1,639,303 research outputs found
Recommended from our members
Approaches to decision-making among late-stage melanoma patients: a multifactorial investigation.
PurposeThe treatment decisions of melanoma patients are poorly understood. Most research on cancer patient decision-making focuses on limited components of specific treatment decisions. This study aimed to holistically characterize late-stage melanoma patients' approaches to treatment decision-making in order to advance understanding of patient influences and supports.Methods(1) Exploratory analysis of longitudinal qualitative data to identify themes that characterize patient decision-making. (2) Pattern analysis of decision-making themes using an innovative method for visualizing qualitative data: a hierarchically-clustered heatmap. Participants were 13 advanced melanoma patients at a large academic medical center.ResultsExploratory analysis revealed eight themes. Heatmap analysis indicated two broad types of patient decision-makers. "Reliant outsiders" relied on providers for medical information, demonstrated low involvement in decision-making, showed a low or later-in-care interest in clinical trials, and expressed altruistic motives. "Active insiders" accessed substantial medical information and expertise in their networks, consulted with other doctors, showed early and substantial interest in trials, demonstrated high involvement in decision-making, and employed multiple decision-making strategies.ConclusionWe identified and characterized two distinct approaches to decision-making among patients with late-stage melanoma. These differences spanned a wide range of factors (e.g., behaviors, resources, motivations). Enhanced understanding of patients as decision-makers and the factors that shape their decision-making may help providers to better support patient understanding, improve patient-provider communication, and support shared decision-making
Effectiveness of interprofessional education by on-field training for medical students, with a pre-post design
open3noBACKGROUND: Interprofessional Education (IPE) implies how to achieve successful teamwork, and is based on collaborative practice which enhance occasions for relationships between two or more healthcare professions. This study evaluates the effectiveness of IPE in changing attitudes after a training recently introduced to medical education for second-year students at the University of Padova, Italy. METHODS: All medical students following a new program for IPE were enrolled in this study. The Interdisciplinary Education Perception Scale (IEPS) was administered before and after training, according to observation-based and practice-based learning. Data were analysed with Student's paired t-test and Wilcoxon's signed rank test. RESULTS: 277 medical students completed both questionnaires. Statistically significant improvements were found in students' overall attitudes as measured by the IEPS and four subscale scores. Gender-stratified analyses showed that improvements were observed only in female students in subscale 4 ("Understanding Others' Values"). Students who had a physician and/or health worker in their family did not show any improvement in subscales 2 ("Perceived need for cooperation") or 4 ("Understanding Others' Values"). CONCLUSIONS: Our results indicate that IPE training has a positive influence on students' understanding of collaboration and better attitudes in interprofessional teamwork. More research is needed to explore other factors which may influence specific perceptions among medical students.openZanotti, Renzo; Sartor, Giada; Canova, CristinaZanotti, Renzo; Sartor, Giada; Canova, Cristin
International medical electives in selected African countries: A phenomenological study on host experience
Objectives: To explore the host experience on international medical electives at a selection of hospitals in low- and middle-income countries in Africa. Outcomes of the study may inform and improve the preparation of global health curriculum, pre-elective training and debriefing for international medical electives.
Methods: A descriptive phenomenological study was undertaken, involving semi-structured interviews with ten elective hosts at seven study sites in three African countries. Purposive convenience sampling augmented by snowballing was utilised to recruit study participants. The data were thematically analysed and interpreted with reflexivity to generate an accurate aggregate of the experience of participants in hosting international medical electives.
Results: Six main themes emerged from the thematic analysis of interview data: international medical student contribution to host hospitals, host professional and personal fulfilment, barriers to student learning experience, international medical student preparedness, hope for reciprocity and barriers to cultural immersion and patient care.
Conclusions: Study participants described the experience of hosting international medical elective students as overwhelmingly positive. However, they highlighted issues such as barriers to students’ learning experience and the lack of reciprocity between host and sending institutions as areas which could be addressed to optimize the experience for both hosts and international medical students. An understanding of the host experience provides stakeholders with a clearer idea of what is important in preparation, organisation and evaluation of the elective experience. This study provides the impetus for further research to examine the effectiveness of introducing appropriate pre-departure training and post-elective debriefing to students embarking on international medical electives
Include medical ethics in the Research Excellence Framework
The Research Excellence Framework of the Higher Education
Funding Council for England is taking place in 2013, its three
key elements being outputs (65% of the profile), impact (20%),
and “quality of the research environment” (15%). Impact will
be assessed using case studies that “may include any social,
economic or cultural impact or benefit beyond academia that
has taken place during the assessment period.”1
Medical ethics in the UK still does not have its own cognate
assessment panel—for example, bioethics or applied
ethics—unlike in, for example, Australia. Several researchers
in medical ethics have reported to the Institute of Medical Ethics
that during the internal preliminary stage of the Research
Excellence Framework several medical schools have decided
to include only research that entails empirical data gathering.
Thus, conceptual papers and ethical analysis will be excluded.
The arbitrary exclusion of reasoned discussion of medical ethics
issues as a proper subject for medical research unless it is based
on empirical data gathering is conceptually mistaken. “Empirical
ethics” is, of course, a legitimate component of medical ethics
research, but to act as though it is the only legitimate component
suggests, at best, a partial understanding of the nature of ethics
in general and medical ethics in particular. It also mistakenly
places medicine firmly on only one side of the
science/humanities “two cultures” divide instead of in its rightful
place bridging the divide.
Given the emphasis by the General Medical Council on medical
ethics in properly preparing “tomorrow’s doctors,” we urge
medical schools to find a way of using the upcoming Research
Excellence Framework to highlight the expertise residing in
their ethicist colleagues. We are confident that appropriate
assessment will reveal work of high quality that can be shown
to have social and cultural impact and benefit beyond academia,
as required by the framework
- …