59. General medicine residents' perception of the mini-CEXs

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
S. Malhotra ◽  
R. Hatala ◽  
C.-A. Courneya
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Focus Group ◽  
Qualitative Study ◽  
Focus Groups ◽  
General Medicine ◽  
Clinical History ◽  
Phenomenological Approach ◽  
Medical Teacher ◽  
The Impact

The mini-CEX is a 30 minute observed clinical encounter. It can be done in the outpatient, inpatient or emergency room setting. It strives to look at several parameters including a clinical history, physical, professionalism and overall clinical competence. Trainees are rated using a 9-point scoring system: 1-3 unsatisfactory, 4-6 satisfactory and 7-9 superior. Eight months after the introduction of the mini-CEX to the core University of British Columbia Internal Medicine Residents, a one hour semi-structured focus group for residents in each of the three years took place. The focus groups were conducted by an independent moderator, audio-recorded and transcribed. Using a phenomenological approach the comments made by the focus groups participants were read independently by three authors, organized into major themes. In doing so, several intriguing common patterns were revealed on how General Medicine Residents perceive their experience in completing a mini-CEX. The themes include Education, Assessment and Preparation for the Royal College of Physicians and Surgeons Internal Medicine exam. Resident learners perceived that the mini-CEX process provided insight into their clinical strengths and weaknesses. Focus group participants favored that the mini-CEX experience will benefit them in preparation, and successful completion of their licensing exam. Daelmans HE, Overmeer RM, van der Hem-Stockroos HH, Scherpbier AJ, Stehouwer CD, van der Vleuten CP. In-training assessment: qualitative study of effects on supervision and feedback in an undergraduate clinical rotation. Medical Education 2006; 40(1):51-8. De Lima AA, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. Medical Teacher January 2005; 27(1):46-52. DiCicco-Bloom B, Crabtree BF. The Qualitative Research Interview. Medical Education 2006; 40:314-32.

scholarly journals Primary care teams’ experiences of delivering mental health care during the COVID-19 pandemic: a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rachelle Ashcroft ◽  
Catherine Donnelly ◽  
Maya Dancey ◽  
Sandeep Gill ◽  
Simon Lam ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Qualitative Study ◽  
Mental Health Care ◽  
Focus Groups ◽  
Care Delivery ◽  
Virtual Care ◽  
Primary Care Teams ◽  
The Impact

Abstract Background Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams’ delivery of mental health care. Methods A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. Results We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. Conclusions From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care’s capacity for mental health care for the duration of the pandemic and beyond.

scholarly journals IS PATIENT SAFETY AT THE HEART OF MEDICAL EDUCATION IN INDONESIA? REFLECTION ON THE IMPACT OF THE NATIONAL EXAMINATION

2019 ◽  
Vol 8 (3) ◽  
pp. 153
Author(s):  
Rachmadya Nur Hidayah
Keyword(s):  
Medical Education ◽  
Quality Assurance ◽  
Patient Safety ◽  
Focus Groups ◽  
Patient Care ◽  
Medical Schools ◽  
Theory Approach ◽  
High Stakes ◽  
Teachers And Students ◽  
The Impact

ABSTRACT Background: National examinations in Indonesia (UKMPPD) has been implemented since 2007 as a quality assurance method for medical graduates and medical schools. The impact of UKMPPD has been studied since then, where one of the consequences were related to how it affected medical education and curricula. This study explored the consequences of UKMPPD, focusing on how the students, teachers, and medical schools’ leaders relate the examination with patient care. This study aimed to explore the impact of UKMPPD on medical education, which focusing on the issue of patient safety. Methods: This study was part of a doctoral project, using a qualitative method with a modified grounded theory approach. The perspectives of multiple stakeholders on the impact of the UKMPPD were explored using interview and focus groups. Interviews were conducted with medical schools’ representatives (vice deans/ programme directors), while focus groups were conducted with teachers and students. A sampling framework was used by considering the characteristics of Indonesian medical schools based on region, accreditation status, and ownership (public/ private). Data was analysed using open coding and thematic framework as part of the iterative process. Results: The UKMPPD affected how the stakeholders viewed this high-stakes examination and the education delivered in their medical schools. One of the consequences revealed how stakeholders viewed the UKMPPD and its impact on patient care. Participants viewed the UKMPPD as a method of preparation for graduates’ real clinical practice. The lack of reference for patient safety as the impact of the UKMPPD in this study showed that there were missing links in how stakeholders perceived the examination as part of quality assurance in health care. Conclusion: The UKMPPD as a high-stakes examination has a powerful impact in changing educational policy and programmes in Indonesia. However, in Indonesia, the examination brought in the reflection on how the “patient” element was lacking from medical education. This research offers an insight on the concept of patient safety in Indonesia and how the stakeholders could approach the issue. Keywords: UKMPPD, national licensing examination, impact, competence, patient safety, curriculum 

scholarly journals 3015 Enhancing Outcomes in Childcare Settings for Young Children with Behavior Disorders: An Examination of Conscious Discipline Implementation

2019 ◽  
Vol 3 (s1) ◽  
pp. 88-88
Author(s):  
Sufna Gheyara John ◽  
Nicola Edge ◽  
Michael Cucciare ◽  
Nicholas Long
Keyword(s):  
Early Childhood ◽  
Focus Group ◽  
Focus Groups ◽  
Positive Impact ◽  
Teacher Perspectives ◽  
Self Control ◽  
Barriers And Facilitators ◽  
Full Implementation ◽  
Perceived Impact ◽  
The Impact

OBJECTIVES/SPECIFIC AIMS: 1. Identify the extent of CD implementation for trained childcare teachers. 2. Explore teacher perspectives on the impact of CD. 3. Explore teacher perspectives on barriers and facilitators to full implementation of CD. METHODS/STUDY POPULATION: We conducted a survey with 267 childcare teachers who had been trained in CD across the state, representing early childhood educational environments in urban and rural settings. Specific questions were asked related to level of CD implementation, perceived benefit, and facilitators/barriers to full implementation. A random subset of the sample (8 teachers) participated in a subsequent focus group to explore survey themes in greater depth. Focus group members were asked about their rationale for attending CD training, CD implementation (including barriers/facilitators to full implementation), and perceived impact on their classrooms. The focus group was recorded and transcribed to capture questions and comments. RESULTS/ANTICIPATED RESULTS: Objective 1: 1. 30% of teachers reported full implementation of CD. 2. 50% of teachers reported partial implementation of CD. Objective 2: 1. The vast majority of teachers (95%) agreed that CD had a positive impact on their classroom, including better structure and enhanced relationships with the children. 2. The vast majority of teachers (85%) agreed that CD had a positive impact on the children in their classroom, including increases in problem-solving abilities and self-control. Objective 3: 1. Most teachers (71%) reported experiencing barriers to CD implementation, with the majority of those surveyed (93%) stating that additional implementation support would be helpful. 2. The top three barriers to implementation elicited in survey and focus groups included uncertainty regarding how to begin implementing CD in the classroom, lacking materials for CD implementation, and lacking time to focus on applying knowledge from training into the classroom. 3. The top three facilitators for implementation elicited in survey and focus groups included coaching support for teachers, training agency leadership in CD, and greater perceived impact of CD. DISCUSSION/SIGNIFICANCE OF IMPACT: Childhood disruptive behaviors are among the most frequent reasons for referral to specialized services in and out of the classroom (Sukhodolsky, Smith, McCauley, Ibrahim, & Piasecka, 2016). Disruptive and aggressive behaviors are problematic, not only for victims of children who are aggressive but also for aggressive children as they age. Although effective treatments exist, the level of effective implementation of these interventions are understudied. These results demonstrate that 2/3 of teachers trained in CD are not fully implementing the model and provides concrete barriers and facilitators to current implementation. These data will provide the initial foundation for the development of a targeted implementation strategy that supports full implementation of CD within early childhood education settings.

scholarly journals Quick diagnostic unit integrated in an emergency department setting reduces medical admissions – an observational study

2013 ◽  
Vol 3 (3) ◽  
pp. 17 ◽  
Author(s):  
Dan Brun Petersen ◽  
Thomas Andersen Schmidt
Keyword(s):  
Internal Medicine ◽  
Emergency Department ◽  
General Medicine ◽  
University Hospital ◽  
First Year ◽  
Special Focus ◽  
Diagnostic Study ◽  
Diagnostic Unit ◽  
Number Of Patients ◽  
The Impact

Background: Hospitals in countries with public health systems have recently adopted organizational changes to improve efficiency and resource allocation, and reducing inappropriate hospitalizations has been established as an important goal, as well as avoiding or buffering overcrowding in Emergency Departments (EDs). Aims: Our goal was to describe the impact of a Quick Diagnostic Unit established on January 1, 2012, integrated in an ED setting in a Danish public university hospital following its function for the first year. Design: Observational, descriptive and comparative study. Methods: Our sample comprised the total number of patients being admitted and discharged from the Department of Internal Medicine in 2011 and 2012, with special focus on the General Medicine Ward. Results: Compared with 2011 the establishment of the Quick Diagnostic Unit integrated in the Emergency Department resulted in the admittance and discharge of fewer patients (40%; p < .0001) to the hospital’s General Medicine Ward and 11.6% (p < .0001) fewer patients in the whole Department of Internal Medicine. Conclusions: A Quick Diagnostic Unit integrated in an ED setting represents a useful and fast track model for the diagnostic study and treatment of patients with simple internal medicine ailments, and also serves as a buffer for overcrowding of the ED.

scholarly journals Postgraduate work-based learning: a qualitative study

2019 ◽  
Vol 9 (4) ◽  
pp. 637-649
Author(s):  
Victoria Stewart ◽  
Matthew Campbell ◽  
Sara S. McMillan ◽  
Amanda J. Wheeler
Keyword(s):  
Qualitative Study ◽  
Lived Experience ◽  
Professional Practice ◽  
Phenomenological Approach ◽  
Learning Opportunities ◽  
Limited Attention ◽  
Content Type ◽  
Postgraduate Students ◽  
Interpretative Phenomenological Approach ◽  
The Impact

Purpose The purpose of this paper is to explore the experiences of students and teachers who had participated in a postgraduate work-based praxis course within a Master of mental health practice qualification. Design/methodology/approach This qualitative study used an interpretative phenomenological approach to understand the lived experience of students and course convenors participating in a work-based praxis course. Seven students and two convenors were recruited. Interview and reflective portfolio data were analysed thematically. Findings The main themes identified were the importance of planning, the value of partnerships, the significance of learning in the workplace and how the facilitation of work-based learning differs from coursework. Originality/value Work-based learning within postgraduate coursework qualifications can support higher-level learning, knowledge and skills has received limited attention in the literature. This study supported the value of providing postgraduate students with work-based learning opportunities, resulting in the application of new or advanced skills, within their existing work roles. This study is important, because it provides insights into the student experience of postgraduate work-based learning and the impact of this learning on professional practice.

scholarly journals Identifying and describing a model region to evaluate the impact of telemedicine

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Harst ◽  
S Oswald ◽  
P Timpel
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Focus Groups ◽  
Health Care Providers ◽  
Rural Areas ◽  
Demographic Data ◽  
Care Providers ◽  
Age Related ◽  
Model Region ◽  
The Impact

Abstract Background Telemedicine solutions providing patient-centered care over distance need to be integrated into the regional setting. The acceptance by both providers and patients hat to be continuously evaluated using methods of participatory implementation research. In controlled trials, often taking place in laboratory settings, these methods cannot be applied. In the following, research in progress is presented. Methods Based on socio-demographic data, epidemiology prevalence of age-related chronic diseases and data on the value of health care provision in Saxony, Germany a model region was chosen. Then, a focus group (n = 6) was conducted to differentiate the results and analyze the health networks of patients. For this, network maps putting the individual in the middle and his/her sources of information and support in case of illness in concentric circles around it, were used. The focus group was audiotaped, transcribed and analyzed by two researchers using MaxQDA. Results With a mean age of 47.8 years (n = 17,431), high prevalence of diabetes (&gt;15.85 %) and hypertension (&gt;39.1%) and an expected shortage of primary physicians in 2030, the town of Kamenz is a mirror image of the current health care challenges in rural areas of Saxony. Participants of the focus groups also stated problems in finding a primary physician or a dentist. Compensatory behavior, such as traveling large distances, relying on self-researched online diagnoses and immediately going to the emergency room for medical support was described. According to the network maps, primary sources of support in case of illness are partners and relatives, yet there is little connection between those and health care providers, as well as between different medical specialists. Conclusions The results will lead to potential use cases of telemedicine to be included into a standardized questionnaire for the assessment of telemedicine readiness in the model region. Key messages Telemedicine implementation in a rural area can be studied using a participatory approach. Focus groups and network maps are useful qualitative methods for participatory research and can inform the design of quantitative measurements.

scholarly journals Motivations, experiences and aspirations of Trainee Nursing Associates in England. A qualitative study

2020 ◽  
Author(s):  
Rachel Louise King ◽  
Emily Wood ◽  
Steve Robertson ◽  
Tony Ryan ◽  
Angela Tod
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Personal Development ◽  
Group Discussion ◽  
Policy And Practice ◽  
The North ◽  
Previous State ◽  
Academic Workload ◽  
The Uk ◽  
The Impact

Abstract Background: The nursing associate role was developed in England in response to the ‘Shape of Caring’ review. It has been implemented to fulfil two aims; to bridge the gap between registered nurses and healthcare assistants, and to provide an alternative route into registered nursing in light of workforce shortages. Other high income countries deploy second level nurses within their healthcare systems, however the UK has a turbulent history with such roles. The previous state enrolled nurse was phased out in the 1990s, and more recently the assistant practitioner (AP) role has faced wide variation in titles, scope and pay. Little is known about those who have embarked on the new nursing associate training course and their experiences of the role. Methods: An exploratory qualitative study was undertaken using focus groups of trainee nursing associates to generate in-depth discussion about their motivations, experiences of training, and career aspirations.Three focus groups (n=15) took place in December 2018 using a purposive sample of trainee nursing associates registered at a University in the North of England. Two researchers facilitated each group discussion at a time and place convenient for participants. The discussions were audio recorded, transcribed and data was analysed thematically.Results: This study found that trainee nursing associates are motivated by affordable, local, career development. During training they face challenges relating to clinical support, academic workload and uncertainty about future career opportunities. They experience role ambiguity both individually and across the wider organisation. Trainee nursing associates rely on broad support networks to build their occupational identity.Conclusions: The barriers and facilitators of trainee nursing associate personal development have implications for policy and practice relating to recruitment and retention. The results increase our understanding of this emerging role, and have informed the development of a larger longitudinal cohort study. Further research is required to evaluate the impact of this new role.

Are you a mentor? A qualitative study: imago-graphic students’ mirror views

2021 ◽  
Vol 8 (3) ◽  
pp. 652-661
Author(s):  
Rania Alkhadragy
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Focus Groups ◽  
Negative Perception ◽  
Personal Support ◽  
Self Development ◽  
The Common ◽  
Group Focus ◽  
Essential Skills

Objectives: Mentoring is widely acknowledged for providing support, fostering students’ learning and self-development. This study was conducted at the Faculty of Medicine, Suez Canal University with the following objectives, exploring students’ perception of their mentors, analysing expected roles and essential skills for mentors. Methodology: A qualitative study was conducted. A focus group was planned in the first mentorship session, a sample of 30  year 1 and 2 students divided into 2 focus groups  (n=15 students per a focus group). Focus group started with an imaginary students’ drawing of the mentor followed by further analysis and discussion. Results: Data displayed in a graphical format, and then further discussed to have more details. Three main themes had emerged: perception of mentors, role of the mentor and expectations from mentors. Perception was then analysed into positive, where the ease of communication was mostly discussed, and negative perception where the fear of humiliation was one of the common students’ fears. For mentors’ roles, guidance for portfolio submission was the highest frequency (45%) then came the role of academic and personal support (30%).   Conclusion: Mentorship experience is a rich process of interaction and communication between mentors and mentees. Mentors should receive appropriate training to be well prepared for their roles. This study provides practical insights into essential skills mentors should have for an effective mentorship experience. Keywords: mentorship, info-graphic, mentors, qualitative, focus group

scholarly journals Chronic Pain Self-Management Program for Low-Income Patients: Themes from a Qualitative Inquiry

Pain Medicine ◽  
2018 ◽  
Vol 21 (2) ◽  
pp. e1-e8 ◽  
Author(s):  
Barbara J Turner ◽  
Natalia Rodriguez ◽  
Raudel Bobadilla ◽  
Arthur E Hernandez ◽  
Zenong Yin
Keyword(s):  
Chronic Pain ◽  
Focus Group ◽  
Qualitative Study ◽  
Focus Groups ◽  
Low Income ◽  
Pain Medication ◽  
Management Program ◽  
Qualitative Inquiry ◽  
Self Management ◽  
Theory Approach

Abstract Objective To examine factors influencing initial engagement, ongoing participation, learned behaviors, and subjective functional outcomes after a trial of the Living Better Beyond Pain (LBBP) chronic pain self-management program. Design Qualitative study using the Grounded Theory approach. Setting Two 60-minute focus groups and phone interviews in May 2017. Subjects Focus groups with 18 participants who completed LBBP and six-month measures; telephone interviews with 17 participants who stopped attending. Methods Study coordinators randomly selected program completers for focus groups and conducted phone interviews with noncompleters. Inductive thematic analysis was used to identify patterns in semantic content with a recursive process applied to focus group transcripts and interview transcriptions to codify into themes. Themes were categorized according to the Theory of Planned Behavior. Results Focus group and telephone interview participants were primarily Hispanic and unemployed. Attitudes fostering participation in LBBP included dissatisfaction with the status quo, need to reduce pain medication, and lack of training and knowledge about chronic pain. Positive social norms from meeting others with chronic pain and support from the LBBP team encouraged attendance and adoption of behaviors. Transportation, pain, and competing activities were barriers, whereas adapting activities for the disabled was a facilitator. Maintaining behaviors and activities at home was challenging but ultimately rewarding due to improvement in daily function with less pain medication. Conclusions This qualitative study complements quantitative results showing clinically significant improvements in function after the LBBP program by adding practical insights into ways to increase participation and outcomes. Participants strongly endorsed the need for chronic pain self-management training.

scholarly journals Feasibility of implementation of CARD™ for school-based immunizations in Calgary, Alberta: a cluster trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Taddio ◽  
Joanne Coldham ◽  
Charlotte Logeman ◽  
C. Meghan McMurtry ◽  
Cheri Little ◽  
...  
Keyword(s):  
Public Health ◽  
Focus Group ◽  
Focus Groups ◽  
Coping Strategies ◽  
School Staff ◽  
Health Staff ◽  
Cluster Trial ◽  
School Based ◽  
Public Health Staff ◽  
The Impact

Abstract Background Negative experiences with school-based immunizations can contribute to vaccine hesitancy in youth and adulthood. We developed an evidence-based, multifaceted and customizable intervention to improve the immunization experience at school called the CARD™ (C-Comfort, A-Ask, R-Relax, D-Distract) system. We evaluated the feasibility of CARD™ implementation for school-based immunizations in Calgary, Canada. Methods In a mixed methods study, two Community Health Centres providing immunization services, including 5 schools each with grade 9 students (aged approximately 14 years), were randomized to CARD™ or control (usual care). In the CARD™ group, public health staff and students were educated about coping strategies prior to immunization clinics. Clinics were organized to reduce fear and to support student’s choices for coping strategies. Public health staff in the CARD™ group participated in a focus group discussion afterwards. We sought a recruitment rate of 80% for eligible schools, an external stakeholder focus group (e.g., school staff) with 6 or more individuals, 85% of individual injection-related data acquisition (student and immunizer surveys), and 80% absolute agreement between raters for a subset of data that were double-coded. Across focus groups, we examined perceptions of acceptability, appropriateness, feasibility and fidelity of CARD™. Results Nine (90%) of eligible schools participated. Of 219 students immunized, injection-related student and immunizer data forms were acquired for 195 (89.0%) and 196 (89.5%), respectively. Reliability of data collection was high. Fifteen public health and 5 school staff participated in separate focus groups. Overall, attitudes towards CARD™ were positive and compliance with individual components of CARD™ was high. Public health staff expressed skepticism regarding the value of student participation in the CARD™ system. Suggestions were made regarding processes to refine implementation. Conclusion While most outcome criteria were satisfied and overall perceptions of implementation outcomes were positive, some important challenges and opportunities were identified. Feedback is being used to inform a large cluster trial that will evaluate the impact of CARD™ during school-based immunizations. Trial registration The trial is registered at ClinicalTrials.gov (NCT03948633); Submitted April 24, 2019.

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