Promoting Strategies to Overcome Low Health Literacy and Improve Patient Understanding in Outpatient Setting

Over 36% of US adults have low health literacy. This contributes to poorer health outcomes and increased costs for individuals and health care systems. Many strategies can be used to overcome the barrier of low health literacy and improve patient understanding in clinical encounters. As health care providers have been shown to underestimate patient\u27s needs for information and overestimate their own ability to communicate effectively with patients, these strategies should be used universally. We prepared a presentation on health literacy, its epidemiology, risk factors and implications, and strategies to overcome low health literacy and improve patient understanding. We focused most heavily on Teach-Back, a strategy to assess patient understanding. We presented this to a group of residents and attendings at EMMC Center for Family Medicine and Residency. We prepared pre-presentation and post-presentation surveys to evaluate effect of presentation.https://scholarworks.uvm.edu/fmclerk/1250/thumbnail.jp

A first assessment of operator compliance and dolphin behavioural responses during swim-with-dolphin programs for three species of Delphinids in the Azores

The popularity of swim-with wild dolphin programs around the world is fast growing, with the studies required to investigate their impact lagging behind. In the Azores, species targeted include the short-beaked common (Delphinus delphis), the bottlenose (Tursiops truncatus) and the Atlantic spotted dolphin (Stenella frontalis). To evaluate the effects of this activity on local dolphin populations, and thus provide support for management decisions, dolphin response data were collected onboard commercial boats off São Miguel Island between 2013 and 2015. All three species revealed high degree of neutral and avoidance behaviours, and very low approach rates. Tursiops showed higher frequency of neutral responses than Delphinus, while Stenella both avoided and approached more frequently than the other species. When boats intersected the path of dolphin groups, avoidance responses were more likely and the duration of swims was shorter. Swims were also shorter when animals were resting and travelling, and when groups were smaller. The operators generally complied with the legislation, except in respect to the number of swim attempts per dolphin group, which was higher than the legal maximum. Improvement of the current legislation and concurrent reinforcement of controls is essential to avoid detrimental long-term effects of this activity on dolphin populations in the Azores.This research was partially supported by the European Regional Development Fund (ERDF) through the COMPETE – Operational Competitiveness Programme and national funds through FCT – Foundation for Science and Technology, under the project PEst-C/MAR/LA0015/2013, by the Strategic Funding UID/Multi/04423/2013 through national funds provided by FCT – Foundation for Science and Technology and European Regional Development Fund (ERDF), in the framework of the programme PT2020 and by cE3c funding (Ref:UID/BIA/003329/2013). It was also partly supported by CIRN (Centro de Investigação de Recursos Naturais, University of the Azores), and CIIMAR (Interdisciplinary Centre of Marine and Environmental Research, Porto, Portugal). A. Cecchetti was supported by the Regional Fund for Science through the scholarship M.3.1.2/F/036/2011. K.A. Stockin was supported by a Royal Society of New Zealand Te Aparangi Rutherford Discovery Fellowship.info:eu-repo/semantics/publishedVersio

Qualitative doctoral research in educational settings: reflecting on meaningful encounters

In qualitative doctoral research the methodological approach, and the research design are extremely important when ensuring the rigorousness of the work. This is particularly significant for all researchers, and even more for doctoral students who are still developing their research and analytical skills. This paper aims to support doctoral students in their research journey by highlighting some of the tensions involved in conducting qualitative research by unpicking the experiences of two doctoral students to learn from the concerns, questions and reflections on the use of qualitative methodology in their doctoral research projects. The findings reveal challenges and insights with regards to reflection, educational research and the developing identity of being a researcher. The paper discusses these reflections to support and guide doctoral students as early career researchers when planning and conducting qualitative research in educational settings

Word searches: on the use of verbal and non-verbal resources during classroom talk

Word finding difficulties in children are typically characterised by search behaviours such as silence, circumlocution, repetition and empty words. Yet, how children’s word searches are constructed (including gesture, gaze and prosody) and the actions accomplished during interaction have not yet been researched. In this study, eightyear- old Ciara is interacting with her teacher in the classroom. 37 segments containing word searches were analysed according to the procedures used by conversation analysts. Ciara’s interactional resources include co-ordinated deployment of syntax, pitch height and downward gaze during solitary searching that assist the enterprise of self-repair. Gaze shift towards the teacher signals a transition relevance place, thus constituting a direct invitation for her to participate in the search. Ciara’s interactional resources include semantic category labelling, phonological self-cuing and pronominal substitution that supply valuable linguistic information to the teacher and trigger production of the searched-for item. Recommendations for language teaching and therapy are presented

Guidelines: The do's, don'ts and don't knows of direct observation of clinical skills in medical education.

IntroductionDirect observation of clinical skills is a key assessment strategy in competency-based medical education. The guidelines presented in this paper synthesize the literature on direct observation of clinical skills. The goal is to provide a practical list of Do's, Don'ts and Don't Knows about direct observation for supervisors who teach learners in the clinical setting and for educational leaders who are responsible for clinical training programs.MethodsWe built consensus through an iterative approach in which each author, based on their medical education and research knowledge and expertise, independently developed a list of Do's, Don'ts, and Don't Knows about direct observation of clinical skills. Lists were compiled, discussed and revised. We then sought and compiled evidence to support each guideline and determine the strength of each guideline.ResultsA final set of 33 Do's, Don'ts and Don't Knows is presented along with a summary of evidence for each guideline. Guidelines focus on two groups: individual supervisors and the educational leaders responsible for clinical training programs. Guidelines address recommendations for how to focus direct observation, select an assessment tool, promote high quality assessments, conduct rater training, and create a learning culture conducive to direct observation.ConclusionsHigh frequency, high quality direct observation of clinical skills can be challenging. These guidelines offer important evidence-based Do's and Don'ts that can help improve the frequency and quality of direct observation. Improving direct observation requires focus not just on individual supervisors and their learners, but also on the organizations and cultures in which they work and train. Additional research to address the Don't Knows can help educators realize the full potential of direct observation in competency-based education

Engineering enterprise through intellectual property education - pedagogic approaches

Engineering faculties, despite shrinking resources, are delivering to new enterprise agendas that must take account of the fuzzying of disciplinary boundaries. Learning and teaching, curriculum design and research strategies reflect these changes. Driven by changing expectations of how future graduates will contribute to the economy, academics in engineering and other innovative disciplines are finding it necessary to re-think undergraduate curricula to enhance students’ entrepreneurial skills, which includes their awareness and competence in respect of intellectual property rights [IPRs]. There is no well established pedagogy for educating engineers, scientists and innovators about intellectual property. This paper reviews some different approaches to facilitating non-law students’ learning about IP. Motivated by well designed ‘intended learning outcomes’ and assessment tasks, students can be encouraged to manage their learning... The skills involved in learning about intellectual property rights in this way can be applied to learning other key, but not core, subjects. At the same time, students develop the ability to acquire knowledge, rather than rely on receiving it, which is an essential competence for a ‘knowledge’ based worker

Norton Healthcare: A Strong Payer-Provider Partnership for the Journey to Accountable Care

Examines the progress of an integrated healthcare delivery system in forming an accountable care organization with payer partners as part of the Brookings-Dartmouth ACO Pilot Program, including a focus on performance measurement and reporting

Relative Safety 2: Risk and unprotected anal intercourse among gay men diagnosed with HIV

In 1999 Sigma Research published Relative safety: an investigation of risk and unprotected anal intercourse among gay men diagnosed with HIV (Keogh et al. 1999). This study explored the social, psychological and cultural meanings associated with unprotected anal intercourse (UAI) among men with diagnosed HIV. It highlighted both the complexity of sexual interaction for men with diagnosed HIV, and the many potential costs and benefits perceived by them. Now, with more than 24,000 homosexually active men diagnosed with HIV in the UK (Health Protection Agency 2008), a figure that is set to increase in years to come, it is vital that agencies involved in HIV prevention interrogate their own beliefs about UAI and ensure that their interventions meet the needs of men with diagnosed HIV. . . . . The following chapter explains how the study was undertaken, outlines the broad topic areas addressed during the interviews, and describes the sample of men who took part. Chapter 3 outlines the range of harms that men with HIV perceive when engaging in UAI. Chapters 4 and 5 explore the ways in which men responded to these perceived harms, firstly those relating to the risk of onward HIV infection, or superinfection, and latterly those concerning the potential for harms to their personal and social identities. Chapter 6 considers the implications of these findings for health promotion interventions targeting men with HIV, and with homosexually active men more broadly

Researching coethnic migrants: privileges and puzzles of "insiderness"

This article reflects on fieldwork experiences with coethnic migrants in London to challenge understandings of insiderness centred in shared ethnicity, as well as the usefulness of the insider-outsider divide in migration research more generally. Drawing on examples from a study of migrants' social relations, it shows how gender, migrant status, and occupational position sometimes shape research encounters in more important ways than shared ethnicity. Furthermore, whilst shared ethnicity is undoubtedly useful in certain respects, participants' ethnicised discourses and practices may also generate feelings of distance in the coethnic researcher. Whilst supporting the "ethnic bias" critique to migration studies (GLICK SCHILLER, ÇAĞLAR & GULDBRANDSEN, 2006), the analysis thus highlights how both ethnic and non-ethnic factors alternate or interact to create perceptions of insiderness or outsiderness in specific research contexts