Willingness of medical students to refer patients to a physician associate or a doctor based on clinical scenarios when time is a trade-off

Background: The Physician Associate (PA) role was introduced in Ireland in 2015 in an effort to bolster medical services. From the perspective of the patient and staff they have been well received. However, the attitude of medical students about PAs is not known.Objective: To investigate the willingness of medical students to refer patients to a PA or a doctor.Methods: A quantitative study was undertaken using an online survey with a sample of 1,909 undergraduate and graduate entry medical students. Based on three outpatient scenarios, they were asked, in their role as future intern (PGY1), to choose a referral to a PA or a doctor, with six time trade-off options offered. Year of study, country of residence and working or treatment experience with PAs and Nurse Practitioners were recorded. Descriptive statistics, and logistic regression models were used.Results: In 2019, in Dublin, 177 medical students took part in the survey. Those surveyed were international and domestic nationals. Overall the PA option was chosen where the patient’s wait time was shorter and the clinical condition was perceived more serious. The doctor option was selected more readily when the wait time difference was less significant. Respondents from countries with established PA roles may have had experience to choose PAs than naïve ones.Conclusion: This study confirms that medical students’ willingness to refer a patient is influenced by familiarity with the PA role and severity of the medical condition. In addition wait time is a primary motivator for selecting the PA over doctor option. These findings suggest a need to improve communication about the PA role among Irish medical students.

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Patient willingness to be seen by a physician associate in Ireland

International Journal of Healthcare ◽

10.5430/ijh.v4n2p41 ◽

2018 ◽

Vol 4 (2) ◽

pp. 41 ◽

Cited By ~ 5

Author(s):

Pauline Joyce ◽

Richard Arnett ◽

Arnold Hill ◽

Roderick S. Hooker

Keyword(s):

Patient Preference ◽

Medical Condition ◽

Wait Time ◽

Mixed Methods Study ◽

Medical Provider ◽

Specific Patient ◽

Trade Off ◽

Knowing That ◽

The Mean ◽

Gender Specific

Background: The physician associate (PA) role was piloted in Dublin, Ireland between 2015 and 2017. However, the concept of a PA and the acceptance of their role in Ireland had not been explored.Objective: To investigate the willingness of Irish citizens to be seen by a PA based on medical scenarios in a typical clinical setting.Design: A mixed methods study was undertaken. A preference survey, with three medical scenarios, gave participants a choice to be treated by a PA or a doctor, with two time trade-off options offered. Responses were supported with qualitative text. Four hundred people were invited to participate as surrogate patients.Setting and participants: In 2017 a total of 270 respondents took part in the study (67.5%) in two hospitals (one private and one public) in Dublin. The mean age was 60; male (n = 142) and female (n = 128) respondents.Findings: In total, 95% of the respondents chose to see a PA over a doctor based on the scenarios presented and a wait time of 30 minutes. Wait time, trust, competency and the severity or seriousness of the medical condition were categorized into three themes for choosing the PA over the doctor. The “surrogate patient” decisions made by this sample were influenced by knowing that the PA is supervised and can check decisions with his/her supervizing physician.Conclusion: These findings are consistent with studies carried out in other countries where willingness to be seen by a PA is neither age nor gender specific. Patient preference seems to concur around the importance of trust and confidence in the medical provider.

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Determinants of Confidence in Overall Knowledge About COVID-19 Among Healthcare Workers in South Africa: Results From an Online Survey

Frontiers in Public Health ◽

10.3389/fpubh.2021.614858 ◽

2021 ◽

Vol 9 ◽

Author(s):

Thabang Manyaapelo ◽

Tholang Mokhele ◽

Sibusiso Sifunda ◽

Philisiwe Ndlovu ◽

Natisha Dukhi ◽

...

Keyword(s):

South Africa ◽

Nurse Practitioners ◽

Healthcare Workers ◽

Online Survey ◽

Control Measures ◽

Doctorate Degree ◽

Logistic Regression Models ◽

Factors Associated ◽

Positive Performance ◽

Study Population

Background: Adequate information and knowledge about COVID-19 has been shown to induce the confidence and positive performance among healthcare workers (HCWs). Therefore, assessing the relationship between confidence in knowledge and associated factors among HCWs is vital in the fight against COVID-19. This paper investigates factors associated with HCWs' confidence in their overall knowledge about COVID-19 in South Africa in the early stages of the epidemic.Methods: Data utilized in this paper were from an online survey conducted among HCWs using a structured questionnaire on a data free online platform. The study population were all the medical fraternity in South Africa including medical and nurse practitioners as well as other healthcare professionals. Bivariate and multivariate logistic regression models were performed to examine the factors associated with confidence in HCWs' overall knowledge about COVID-19.Results: Overall, just below half (47.4%) of respondents indicated that they had confidence in their overall knowledge about COVID-19. Increased odds of having confidence in the knowledge about COVID-19 were significantly associated with being male [aOR = 1.31 95% CI (1.03–1.65), p < 0.05], having a doctorate degree [aOR = 2.01 (1.23–3.28), p < 0.05], being satisfied with the information about COVID-19 guidelines [aOR = 6.01 (4.89–7.39), p < 0.001], having received training in 6–8 areas [aOR = 2.54 (1.89–3.43), p < 0.001] and having received training in 9–11 areas [aOR = 5.33 (3.81–7.47), p < 0.001], and having already treated COVID-19 patients [aOR = 1.43 (1.08–1.90), p < 0.001]. Those who were highly concerned with the levels of training of HCWs [aOR = 0.47 (0.24–0.92), p < 0.05] had decreased odds of having confidence in their overall knowledge about COVID-19.Conclusion: This study sheds light on the importance of capacitating HCWs with knowledge and adequate relevant training as part of infection prevention control measures during pandemics. Future training and information sharing should be sensitive to knowledge gaps by age, gender, qualifications, professional categories, and experience.

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Assessment of the Depression Level among Medical Students at University of Baghdad, College of Medicine

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v17i3.248 ◽

2021 ◽

Vol 17 (3) ◽

pp. 175-179

Author(s):

Zainab Ali Jaber ◽

Raghad Awfeeq Salman ◽

Dania Yasser Abid Al Wahab ◽

Manal Adnan Habib ◽

Israa Ali Hussein

Keyword(s):

Medical Students ◽

Online Survey ◽

Medical Condition ◽

Well Being ◽

Cross Sectional Study ◽

Mild Depression ◽

Major Life ◽

Cross Sectional ◽

Prevalence Of Depression ◽

The University

Background: Depression, a state of low mood and aversion to activity, can affect people's thoughts, behavior, tendencies, feelings, and sense of well-being. It can either be short-term or long-term, depending on the severity of the person's condition. Risk factors include personal or family history of depression, major life changes, trauma, stress, certain physical illnesses, and medications. Objective: This study investigates the prevalence of depression among medical students at the University of Baghdad, college of medicine in Iraq, and the association between some variables and depression. Subjects and Methods: A cross-sectional study design with a convenience sampling method was conducted. A sample of 323 medical students attending the University of Baghdad, college of medicine, were included in this study between July 2019 and September 2019, regardless of their age or gender. The study included five grades according to the year 2019-2020. An online survey was conducted using Google Forms which included two sections. Section 1 included questions about participants' demographics. The second section included the PHQ-9 (Patient Health Questionnaire-9) score. Results: A total of 323 students of different demographics participated in this study. The number of males was 108 (33.4%), and the number of females was 215 (66.6%). The frequency of participants who got mild depression was the highest, i.e., 127 (39.3%), whereas 85 (26.3%) were non-depressed. Therefore, this study sample had a high prevalence of depression. On the other hand, the frequency of mild-moderate depression was 57.9%. Conclusion: The prevalence of depression among medical students at the University of Baghdad was high. Gender, having friends, having a medical condition or disease, having family issues, whether it's easy to communicate with others, encountering an event that affected them, and having a family member who suffers from a psychological condition are associated with depression among students. In contrast, age, marital status, college year, seeking help in the past, and having a part-time job have no association with depression

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Quantifying empathy levels among UK undergraduate medical students: an online survey

British Journal of General Practice ◽

10.3399/bjgp20x711293 ◽

2020 ◽

Vol 70 (suppl 1) ◽

pp. bjgp20X711293

Author(s):

Sarah Garnett ◽

Hajira Dambha-Miller ◽

Beth Stuart

Keyword(s):

Medical Students ◽

Health Outcomes ◽

Medical School ◽

Curriculum Design ◽

Online Survey ◽

Mental Wellbeing ◽

Reactivity Index ◽

Free Text ◽

Undergraduate Medical Students ◽

Cross Sectional

BackgroundEmpathy is a key health care concept and refers to care that incorporates understanding of patient perspective’s, shared decision making, and consideration of the broader context in which illness is experience. Evidence suggests experiences of doctor empathy correlate with improved health outcomes and patient satisfaction. It has also been linked to job satisfaction, and mental wellbeing for doctors. To date, there is a paucity of evidence on empathy levels among medical students. This is critical to understand given that it is a key point at which perceptions and practices of empathy in the longer term might be formed.AimTo quantify the level of empathy among UK undergraduate medical studentsMethodAn anonymised cross-sectional online survey was distributed to medical students across three universities. The previously validated Davis’s Interpersonal Reactivity Index was used to quantify empathy. The survey also collected information on age, sex, ethnicity, year of medical school training and included a free-text box for ‘any other comments’.ResultsData analysis is currently underway with high response rates. Mean empathy scores by age, sex, year of study and ethnic group are presented. A correlation analysis will examine associations between age and year of study, and mean empathy sores.ConclusionThese data will help to provide a better understanding of empathy levels to inform the provision of future empathy training and medical school curriculum design. Given previous evidence linking experiences of empathy to better health outcomes, the findings may also be significant to future patient care

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Introduction of Wireless Buzzer to Improve Efficiency in Gynecology Triage (Preprint)

10.2196/preprints.19287 ◽

2020 ◽

Author(s):

Nicholas Mark Stansbury ◽

Erin Nelson

Keyword(s):

Medical Students ◽

Nurse Practitioners ◽

Nursing Staff ◽

Internal Control ◽

Patient Flow ◽

Low Cost ◽

Work Flow ◽

Optimal Time ◽

Nursing Experience ◽

Asking Questions

BACKGROUND Current workflow in GYN triage has medical students interviewing patients after triage by nursing staff. The optimal time to initiate patient contact is unclear. This confusion has led to duplication of questions to patients, interruptions for nurses and fewer patient encounters for students. OBJECTIVE Determine if a restaurant-style buzzer can streamline workflow in gynecology (GYN) triage. METHODS A Plan-Do-Study-Act approach was used. Stakeholders were medical students, nurses, Nurse Practitioners and physicians. Factors contributing to workflow slowdown: students re-asking questions of patients, interruption of nursing staff, confusion about optimal patient flow. The net result was fewer interviews completed by students. The project was introduced during clerkship orientation. Buzzers were provided on weeks 1, 3, 5 of the rotation. Weeks 2, 4, 6 no buzzers were provided as an internal control. After each clerkship, students received a survey assessing key areas of waste and workflow disruption. A focus group with ten nurses was also conducted. RESULTS From February-July 2019, 30/45 surveys were completed (66%) 1. Very difficult/difficult to know when to begin the encounter: 90% without; 21.4% with buzzer p<.001 2. Students re-asking questions: very often/often 96.7% without; 14.8% with buzzer p<.001 3. Nursing staff interruptions: 76.7% very often/often without; 18.5% with buzzer p<.001 4. The odds of interviewing 5 or more patients per shift are ~10X greater using the buzzer χ²=14.2; p<.001 CONCLUSIONS The 10 nurses interviewed unanimously favored the use of the buzzer. Introduction of a simple, low-cost restaurant-style buzzer improved triage work-flow, student and nursing experience.

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COVID-19 Preventive Behaviours in Cameroon: A Six-Month Online National Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052554 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2554

Author(s):

Joseph Nelson Siewe Fodjo ◽

Leonard Ngarka ◽

Wepnyu Y. Njamnshi ◽

Leonard N. Nfor ◽

Michel K. Mengnjo ◽

...

Keyword(s):

Regression Models ◽

Health Personnel ◽

Online Survey ◽

Preventive Measures ◽

Face Mask ◽

Logistic Regression Models ◽

Adherence Score ◽

Preventive Behaviour ◽

Predictors Of Adherence

Since March 2020, the Cameroonian government implemented nationwide measures to stall COVID-19 transmission. However, little is known about how well these unprecedented measures are being observed as the pandemic evolves. We conducted a six-month online survey to assess the preventive behaviour of Cameroonian adults during the COVID-19 outbreak. A five-point adherence score was constructed based on self-reported observance of the following preventive measures: physical distancing, face mask use, hand hygiene, not touching one’s face, and covering the mouth when coughing or sneezing. Predictors of adherence were investigated using ordinal logistic regression models. Of the 7381 responses received from all ten regions, 73.3% were from male respondents and overall mean age was 32.8 ± 10.8 years. Overall mean adherence score was 3.96 ± 1.11 on a scale of 0–5. Mean weekly adherence scores were initially high, but gradually decreased over time accompanied by increasing incidence of COVID-19 during the last study weeks. Predictors for higher adherence included higher age, receiving COVID-19 information from health personnel, and agreeing with the necessity of lockdown measures. Meanwhile, experiencing flu-like symptoms was associated with poor adherence. Continuous observance of preventive measures should be encouraged among Cameroonians in the medium- to long-term to avoid a resurgence in COVID-19 infections.

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Mentors' experiences in an osteopathic medical student research program

Journal of Osteopathic Medicine ◽

10.1515/jom-2020-0251 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Tyler Hamby ◽

W. Paul Bowman ◽

Don P. Wilson ◽

Riyaz Basha

Keyword(s):

Medical Students ◽

Research Program ◽

Online Survey ◽

Medical Schools ◽

Systematic Instruction ◽

Medical Student Research ◽

Research Programs ◽

Student Mentor ◽

The University

Abstract Context Medical students, especially at osteopathic medical schools, have limited research exposure. Systematic instruction in research, supervised by qualified mentors, could motivate osteopathic medical students to pursue research in their careers, thereby increasing the number of future clinician-scientists. Recruiting and retaining suitable research mentors are crucial to sustaining such programs, but this task is also particularly challenging for osteopathic medical schools. Objectives To assess mentors' experiences in a voluntary student-mentor medical research program. Methods An online survey was sent to 76 university- or hospital-based participants who previously mentored 219 medical students between 2014 and 2019. The questionnaire consisted of 13 items with responses in checklist, five-point Likert scale, and categorical multiple-choice formats, assessing motivation for participation, satisfaction with the program, and interest in future participation. Data were analyzed descriptively, and responses from mentors at the university and hospital were compared using univariate logistic and ordinal regression analyses. Results Among 70 (92.1%) mentors who responded to the survey, 61 (87.1%) reported being motivated by a desire to help medical students learn research. Forty-nine (70.0%) mentors indicated that furthering their own research productivity was a motivation, and hospital-based mentors were statistically significantly more likely to endorse this source of motivation (OR=2.02; 95% CI=1.18–3.45; p=0.01). Most respondents were satisfied with the quality of the students' work (59 [84.3%]) and with the program (59 [85.5%]). However, 46 (65.7%) suggested the program could be enhanced by requiring medical students to be physically present in the clinic or laboratory for a minimum amount of time. Importantly, most (58 [84.1%]) mentors reported that they would be interested in participating in future mentored research programs. Conclusions Mentors were motivated to participate in the voluntary research program for both altruistic and professional reasons. Since most mentors reported being satisfied with the program, it is likely they would participate in future mentored research programs. Our results suggest that mentors viewed this voluntary research program as mutually beneficial.

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P87 Paradigms about the COVID-19 pandemic: knowledge, attitudes and practices from medical students

BJS Open ◽

10.1093/bjsopen/zrab032.086 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

Eddy Lincango-Naranjo ◽

Paola Solis-Pazmino ◽

Eddy Lincango-Naranjo

Keyword(s):

Medical Students ◽

Healthcare Workers ◽

Online Survey ◽

National Curriculum ◽

Negative Attitude ◽

Front Line ◽

Macroeconomic Factors ◽

Attitudes And Practices ◽

And Behavior ◽

Knowledge Attitudes And Practices

Abstract Introduction As new coronavirus has spread globally, economic instability in healthcare systems has been significant. This reality is especially accentuated in Ecuador where, the shortage of healthcare workers combined with cultural and macroeconomic factors have led it to face the most aggressive outbreak in Latin America. In this context, the participation of medical students on the front line is indispensable. Appropriate training on COVID-19 is an urgent need that universities and health systems must guarantee. We aimed to describe the knowledge, attitudes and practices in Ecuadorian final year medical students in order to identify the knowledge gaps, perceptions and behavior patterns which could guide the desig3n of better medical education curricula regarding COVID-19. Methods This descriptive 33-item online survey conducted between April 6 to April 20 sent by email and by Facebook and WhatsApp. Results 309 students responded to the survey. 88% scored high (≥ 70% correct) for knowledge of the disease. The majority of students were pessimistic about possible government actions, which is reflected in the negative attitude towards the control of COVID19 in Ecuador and volunteering during the outbreak (77%, and 58% of the students, respectively). Moreover, 91% of students said they did not have adequate protective equipment or training in their health facilities. Conclusions Ecuador has a capable upcoming workforce that could benefit from an opportunity to strengthen, improve and advance their training in preparation for COVID-19. Creating a national curriculum may be one of the most effective ways for all students to be trained, while simultaneously focusing on the students’ most pressing concerns.

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Is the public supportive and willing to pay for a national assistive reproductive therapies programme? Results from a multicountry survey

BMJ Open ◽

10.1136/bmjopen-2020-044986 ◽

2021 ◽

Vol 11 (3) ◽

pp. e044986

Author(s):

Chris Skedgel ◽

Eleanor Ralphs ◽

Elaine Finn ◽

Jennifer A Whitty ◽

Marie Markert ◽

...

Keyword(s):

Outcome Measures ◽

Online Survey ◽

Medical Condition ◽

Public Attitudes ◽

Fertility Treatment ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Additional Contribution ◽

The Public ◽

The Usa

ObjectivesTo understand attitudes towards infertility and willingness to pay (WTP) towards a publicly funded national assistive reproductive therapies (ART) programme.DesignAttitudes survey with dichotomous and open-ended WTP questions.SettingOnline survey administered in the USA, UK, Spain, Norway, Sweden, Finland, Denmark and China.Participants7945 respondents, analysed by country. Nordic respondents were pooled into a regionally representative sample.Primary and secondary outcome measuresPrimary outcome measures were proportion of sample agreeing with different infertility-related and ART-related value statements and supporting a monthly contribution to fund a national ART programme, expressed in local currency. Secondary outcome measure was maximum WTP.ResultsAcross the nationally representative samples, 75.5% of all respondents agreed with infertility as a medical condition and 82.3% and 83.7% with ART eligibility for anyone who has difficulty having a baby or a medical problem preventing them from having a baby, respectively. 56.4% of respondents supported a defined monthly contribution and 73.9% supported at least some additional contribution to fund a national ART programme. Overall, converting to euros, median maximum WTP was €3.00 and mean was €15.47 (95% CI 14.23 to 16.72) per month. Maximum WTP was highest in China and the USA and lowest in the European samples.ConclusionsThis large, multicountry survey extends our understanding of public attitudes towards infertility and fertility treatment beyond Europe. It finds evidence that a majority of the public in all sampled countries/regions views infertility as a treatable medical condition and supports the idea that all infertile individuals should have access to treatments that improve the chance of conception. There was also strong agreement with the idea that the desire for children is a basic human need. WTP questions showed that a majority of respondents supported a monthly contribution to fund a national ART programme, although there is some evidence of an acquiescence bias that may overstate support among specific samples.

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Perceptions of a Remote Learning Pathology Elective for Advanced Clinical Medical Students

Academic Pathology ◽

10.1177/23742895211006846 ◽

2021 ◽

Vol 8 ◽

pp. 237428952110068

Author(s):

Kara S. Tanaka ◽

Rageshree Ramachandran

Keyword(s):

Medical Students ◽

Learning Environment ◽

Online Survey ◽

Learning Goals ◽

Asynchronous Learning ◽

Self Directed Learning ◽

Anatomic Pathology ◽

Institutional Review ◽

Clinical Clerkships ◽

Remote Learning

In mid-March 2020, our institution removed most medical students from in-person clinical clerkships due to the COVID-19 pandemic. The Department of Pathology responded by transitioning a fourth-year clinical elective to an all-remote format composed of synchronous didactics, daily clinical sign-out utilizing digital microscopy, and asynchronous learning materials. Thirty-seven medical students completed 2- or 4-week anatomic pathology electives tailored to meet their career goals and allowing them to progress toward graduation. Institutional Review Board approval was granted to survey students’ perceptions of engagement in the remote learning environment. Quantitative and qualitative data were collected using a standardized school-wide end-of-rotation survey, an online survey developed by the authors, and students’ self-directed learning goals. End-of-rotation data showed the remote pathology course performed well (4.88 of possible 5) when compared to all advanced clinical clerkships (4.51, n = 156 courses), all elective rotations (4.41, n = 50 courses), and the traditional in-person pathology elective (4.73). Core strengths in the virtual environment included high educational value, flexibility of content and schedule, organization, tailoring to an individual’s learning goals, and a positive education environment. Deficits included the inability to gross surgical specimens, inadequate observation or feedback about students’ skills, and impaired social connections. Areas for improvement included requests for in-person experiences and development of themed tracks for career exploration. Many aspects of anatomic pathology appear well-suited to the remote learning environment. While the remote model may not be sufficient for students pursuing careers in pathology, it can be adapted to increase nonpathologists’ understanding of interdisciplinary clinical collaboration with pathologists.

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