Students’ lack of knowledge regarding healthcare providers’ duties, and their preferences for information when selecting new providers

2015 ◽  
Vol 3 (1) ◽  
pp. 113 ◽  
Author(s):  
Evan Perrault

Rationale, aims and objectives: When USA college students need medical care, their first destinations are usually campus health centers. Normally, staffed by a variety of care providers (e.g., nurse practitioners, physician assistants, physicians), students may be confused about who they may need to see and possibly hesitant to receive care. The present study sought to determine students’ knowledge about primary care providers and the qualities they would like to know about them prior to consultations. The goal of this paper is to improve the information campus health centers in terms of their ability to provide students health solutions when and where they need them. Methods: 534 USA college students from a large Midwestern USA university completed a web-based survey about their knowledge, attitudes and information preferences regarding their various care providers. They also viewed 3 experimentally manipulated biographies of providers and chose the provider they would want to visit. Results: The majority of students did not know the differences between physicians, physician assistants and nurse practitioners and the types of care that they could provide. About 9% stated they would not seek care and 16% would delay seeking care if unable to see a physician immediately. The most important pieces of information desired were providers’ philosophies of care, certifications, areas of specialization and length of time practising medicine. As students perceived greater similarities due to more personal information provided in the biographies, they viewed, uncertainty was reduced leading to higher levels of anticipated patient satisfaction and quality of care. Conclusions: USA college students need greater levels of education regarding the care that can be received from a variety of healthcare professionals. Information provided should also include more personal information about the providers to help reduce students’ uncertainty and to enable students to access services that are person-centered in their nature.

2021 ◽  
pp. 247553032110628
Author(s):  
Suzanne Murray ◽  
Jeffrey Crowley ◽  
Melinda J. Gooderham ◽  
Alan Kivitz ◽  
Vinod Chandran ◽  
...  

Background The paradigm shift toward biologic medications in psoriasis care requires healthcare providers (HCPs) to become acquainted with mechanisms of action and safety profiles of these new treatments to confidently use them in practice. A better understanding of this paradigm shift is necessary to provide adequate education for HCPs in psoriasis care. Objectives This study assessed clinical practice gaps and challenges experienced by HCPs caring for patients with psoriasis. Methods A mixed-methods approach was used to identify practice gaps and clinical challenges of dermatologists, rheumatologists, primary care physicians, physician assistants, and nurse practitioners with various levels of clinical experience in academic and community-based settings. Qualitative and quantitative data were collected sequentially. Interviews were transcribed and thematically analyzed. Results A total of 380 psoriasis care providers in Canada and the US participated in this study. Analysis revealed challenges in establishing an accurate diagnosis of psoriasis (including screening for sub-type and distinguishing psoriasis from other skin conditions), selecting treatment (particularly regarding recently approved treatments), monitoring side effects, and collaborating with other HCPs involved in psoriasis care. Conclusion These findings highlight educational needs of HCPs involved in psoriasis care that could have repercussions on accurate and timely diagnosis of the condition, treatment initiation, side effect monitoring, and continuity of care. Findings provide a starting point for clinicians to reflect on their practice and for the improvement of continuing professional development interventions that would bridge these gaps.


2011 ◽  
Vol 38 (5) ◽  
pp. 931-937 ◽  
Author(s):  
SYDNEY C. LINEKER ◽  
MARY J. BELL ◽  
ELIZABETH M. BADLEY

Objective.To describe the evaluation of a community-based continuing health education program designed to improve the management of rheumatoid arthritis (RA) and osteoarthritis (OA), and to examine the results by discipline.Methods.The Getting a Grip on Arthritis©program was based on clinical practice guidelines adapted for the primary care environment (best practices). The program consisted of an accredited inter-professional workshop and 6 months of activities to reinforce the learning. Analyses compared best practice scores derived from responses to 3 standardized case scenarios (early and late RA; moderate knee OA) at baseline and 6 months post-workshop using the ACREU Primary Care Survey.Results.In total, 553 primary care providers (nurses/licensed practical nurses 30.9%, rehabilitation professionals 22.5%, physicians 22.5%, nurse practitioners 10.9%, other healthcare providers/non-clinical staff/students 13.1%) attended one of 27 workshops across Canada; 275 (49.7%) completed followup surveys. Best practice scores varied by discipline at baseline (p < 0.05) and improved for all 3 case scenarios, with nurse practitioners and rehabilitation therapists improving the most (p ≤ 0.05).Conclusion.Results suggest that inter-professional education may be an effective method for dissemination of guidelines and has potential to improve the delivery of arthritis care, particularly when nurse practitioners and rehabilitation therapists are involved in the care of patients.


Author(s):  
Troy McGill ◽  
Debra Stern ◽  
Morey Kolber ◽  
John McGee

Purpose: The purpose of this study was to compare the cost of physical therapist (PT) management of patients with musculoskeletal (MSK) disorders to management by traditional primary care managers (PCMs); medical doctors (MDs), doctors of osteopathic medicine (DOs), advanced registered nurse practitioners (ARNPs), and physician assistants (PAs). Methods: This is a retrospective study of electronic medical records using an exploratory, non-experimental, cross-sectional, and quantitative design method. The records of patients with MSK disorders were assessed at an Air Force military medical clinic for 18 months from January 2016 through June 2017. Results: PT management of MSK patients resulted in a significantly lower rate of imaging studies, NSAIDS, and cost of care when compared to MDs, DOs, PAs, or ARNPs. Patients with MSK disorders managed by PTs had no significant difference in return-to-work rate when compared to MDs, DOs, PAs, or ARNPs. Conclusions:The military model of physical therapy direct access care has been shown to be cost effective when compared to care provided by traditional primary care managers.


Pain Care Essentials targets the needs of primary care providers and entry-level healthcare professionals to understand pain. Based on the successful approach of examining four basic questions, this textbook addresses: What is pain? How is pain assessed? How is pain managed? and How does clinical context impact pain experience and management? Weaving together advances in science and clinical practice, this text covers the full spectrum from basic pain signaling mechanisms, psychology, and epidemiology, to clinical skills, treatment choices, and impacts on children, older adults, and those with substance use disorders, at a depth attuned to the foundations of clinical practice. Based on a learner-centered teaching philosophy; we believe that a deeper understanding of patient-centered pain care, including socioemotional development, enhances the clinical experience for patients, caregivers, and healthcare providers; leading to better outcomes, higher levels of patient satisfaction, and less provider burnout. Each chapter includes learning objectives, a clinical case, multiple choice questions, and selected references. Figures, tables, and textboxes enhance reader engagement. The goal is to deliver essential pain content that can be incorporated into an integrated curriculum preparing students for formative and summative assessments of core competencies in pain, as well as meeting the needs of the more experienced general reader seeking a quick update. Prepared by an interprofessional authorship team for an audience that includes physicians, nurse practitioners, physician assistants, pharmacists, and students of all healthcare professions, this work fills an important gap by focusing on pain as encountered by the broadest spectrum of healthcare practitioners.


2017 ◽  
Vol 24 (7) ◽  
pp. 465-472 ◽  
Author(s):  
Jonas Kwok ◽  
J Nwando Olayiwola ◽  
Margae Knox ◽  
Elizabeth J Murphy ◽  
Delphine S Tuot

Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers’ perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales. Differences in primary care providers’ perceptions were examined overall and by primary care providers’ speciality, provider type and years of experience. Results Among 221 primary care provider participants (35% response rate), 83.9% agreed or strongly agreed that the integrated electronic consultation and referral system provided educational value. There were no significant differences in educational value reported by provider type (attending physician, mid-level provider, or trainee physician), primary care providers’ speciality, or years of experience. Perceived benefit of the electronic consultation and referral system in clinical management appeared stronger for laboratory-based conditions (i.e. subclinical hypothyroidism) than more diffuse conditions (i.e. abdominal pain). Nurse practitioners/physician assistants and trainee physicians were more likely to report improved abilities to manage specific clinical conditions when using the electronic consultation and/or referral system than were attending physicians, as were primary care providers with ≤10 years experience, versus those with >20 years of experience. Conclusions Primary care providers report overwhelmingly positive perceptions of the educational value of an integrated electronic consultation and referral system. Nurse practitioners, physician assistants, trainee physicians and less-experienced primary care providers report the greatest clinical educational benefit, particularly for conditions involving lab-based diagnosis and management.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linda Takamine ◽  
Jane Forman ◽  
Laura J. Damschroder ◽  
Bradley Youles ◽  
Jeremy Sussman

Abstract Background Although risk prediction has become an integral part of clinical practice guidelines for cardiovascular disease (CVD) prevention, multiple studies have shown that patients’ risk still plays almost no role in clinical decision-making. Because little is known about why this is so, we sought to understand providers’ views on the opportunities, barriers, and facilitators of incorporating risk prediction to guide their use of cardiovascular preventive medicines. Methods We conducted semi-structured interviews with primary care providers (n = 33) at VA facilities in the Midwest. Facilities were chosen using a maximum variation approach according to their geography, size, proportion of MD to non-MD providers, and percentage of full-time providers. Providers included MD/DO physicians, physician assistants, nurse practitioners, and clinical pharmacists. Providers were asked about their reaction to a hypothetical situation in which the VA would introduce a risk prediction-based approach to CVD treatment. We conducted matrix and content analysis to identify providers’ reactions to risk prediction, reasons for their reaction, and exemplar quotes. Results Most providers were classified as Enthusiastic (n = 14) or Cautious Adopters (n = 15), with only a few Non-Adopters (n = 4). Providers described four key concerns toward adopting risk prediction. Their primary concern was that risk prediction is not always compatible with a “whole patient” approach to patient care. Other concerns included questions about the validity of the proposed risk prediction model, potential workflow burdens, and whether risk prediction adds value to existing clinical practice. Enthusiastic, Cautious, and Non-Adopters all expressed both doubts about and support for risk prediction categorizable in the above four key areas of concern. Conclusions Providers were generally supportive of adopting risk prediction into CVD prevention, but many had misgivings, which included concerns about impact on workflow, validity of predictive models, the value of making this change, and possible negative effects on providers’ ability to address the whole patient. These concerns have likely contributed to the slow introduction of risk prediction into clinical practice. These concerns will need to be addressed for risk prediction, and other approaches relying on “big data” including machine learning and artificial intelligence, to have a meaningful role in clinical practice.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 827-827
Author(s):  
Lee Lindquist ◽  
Aylin Madore ◽  
Stephanie Miller ◽  
Alice Kerr ◽  
Sara Bradley

Abstract Primary care providers (PCP) - internists, family practitioners, nurse practitioners, physician assistants - play an integral role in the care of older adults, although many receive limited geriatrics education. We sought to examine what questions community-based PCPs had about geriatrics and clinical care of older adults. As part of large clinical continuing medical education (CME) conferences across 12 states (FL,GA,CA,IL,NY,MA,DC, PA,AZ,TX,TN,WA), PCPs attended a live in-person 60-minute geriatrics-focused lecture and entered questions into a mobile application. Questions were then qualitatively analyzed using constant-comparison and tie-break methodology. At all sites, 103 questions were asked with 158 upticks (PCPs could check off that they had similar question) with a range of 3-18 questions per lecture. PCPs asked questions on the following common themes: 1.) Medication-related (e.g. discontinuing medicines in asymptomatic patients, optimizing pain relief), 2.) Dementia (e.g. prevention, nutraceuticals, agitation) 3.) Medicare Coding 4.) Falls 5.) Weight loss, and 6.) Insomnia. There were a number of questions referencing incorrect practices (e.g. prescribing inappropriate medications such as benzodiazepines for sleep, placement of gastric tubes in late-stage dementia, antibiotics to treat asymptomatic bacteria). In conclusion, community-based PCPs nationally experience gaps in geriatric knowledge and several utilize practices that could jeopardize older adult health. While attending CME-based lectures is one means of overcoming these gaps, some PCPs may not find time or realize geriatrics as an educational need. PCPs need to be better supported with opportunities to ask geriatric care-related questions in order to improve the care of older adults.


2017 ◽  
Vol 52 (2) ◽  
pp. 190-195
Author(s):  
Joanna Gedzior ◽  
Arlen Kwong

In August 2016, U.S. Surgeon General Vivek Murthy, MD, MBA, issued a letter to healthcare providers requesting aid in addressing “an urgent health crisis facing America: the opioid epidemic.” In this article, we address some of the more poignant challenges that surface in treating patients with opiate addiction. We provide an outline of recommendations from the leading medical organizations to educate primary care providers on how to navigate patients to decreased or discontinued medication loads.


CJEM ◽  
2009 ◽  
Vol 11 (05) ◽  
pp. 455-461 ◽  
Author(s):  
James Ducharme ◽  
Robert J. Alder ◽  
Cindy Pelletier ◽  
Don Murray ◽  
Joshua Tepper

ABSTRACT Objective: We sought to assess the impact of the integration of the new roles of primary health care nurse practitioners (NPs) and physician assistants (PAs) on patient flow, wait times and proportions of patients who left without being seen in 6 Ontario emergency departments (EDs). Methods: We performed a retrospective review of health records data on patient arrival time, time of initial assessment by a physician, time of discharge from the ED and discharge status. Results: Whether a PA or NP was directly involved in the care of patients or indirectly involved by being on duty, the wait times, lengths of stay and proportion of patients who left without being seen were significantly reduced. When a PA or NP were directly involved in patients' care, patients were 1.6 (95% confidence interval [CI] 1.3–2.1, p &lt; 0.05) and 2.1 (95% CI 1.6–2.8, p &lt; 0.05) times more likely to be seen within the wait time benchmarks, respectively. Lengths of stay were 30.3% (95% CI 21.6%–39.0%, p &lt; 0.01) and 48.8% (95% CI 35.0%–62.7%, p &lt; 0.01) lower when PAs and NPs, respectively, were involved. When PAs and NPs were not on duty, the proportion of patients who left without being seen were 44% (95% CI 31%–63%, p &lt; 0.01) and 71% (95% CI 53%–96%, p &lt; 0.05), respectively. Conclusion: The addition of PAs or NPs to the ED team can improve patient flow in medium-sized community hospital EDs. Given the ongoing shortage of physicians, use of alternative health care providers should be considered. These results require validation, as their generalizability to other locations or types of EDs is not known.


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