing ◽  
Self Assessment ◽  
Individual Assessment ◽  
Hygiene Measures ◽  
Antibody Titres ◽  
Antiviral Antibody ◽  
Sequential Combination ◽  
The Individual

IntroductionThe actual prevalence of a SARS-CoV-2 infection and the individual assessment of being or having been infected may differ. Facing the great uncertainty—especially at the beginning of the pandemic—and the possibility of asymptomatic or mildly symptomatic, subclinical infections, we evaluate the experience of SARS-CoV-2 antibody screening at a tertiary clinical setting.Methods and analysisAll employees of a tertiary eye centre and a research institute of ophthalmology were offered antibody testing in May 2020, using a sequential combination of different validated assays/antigens and point-of-care (POC) testing for a subset (NCT04446338). Before taking blood, a systematic inquiry into past symptoms, known contacts and a subjective self-assessment was documented. The correlations between serostatus, patient contacts and demographic characteristics were analysed. Different tests were compared by Kappa statistics.ResultsAmong 318 participants, SARS-CoV-2 antibodies were detected in 9 employees. Chemiluminescence assays (chemiluminescence immunoassay and electrochemiluminescence) showed superior specificity and high reproducibility, compared with ELISA and POC results.In contrast to the low seropositivity (2.8%) of healthcare workers, higher than that of the other departments of the hospital, a large proportion mistakenly assumed that they might have already been infected. Antiviral antibody titres increased and remained on a plateau for at least 3 months.ConclusionsThe great demand and acceptance confirmed the benefit of highly sensitive testing methods in the early phase of the pandemic. The coincidence of low seroprevalence and anxious employees may have contributed to internalising the need of hygiene measures.

scholarly journals Comparative physical activity as a global question to assess physical activity among university students

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Katharina Diehl ◽  
Alessia Brassat ◽  
Jennifer Hilger-Kolb
Keyword(s):  
Physical Activity ◽  
University Students ◽  
Online Survey ◽  
Group Level ◽  
Comparative Measurement ◽  
Cross Sectional ◽  
Physically Active ◽  
Comparative Optimism ◽  
Individual Assessment ◽  
The Individual

Abstract Background To assess physical activity (PA), a comparative measurement – evaluating one’s own PA compared to others – may be an appropriate method. In previous studies, the use of comparative measurements led to an effect known as unrealistic comparative optimism (UCO) – people being unrealistically optimistic about their behavior. Our aim was to use this comparative measurement in university students to quantify the prevalence of UCO at the group level and to draw conclusions on its validity. Methods We used data from the Nutrition and Physical Activity in Adolescence Study (NuPhA), a cross-sectional online survey that included only self-reports (n = 689). To assess PA among students, they were asked to rate their PA level compared to that of their same-aged fellow students. In addition, we used the Godin-Shephard leisure-time PA questionnaire and other questions on PA for comparisons. We used bivariate and cluster-based analyses to identify potential UCO. Results We found that UCO at the group level led to an uneven distribution, with a higher proportion of students who rated themselves as being more physically active than average. However, the individual assessment of PA with a single and simple comparative question seemed to be valid. Discussion A global single comparative question seems useful for studies where PA is measured as a covariate in university students.

The Tegument and Associated Structures of Fasciola Hepatica

1963 ◽  
Vol s3-104 (68) ◽  
pp. 505-512
Author(s):  
L. T. THREADGOLD
Keyword(s):  
Electron Microscopy ◽  
Surface Layer ◽  
Light Microscopy ◽  
Fasciola Hepatica ◽  
Golgi Bodies ◽  
New Knowledge ◽  
Pinocytotic Vesicles ◽  
The Individual ◽  
And Function ◽  
Internal Level

The cuticle of light microscopy is shown by electron microscopy to be a surface layer of protoplasm which is an extension of areas of nucleated protoplasm lying deep in the parenchyma. The cuticle therefore exists at two levels. The external level is syncytial, consisting of plateaux separated by branching valleys. This level contains apical pinocytotic vesicles, numerous mitochondria, endoplasmic membranes, large basal and other vacuoles, and dense spines. Tube-like evaginations from the base of the external level connect it to the individual areas of flask-shaped protoplasm which compose the internal level. Each of these areas of protoplasm contains a nucleus, great numbers of mitochondria, some vacuoles and diffuse inclusions, and the Golgi bodies. The histochemistry and function of the cuticle is discussed in the light of this new knowledge of cuticular ultrastructure, and a comparison is made between the cuticle of Cestoda and Trematoda.

Perception of the lived experience of women with dyspareunia and vaginismus: qualitative study

2021 ◽  
Author(s):  
Maryam Heydarian ◽  
Maryam Gholamzadehjefreh ◽  
Shahbazi Masoud
Keyword(s):  
Lived Experience ◽  
Physical Symptoms ◽  
Research Literature ◽  
Sexual Intimacy ◽  
Structured Interviews ◽  
Purposeful Sampling ◽  
The Family ◽  
Data Saturation ◽  
The Individual ◽  
Inferiority Feeling

Aim: Dyspareunia and vaginismus are important issues in the lives of women with these disorders and have adverse, damaging consequences for the individual, the family, and the couple's intimacy. Therefore, the purpose of the present study was to investigate the lived experience of women with dyspareunia and vaginismus. Methods: The method of this study was descriptive-phenomenological psychological in which nine female participants suffering from dyspareunia and vaginismus were selected through purposeful sampling and data collection was continued through semi-structured interviews until data saturation was reached. After collecting the data and transcribing them, the researcher used Giorgi’s five-step phenomenological data analysis method. Results: Analyzing data led to 12 contributing components of the lived experience of women with dyspareunia and vaginismus which included: lack of awareness, experiencing the physical symptoms of anxiety, fear, predicting pain, feeling of inadequacy and inferiority, feeling of shame, hatred of sex and of spouse, a feeling of suffering, feeling of anger, feeling of guilt, decreased emotional and sexual intimacy, and regret about marriage. Conclusion: The results of this study also enrich the previous research literature on the lived experience of dyspareunia and vaginismus. Also, the structure of the lived experience of dyspareunia and vaginismus derived from this study is widely used to develop and apply preventive and therapeutic programs for this condition and its consequences.

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