Benefits of preclinical osteopathic medical students\u27 joining interprofessional research teams

Challenge/ Issues: There are few options for interprofessional research experiences that offer medical students the ability to collaborate with clinical psychology doctoral (PsyD) students. While a core principle of osteopathic medicine is holistic care, exposure to psychosocial aspects of medical conditions is limited or unrepresented in the preclinical education years. As an example, the psychosocial aspects and quality of life issues related to kidney dialysis are not discussed in the classroom. Objectives: The objectives for integrating medical students into a research study on quality of life and psychosocial aspects in persons undergoing kidney dialysis are to: a) have psychology and medical students learn from, with, and about each others’ professions as it relates to the care of this patient population while in preclinical education; b) foster interprofessional communication, collaboration, and teamwork in research relating to patient care, and c) gain an appreciation for others’ roles and responsibilities. Approach: The principal investigator recruited research assistants to aid in this biopsychosocial study, with intentional selection of osteopathic medical (DO) and Clinical PsyD students. Joining the team required students to complete IRB training, participate in journal article discussions, learn psychometric properties and administration rules for neuropsychological and psychosocial assessments, and consent and interviewing skills to interact with dialysis patients. Future opportunities for data analysis and presentations are anticipated. Through collaboration and interprofessional education, students develop a more intimate understanding of the relationship between the body, mind, and spirit for this patient population. Results: The result of having an interdisciplinary lab was that medical and psychology students shared profession-based knowledge with each other. Psychology doctoral students had more prior research training than osteopathic medical students. Conversely, medical students had more baseline knowledge of physiology and physical systems. Thus, the goals of interprofessional communication, and learning the roles and responsibilities of dialysis patient care were met by discussions surrounding these topics. Having psychology and medical students work together led to the development of new research hypotheses through effective teamwork. Further qualitative reports from the 2 DO students and 8 PsyD students will be available at the time of presentation regarding this shared learning experience. The main obstacles encountered thus far have been availability, scheduling, differences in foundational knowledge, and COVID-19 restrictions to entering the dialysis clinic. However, this novel approach demonstrates the feasibility of having medical students join psychology research teams for advancing their biopsychosocial knowledge about patient populations and research. It is anticipated that participating medical students will have a greater sensitivity to the psychosocial aspects of dialysis and chronic illnesses, and that this model for interdisciplinary research will be replicated with formalized outcome measures to be developed

LQTS patients’ satisfaction with emergency room care

Abstract: Long QT Syndrome (LQTS) is a genetic condition affecting 1:2,500 that predisposes individuals to cardiac arrhythmias (Ellis et al., 2009). Life threatening symptoms are often unpredictable although there are known triggers to LQTS specific cardiac events. Triggers include physical exertion, emotional upset, and sleep. Events could be triggered by medications, dehydration, and other circumstances that affect cardiac rhythm. Treatments include betablockers, pacemakers, internal cardioverter defibrillators, and automated external defibrillator as precautionary measures. As such, LQTS patients often present to their emergency room (ER) when they become symptomatic. Research suggests that LQTS patients’ experience dissatisfaction in the ER and treatment is a concern (Felgoise et al., 2012). Cardiac training in emergency medicine specialties is limited. Given that ER physician training in cardiology is general, rarer cardiac arrhythmias such as LQTS are unknown by many ER physicians. Studies of ER patient satisfaction have shown that quality of communication and interactions between ER physician and patient, understanding of care, and wait times are related to patient satisfaction in pediatric and adult populations (Margaret et al., 2002). This study aims to learn why LQTS patients are dissatisfied by assessing doctor-patient relationship variables, patient satisfaction, patients’ perception of physicians’ knowledge, and problem-solving skills. The goal is to identify how to increase patients’ ability to be better consumers of ER care, use problem-solving strategies and advocate for appropriate treatment with regard to LQTS-related needs. This study fuses multidisciplinary perspectives for enhancement of patient satisfaction. This is a prospective cross-sectional study of pediatric and adult patients with LQTS and parent perceptions of ER care. A convenience sample of LQTS patients or their parent will complete an online survey. 150 participants will be recruited via announcements on websites focused on cardiac arrhythmias. Measures include Working Alliance Inventory, Personal Information Questionnaire, a standardized ER patient satisfaction questionnaire, and the Social Problem-Solving Inventory. Pearson product moment correlations and multiple regression analyses will be conducted to determine the relationship among the variables. Subscales of the WAI, average estimated wait times, problem-solving skills, and ratings of knowledge and communication from the and ER satisfaction questionnaire will be input as predictor variables and global patient satisfaction will be the criterion variable. Results will lead to understanding ER experiences that may be advantaged by introducing CBT strategies to promote better consumerism of services by LQTS patients. Data will provide physicians with an understanding of LQTS patients’ perceptions of ER care. Findings will determine what predicts satisfaction and whether patients have realistic expectations for ER care. Problem-solving skills training have been effective for helping other medical patients navigate the healthcare system (Nezu et al., 1998), and may be appropriate for LQTS patients. Results will provide guidance for cardiologists and psychologists to best prepare LQTS patients for ER experiences

An Examination of Physician Decision Making with Children and Adolescents Diagnosed with Long QT Syndrome: A Qualitative Study

Introduction: LQTS… Is a life threatening, hereditary cardiac arrhythmia disorder. Affects 1 in 2,000 people in the United States may be the cause of SIDS and unexplained death in children Is unpredictable. Physicians Are faced with ongoing challenges in diagnosis and treatment due to unpredictability and individual patient characteristics

QoL in Child LQTS Patients Compared to Cardiac Patients

Introduction: • Long QT Syndrome (LQTS) is a life threatening geneticallyinherited cardiac arrhythmia disorder affecting approximately 1:2500 persons1, often diagnosed in childhood. • Management of LQTS changes patients’ lifestyles which can affect quality of life (QoL). Patients have restrictions in physical activity, diet, treatment of noncardiac conditions; take daily doses of medicine and/or have implantable cardiac devices (pacemaker/defibrillator). • General pediatirc cardiac patients show significantly worse QoL in comparison to healthy controls2,3. • Nearly 1 in 5 with other cardiac disorders reported impaired psychosocial functioning3. • The effects of implanted cardiac rhythm devices in cardiac patients demonstrated a significant effect on QoL in pediatric patient scores4. • LQTS patients are typically not assessed for psychological symptoms. • Little research on QoL in pediatric LQTS patients has been conducted to determine if psychosocial interventions are warranted

Attitudes and Practice Patterns in the Use of OMM in Patients with Serious Illness

INTRODUCTION: In addition to evidence-based medicine, the osteopathic approach to person-centered care consists of the osteopathic philosophy of integrated structure and function and applying manual techniques to treat somatic dysfunction. Known collectively as Osteopathic Manipulative Medicine (OMM), this approach can be utilized when treating patients with both chronic and acute conditions; however, there is limited data on how often or to what extent OMM is used to treat pain and other symptoms in patients facing serious or life-limiting illnesses. METHODS: A voluntary, anonymous survey was created to capture the practice patterns and attitudes of osteopathic physicians, regardless of specialty, in the uses and benefits of OMM in treating patients with serious illness. The survey was approved by the IRB and designed using a Likert-scale, multiple choice format using Redcap software and permission to distribute the survey electronically was granted from various national and local professional organizations including the American Osteopathic Association (AOA), Pennsylvania Osteopathic Medical Association (POMA) and the PCOM alumni association. Among key data analyzed were the frequency of OMM use in serious or life-limiting illness (Cancer, CHF, and COPD), attitudes about OMM, beliefs about OMM, and use of OMM in older adults. RESULTS: Osteopathic Physicians that utilize OMM when treating patients with serious illness have found OMM to be beneficial when treating certain conditions such as chronic and musculoskeletal pain, shortness of breath, and nausea. The physicians who use OMM also felt comfortable and proficient when utilizing it to treat certain conditions. They also felt their foundation in osteopathic Medicine enabled them to approach and care for patients with empathy and compassion. DISCUSSION: OMM is used by many osteopathic physicians when treating pain and other symptoms of patients who have serious illness. OMM has been found to be beneficial when treating conditions related to CHF, COPD, and Cancer. Osteopathic Physicians who do utilize Osteopathic Manipulative Medicine believe that their training has allowed them to engage and treat patients with compassion and empathy

Amyotrophic lateral sclerosis–specific quality of life–short form (ALSSQOL‐SF): A brief, reliable, and valid version of the ALSSQOL‐R

Introduction: The Amyotrophic Lateral Sclerosis (ALS)‐Specific Quality of Life instrument and its revised version (ALSSQOL and ALSSQOL‐R) have strong psychometric properties, and have demonstrated research and clinical utility. In this study we aimed to develop a short form (ALSSQOL‐SF) suitable for limited clinic time and patient stamina. Methods: The ALSSQOL‐SF was created using Item Response Theory and confirmatory factor analysis on 389 patients. A cross‐validation sample of 162 patients assessed convergent, divergent, and construct validity of the ALSSQOL‐SF compared with psychosocial and physical functioning measures. Results: The ALSSQOL‐SF consisted of 20 items. Compared with the ALSSQOL‐R, optimal precision was retained, and completion time was reduced from 15–25 minutes to 2–4 minutes. Psychometric properties for the ALSSQOL‐SF and its subscales were strong. Discussion: The ALSSQOL‐SF is a disease‐specific global QOL instrument that has a short administration time suitable for clinical use, and can provide clinically useful, valid information about persons with ALS. Muscle Nerve 58: 646–654, 2018Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146574/1/mus26203_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146574/2/mus26203.pd

The Rational-Experiential Information Processing Systems Model: Its Implications For Cognitive Therapy

ABSTRACT. Recent models of the cognitive system include the notion of different levels of information processing. According to these models, cognitive organization and capacity for parallel processing allows a multilayered system of appraisals in which different levels of evaluation are simultaneously available. Thus, the interpretations of a single stimulus may comprise several forms of representation coupled together. A general argument advanced in this paper is that, given the capacity to represent reality and process information in qualitatively different ways, the strategies for intervention must accommodate to such differences in order to increase their effectiveness. The present paper –theoretical study- discusses relevant problems in the standard cognitive therapy model regarding representation of reality and information processing. It presents an alternative information-processing model, the rational-experiential model. Finally, the paper discusses some implications for cognitive therapy practice resulting from the alternative formulation about information processing