1,799,921 research outputs found

    Medical Students’ First Male Urogenital Examination: Investigating the Effects of Instruction and Gender on Anxiety

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    Objectives: To investigate the effect that standardized instruction of the male urogenital examination had on the anxiety levels of students and to determine what influence, if any, the gender of the student had on this experience. Methods: One hundred thirty six second year medical students were asked to report their level of anxiety before and after participation in a small group teaching session on the male urogenital examination. We gathered both qualitative and quantitative information to better understand students’ anxiety surrounding this instruction. Results: Students had significantly lower state-anxiety scores following the instruction than before (F(1, 76)=102.353, p=.000, eta2=.574) and female students were more likely to have greater state-anxiety than male students (F=6.952, p=.010, eta2=.084). Ninety-nine percent of students reported that the teaching associates successfully reduced their anxiety. This decrease was attributed predominantly to the personal qualities of the teaching associates and to the format of the instruction. Conclusions: This study provides both quantitative and qualitative evidence that the use of male teaching associates to provide standardized instruction on the urogenital exam is effective at reducing students’ anxiety, particularly with regard to female students. Added standardized instruction may lead to increased confidence, skill, and future compliance with intimate physical exam screening practices

    Pilot and Feasibility Test of an Implementation Intention Intervention to Improve Fruit and Vegetable Intake Among Women with Low Socioeconomic Status

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    Fruit and vegetable intake (FVI), a modifiable risk factor for chronic diseases, is lower in low socioeconomic status (SES) populations. Implementation intentions (a specific type of planning that extends the Theory of Planned Behavior) has been studied to improve FVI, but not exclusively with low SES groups. Using mixed methods, we evaluated the feasibility, acceptability, and preliminary efficacy of an implementation intention intervention (versus a general plan) to increase FVI in women with low SES. For the pilot randomized controlled trial, demographics, body mass index, attitude, perceived behavioral control, goal intention strength, and FVI were measured at baseline and FVI again 1-month following the intervention. Feasibility data were collected for recruitment, randomization, retention, and assessment procedures and compared to predetermined targets. Semi-structured interview data was analyzed for emergent themes regarding acceptability of the trial. Preliminary efficacy of the intervention to improve FVI was analyzed descriptively. Feasibility targets were met for randomization (100% vs. ≥80% target), retention (93.5% vs. ≥70% target) and the assessment metrics missing data points (2% vs. ≤10% target) and days from intervention to follow up (mean=69.2, sd=42.6 vs.days). Targets for recruitment were not met with the exception of participants giving informed consent (100% vs. ≥70% target). Participants described the intervention as enjoyable and reported behavioral constructs outside of those measured as important to improve FVI. Limited efficacy analysis suggested that both groups increased their FVI (experimental: +0.17 servings per day, 95% CI: -0.85, 1.20; control: +0.50 servings per day, 95% CI: -0.56, 1.58). Further research which examines interventions based upon behavior change models to improve dietary health behaviors in marginalized groups is needed

    A Call for the Structured Physicist Report

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    Introduction: The field of diagnostic radiology continues to struggle with the clinical adoption of the structured interpretive report, with many radiologists preferring a semistructured, free-text dictation style to a more rigid, highly structured approach that some professional leaders have promoted [1]. Although structured reporting compliance in the radiologist community has been difficult to achieve, diagnostic radiologists have been thinking about and discussing this important issue for many years; it is also a part of the ACR’s Imaging 3.0_ campaign [2]. In the breast imaging community, the well-established BI-RADS_ recommendations produce a very structured report, with a discussion of interpretive findings culminating in a numeric BI-RADS score ranging from 0 to 6 [3]. Unlike some interpretive radiology reports, which can be ambiguous in terms of the next course of action, the BI-RADS scale is not only a diagnostic scale but also prescriptive of what the necessary follow-up should be

    Physician Communication Skills: Results of a Survey of General/Family Practitioners in Newfoundland

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    Purpose: To describe the attitudes related to communication skills, confidence in using commnication skills, and use of communication skills during the physician-patient encounter among a population-based sample of family physicians. Procedures: A mailed survey, distributed to all family physicians and general practitioners currently practicing in Newfoundland. The questionnaire was designed to collect data in five general areas participant demographics, physician confidence in using specific communication strategies, perceived adequacy of time spent by physicians with their patients, physician use of specific communication strategies with the adult patients they saw in the prior week, and physician use of specific communication strategies during the closing minutes of the encounters they had with adult patients in the prior week. Main Findings: A total of 160 completed surveys was received from practicing family physicians/general practitioners in Newfoundland, yielding an adjusted response rate of 43.1%. Most of the respondents (83.8%) indicated their communication skills are as important as technical skills in terms of achieving positive patient outcomes. Between one-third and one-half of the respondents, depending on the educational level queried, rated their communications skills training as being inadequate. Fewer than 20% of the respondents rated the communications skills training they received as being excellent. Physicians indicated a need to improve their use of 8 of 13 specific communication strategies during patient encounters, and reported using few communication strategies during the closing minutes of the encounter. Interactions that occurred during a typical encounter tended to focus on biomedical versus psychosocial issues. Conclusions: Family physicians/general practitioners recognize a need to improve their commnications skills. Well-designed communications skills training programs should be implemented at multi-levels of physician training in order to improve patient satisfaction with their encounters with family/general practitioners, and to increase the likelihood of positive patient outcomes