scholarly journals Internal Medicine Residents’ Perceptions of Nephrology as a Career: A Focus Group Study

Kidney360 ◽  
2020 ◽  
Vol 1 (10) ◽  
pp. 1050-1057
Author(s):  
Natalie Beck ◽  
Seth Furgeson ◽  
Michel Chonchol ◽  
Jessica Kendrick

BackgroundInterest in nephrology as a career has declined dramatically over the past several years. Only 62% of nephrology fellowship positions are filled for the upcoming 2020 appointment year. The purpose of this study was to identify perceptions, attitudes, motivators, and barriers to a career in nephrology among internal medicine residents.MethodsWe recruited focus groups of internal medicine residents (N=25) from the University of Colorado, and asked questions aimed at exploring perceptions, attitudes, and barriers to a career in nephrology, and ways to increase interest in nephrology. All focus groups were conducted on the University of Colorado Denver Anschutz Medical Campus. Focus group sessions were recorded and transcribed. Thematic analysis was used to identify key concepts and themes.ResultsResidents described many barriers to a career in nephrology, including lack of exposure, lack of advances in the field, low monetary compensation, high complexity, lack of role models/mentors, and low-prestige/noncompetitive nature of the field. Most residents had no exposure to outpatient nephrology. Lack of new therapeutics was a significant deterrent to nephrology. Nephrology teaching in medical school was described as not clinically relevant and too complicated. Several residents felt they were not smart enough for nephrology. Only three residents had a role model within nephrology. Residents used the word “stigmatized” to describe nephrology, and discussed how low prestige decreased their interest in a field. Participants expressed suggestions to increase interest in nephrology through earlier and more outpatient nephrology exposure, enhanced interactions with nephrologists, and research and advancements in the field.ConclusionsResidents identified several modifiable barriers to a career in nephrology. Changing how nephrology is taught in medical school, enhancing interactions with nephrologists through increased exposure, and highlighting research and advancements in nephrology may change the perception of nephrology and increase the number of residents entering the field.

2008 ◽  
Vol 3 (3) ◽  
pp. 228-237 ◽  
Author(s):  
Kathlyn E. Fletcher ◽  
Vikas Parekh ◽  
Lakshmi Halasyamani ◽  
Samuel R. Kaufman ◽  
Marilyn Schapira ◽  
...  

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
S. Malhotra ◽  
R. Hatala ◽  
C.-A. Courneya

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.


2021 ◽  
Vol 12 (02) ◽  
pp. 355-361
Author(s):  
Kinjal Gadhiya ◽  
Edgar Zamora ◽  
Salim M. Saiyed ◽  
David Friedlander ◽  
David C. Kaelber

Abstract Background Drug alerts are clinical decision support tools intended to prevent medication misadministration. In teaching hospitals, residents encounter the majority of the drug alerts while learning under variable workloads and responsibilities that may have an impact on drug-alert response rates. Objectives This study was aimed to explore drug-alert experience and salience among postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2), and postgraduate year 3 (PGY-3) internal medicine resident physicians at two different institutions. Methods Drug-alert information was queried from the electronic health record (EHR) for 47 internal medicine residents at the University of Pennsylvania Medical Center (UPMC) Pinnacle in Pennsylvania, and 79 internal medicine residents at the MetroHealth System (MHS) in Ohio from December 2018 through February 2019. Salience was defined as the percentage of drug alerts resulting in removal or modification of the triggering order. Comparisons were made across institutions, residency training year, and alert burden. Results A total of 126 residents were exposed to 52,624 alerts over a 3-month period. UPMC Pinnacle had 15,574 alerts with 47 residents and MHS had 37,050 alerts with 79 residents. At MHS, salience was 8.6% which was lower than UPMC Pinnacle with 15%. The relatively lower salience (42% lower) at MHS corresponded to a greater number of alerts-per-resident (41% higher) compared with UPMC Pinnacle. Overall, salience was 11.6% for PGY-1, 10.5% for PGY-2, and 8.9% for PGY-3 residents. Conclusion Our results are suggestive of long-term drug-alert desensitization during progressive residency training. A higher number of alerts-per-resident correlating with a lower salience suggests alert fatigue; however, other factors should also be considered including differences in workload and culture.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049829
Author(s):  
Elizabeth Tyler ◽  
Fiona Lobban ◽  
Rita Long ◽  
Steven H Jones

ObjectivesAs awareness of bipolar disorder (BD) increases and the world experiences a rapid ageing of the population, the number of people living with BD in later life is expected to rise substantially. There is no current evidence base for the effectiveness of psychological interventions for older adults with BD. This focus group study explored a number of topics to inform the development and delivery of a recovery-focused therapy (RfT) for older adults with BD.DesignA qualitative focus group study.SettingThree focus groups were conducted at a university in the North West of England.ParticipantsEight people took part in the focus groups; six older adults with BD, one carer and one friend.ResultsParticipant’s responses clustered into six themes: (1) health-related and age-related changes in later life, (2) the experience of BD in later life, (3) managing and coping with BD in later life, (4) recovery in later life, (5) seeking helping in the future and (6) adapting RfT for older people.ConclusionsParticipants reported a range of health-related and age-related changes and strategies to manage their BD. Participants held mixed views about using the term ‘recovery’ in later life. Participants were in agreement that certain adaptations were needed for delivering RfT for older adults, based on their experience of living with BD in later life. The data collected as part of the focus groups have led to a number of recommendations for delivering RfT for older adults with BD in a randomised controlled trial (Clinical Trial Registration: ISRCTN13875321).


2017 ◽  
Vol 27 (1) ◽  
pp. 72-77 ◽  
Author(s):  
Crawford Moodie

IntroductionTobacco companies have a long tradition of including promotional material within cigarette packs, such as cigarette cards and coupons. Only in Canada are they required, by the government, to include educational material within cigarette packs, in the form of inserts highlighting the benefits of quitting or providing tips on how to do so.MethodsTwenty focus groups were conducted in Glasgow and Edinburgh in 2015, with smokers (n=120) segmented by age (16–17, 18–24, 25–35, 36–50, >50), gender and social grade, to explore perceptions of the inserts used in Canada.ResultsThe consensus was that these inserts would capture attention and be read due to their novelty and visibility before reaching the cigarettes, and as they can be removed from the pack. While they may be ignored or discarded, and rotation was considered necessary, they were generally thought to prolong the health message. The positive style of messaging was described as refreshing, educational, encouraging, reassuring and inspirational and thought to increase message engagement. It was regarded as more sympathetic than command-style messaging, offering smokers ‘a bit of hope’. The inserts were often considered preferable to the on-pack warnings, although it was felt that both were needed. Some participants suggested that inserts could encourage them to stop smoking, and they were generally viewed as having the potential to alter the behaviour of others, particularly younger people, would-be smokers and those wanting to quit.ConclusionsInserts are an inexpensive means of communication and offer regulators a simple way of supplementing on-pack warnings.


2021 ◽  
Vol 12 ◽  
Author(s):  
Sonam Zamir ◽  
Felicity Allman ◽  
Catherine Hagan Hennessy ◽  
Adrian Haffner Taylor ◽  
Ray Brian Jones

BackgroundVideo-calls have proven to be useful for older care home residents in improving socialization and reducing loneliness. Nonetheless, to facilitate the acceptability and usability of a new technological intervention, especially among people with dementia, there is a need for user-led design improvements. The current study conducted focus groups with an embedded activity with older people to allow for a person-centered design of a video-call intervention.MethodsTwenty-eight residents across four care homes in the South West of England participated in focus groups to aesthetically personalize and ‘dress-up’ the equipment used in a video-call intervention. Each care home was provided with a ‘Skype on Wheels’ (SoW) device, a wheelable ‘chassis’ comprising an iPad or tablet for access to Skype, and a telephone handset. During the focus group, residents were encouraged to participate in an activity using colorful materials to ‘dress-up’ SoW. Comments before, during and after the ‘dress up’ activity were audio recorded. Framework analysis was used to analyze the focus group data.ResultsOlder people, including seven with dementia were able to interact with and implement design changes to SoW through aesthetic personalization. Themes arising from the data included estrangement, anthropomorphism, reminiscence, personalization, need for socialization versus fear of socialization and attitudes toward technology. After this brief exposure to SoW, residents expressed the likelihood of using video-calls for socialization in the future.ConclusionCare home residents enjoy engaging with new technologies when given the opportunity to interact with it, to personalize it and to understand its purpose. Low cost aesthetic personalization of technologies can improve their acceptability, usability, and implementation within complex care environments.


2020 ◽  
Author(s):  
Anne-Laure Philippon ◽  
Jennifer Truchot ◽  
Nathalie De Suremain ◽  
Marie-Christine Renaud ◽  
Arnaud Petit ◽  
...  

Abstract Background Simulation-based assessment is scarcely used for undergraduate medical students. We created a simulation-based assessment to validate medical students’ technical and psychometrics’ skills, during their emergency medicine and pediatric curriculum. The aim of our study was to collect medical students’ perception on this novel assessment.Methods This is a qualitative study that includes 9 focus groups among the 215 students who participated in either a pediatric or an emergency medicine simulation-based-course. These sessions ended by an assessment on a manikin. Among the 40 students who were randomly selected to participate in the focus groups, 30 agreed to participate. Data were analyzed using grounded theory and, data were coded the by two independent investigators.Results Seven major and two minor themes emerged from the focus groups. The importance of being certified by simulation to be more self-confident in hospital clerkships, the perception of simulation-based assessment as a high quality assessment, the contribution of the simulation-based assessment to change students’ practices and enhance their engagement in their curriculum and a disappointment because simulation-based assessment didn’t help student for the faculty high stakes assessments. Some students also found that simulation-based assessment was a stressful and unfair exercise. The last discussion was about practical issues of the assessment such as this normative way, and about the importance of the feedback.Conclusion The students reported positive aspects of the simulation-based assessment method such as helpful for their hospital clerkship, change of their practices and way of learning. However they also reported that it might be a biased and a stressful assessment method.


Water ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 3467
Author(s):  
Cillian P. McDowell ◽  
Luisa Andrade ◽  
Viviana Re ◽  
Jean O’Dwyer ◽  
Paul D. Hynds ◽  
...  

Flooding events can inflict major disruption on society and cause significant infrastructural and environmental damage. However, the adverse health impacts of flooding, particularly as they pertain to private groundwater resources used for consumption, are frequently overlooked. Whilst the literature has previously found a lack of well stewardship among private well owners under ‘normal’ conditions, our understanding of private well owners’ perceptions of and preparedness for the risks posed by flooding to their domestic well-water supply is limited. This study advances the qualitative literature on this subject. It is amongst the first qualitative studies employing focus groups to examine private well owners, and the first in an Irish context. Six focus groups were conducted in four counties in Ireland, with the themes emerging from the focus groups refined, organised, and interpreted in the context of the Health Belief Model. Most focus group participants expressed awareness of the potential severity of well contamination following flooding, but many did not consider their local area “at risk” of it, notwithstanding the occurrence of previous local flooding events. All focus group participants shared the view that owners were primarily responsible for their own wells. However, their capacity to undertake appropriate actions was reduced by reliance on visual and olfactory evidence to assess water quality, and concerns regarding the financial cost and accessibility of water testing facilities. The phenomenon of misperception was also evident among participants. In light of the increasing frequency and severity of extreme weather events including flooding, these findings provide direction for future socio-hydrogeological interventions. Targeted communication strategies highlighting the risks posed by flooding, mitigation measures that promote well stewardship, and protective behaviours are required. The provision of access to free well water testing would also promote protective actions.


2021 ◽  
Vol 1 (2) ◽  
pp. 73-77
Author(s):  
Hairunnisa Hairunnisa ◽  
Irsalinda Wesa Nurrahim ◽  
Shiba Syahidah Syahidah ◽  
Ahmad Naufal Rifaldi ◽  
Muhammad Naufal Al-Hadad

Mahasiswa S1 Psikologi merupakan bagian dari masa depan bangsa yang diharapkan mampu memberikan teladan dalam kepemimpinan di masyarakat luas. Setiap prilaku dan ucapan yang disampaikan diharapkan menjadi contoh dan teladan yang baik untuk masyarakatnya. Agar hal tersebut terlaksana dengan baik maka diperlukan dan menjadi keharusan untuk dibekali keterampilan berbicara yang baik dan santun, sehingga mereka mampu menjadi tenaga-tenaga pamong yang handal, kompeten, tangguh dan professional dalam menangani permasalahan-permasalahan masyarakat dan memberikan pelayanan kepada public. Strategi yang digunakan dalam kegiatan pelatihan Public Speaking untuk profesi psikologi ini ialah menggunakan Focus Group Discussion (FGD). FGD itu sendiri ialah diskusi terfokus dari suatu grup dalam membahas suatu masalah tertentu. Diharapkan setelah ini Mahasiswa mendapatkan manfaat secara komprehensif dalam keterampilan dasar dan lanjutan untuk penerapan kepiawaian berbicara yang baik dan santun dihadapan public sehingga menjadi motivator/interest rekan sejawat di lingkungan kampus.    Kata Kunci : Profesi Psikologi, Ilmu komunikasi, Public Speaking Abstract: Undergraduate Psychology students are part of the nation's future who are expected to be able to provide role models in leadership in the wider community. Every behavior and speech conveyed is expected to be a good example and role model for the community. In order for this to be carried out properly, it is necessary and imperative to be equipped with good and polite speaking skills, so that they are able to become reliable, competent, tough and professional civil servants in dealing with community problems and providing services to the public. The strategy used in the Public Speaking training for the psychology profession is to use a Focus Group Discussion (FGD). FGD itself is a focused discussion of a group in discussing a particular problem. It is hoped that after this students will get comprehensive benefits in basic and advanced skills for the application of good and polite speaking skills in front of the public so that it becomes a motivator / interest for colleagues in the campus environment.   Keyword: Profession Psychology, Communication Studies, Public Speaking


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