Exploring gender differences in doctors' working lives

Background: As the proportion of women in medicine draws towards parity, long-standing questions about gender differences in the way that doctors work become more pertinent. Gender differences in medical working patterns and career choices are well documented; but there is a lack of understanding of everyday differences in the working lives of male and female doctors, particularly in UK hospital medicine. In this thesis, potential sources of gender variations in activity rates, previously reported in the literature, are identified. Methods: Multiple methods were employed to explore potential gender differences in doctors’ working lives. Systematic review methods synthesised existing literature on gender differences in the communication style, content and length of medical consultations. Qualitative methods were used to develop in-depth and contextualised understanding of potential gender differences in UK hospital consultants’ working lives, using observation and interviews. Potential variations in clinic length data were analysed quantitatively and synthesised with the existing literature using meta-analysis. Finally, a pilot questionnaire was designed and tested to build on qualitative findings and investigate variations in a wider sample. Results: Doctors’ gender appears to influence their working lives, and the interface between home and work, and these influences may partly explain variations in activity rates. Specifically, female doctors appear to spend longer on consultations; adopt different styles of communication such as lowered dominance and greater use of psychosocial communication; experience greater barriers in their careers such as gender discrimination and problems with work-family conflict; and may experience lower levels of cooperation from colleagues. Conclusions: This research provides important and timely understanding about the sources of gender differences in the working lives of hospital consultants, which may affect both the quality and quantity of care provided by male and female doctors

Improving Patient Safety by Reducing Falls

In the microsystem setting of this project, there have been two patient falls, within the last year. These falls did not result in injury, hence, did not create additional cost for the hospital, nor the patient. Evaluation of the patient’s charts concluded that the fall risk assessments for the patients in question were not entirely indicative of their risk for falls. Additionally, the fall risk care plans were not patient specific in that they did not fully address the designated fall risks of the patient. An abundance of evidence exists supporting the need to reduce falls, and that fall reduction can be attained by adequately assessing fall risk, as well as by care planning in a multidisciplinary manner. The aim of this project is to improve patient safety by reducing falls. To attain this goal, staff teaching was done regarding the necessity of patient-specific fall risk assessments, as well as care planning specifically for these individualized fall risks. The duration of the evaluation of the process began upon admission to the microsystem, and ended upon discharge from the same microsystem. The resulting conclusion of this process improvement project is projected to be that the fall incidence rate will be reduced to zero, and will remain at zero, through the end of the year. However, final outcomes remain pending

Autobiographical memory narratives in psychotherapy: A coding system applied to the case of Cynthia

Recent cognitive and psychodynamic oriented therapies have converged on the powerful role that narrative processing plays in psychotherapy. Although previous coding systems have examined specific aspects of memory narratives, there are no comprehensive methods for coding segments of clinical evaluations or psychotherapy sessions that zero in on the unit of a briefly recounted autobiographical memory narrative. The present single case study aims to introduce and to demonstrate the Coding System for Autobiographical Memory Narratives in Psychotherapy (CS-AMNP; Singer & Bonalume, 2008) with a young female client whom we call Cynthia. We applied this autobiographical memory narrative approach to the diagnostic interview of Cynthia in evaluation for psychotherapy and compared predictions based on its results to the clinician’s report of Cynthia\u27s actual therapeutic outcome. This study demonstrates the utility of the coding system for personality assessment and case conceptualization in the service of ongoing treatment. In addition, implications of this coding system for future research, clinical practice, and training are discussed

Building Health Equity One Institution at a Time: The Research Infrastructure in Minority Institutions Project

Developing a well-trained workforce interested in, and prepared for, conducting health equity research is an important national priority. Scientists from Minority-Serving Institutions (MSIs) bring unique perspectives and experiences with racial, ethnic and social inequities in health and health status but often lack access to training and mentoring opportunities, which is crucial for increasing the diverse pool of investigators who are adequately prepared to conduct health disparities research and to compete for National Institutes of Health research funding. The focus of the California State University, Long Beach (CSULB) Research Infrastructure in Minority Institutions (RIMI) Project was to: (a) enhance CSULB’s infrastructure and research capacity, (b) conduct applied community health research on health conditions disproportionately affecting disadvantaged populations, and (c) support faculty to embark on careers in reducing health disparities. Faculty received training, mentorship, and release time support to participate in research-related activities. Select faculty also received funding to conduct a two-year health disparities research project. Within a relatively short period of time, the RIMI Project made important strides toward strengthening the research infrastructure at CSULB by enhancing faculty capacity, improving research utilization to address health disparities, and strengthening campus and community collaborations. MSIs are encouraged to apply for opportunities to build their institution’s research capacity. The lessons learned from this project may be used as a guide for other teaching institutions that have the goal to develop minority faculty researchers

toward the scientific study of autobiographical memory narratives in psychotherapy

 In responding to Adler (2010) and Moertl, Boritz, Bryntwick, and Angus (2010), we elaborate three areas of discussion: (1) Defining the autobiographical memory narrative unit; (2) Clarifications regarding our approach to coding narrative memories; and (3) Potential future research.  Our response highlights the importance of a coding system specific to long-term narrative memories, the need to distinguish clearly what is meant by narrative memory, and the value of creating a bridge between the study of narrative memory in psychotherapy and research in cognitive science and personality psychology.    Â

General practitioner well-being during the COVID-19 pandemic : a qualitative interview study

OBJECTIVES: The COVID-19 pandemic presented new challenges for general practitioners' (GPs') mental health and well-being, with growing international evidence of its negative impact. While there has been a wide UK commentary on this topic, research evidence from a UK setting is lacking. This study sought to explore the lived experience of UK GPs during COVID-19, and the pandemic's impact on their psychological well-being. DESIGN AND SETTING: In-depth qualitative interviews, conducted remotely by telephone or video call, with UK National Health Service GPs. PARTICIPANTS: GPs were sampled purposively across three career stages (early career, established and late career or retired GPs) with variation in other key demographics. A comprehensive recruitment strategy used multiple channels. Data were analysed thematically using Framework Analysis. RESULTS: We interviewed 40 GPs; most described generally negative sentiment and many displayed signs of psychological distress and burnout. Causes of stress and anxiety related to personal risk, workload, practice changes, public perceptions and leadership, team working and wider collaboration and personal challenges. GPs described potential facilitators of their well-being, including sources of support and plans to reduce clinical hours or change career path, and some described the pandemic as offering a catalyst for positive change. CONCLUSIONS: A range of factors detrimentally affected the well-being of GPs during the pandemic and we highlight the potential impact of this on workforce retention and quality of care. As the pandemic progresses and general practice faces continued challenges, urgent policy measures are now needed

University Students’ Perceptions of Social Justice: The Impact of Implementing a Summer Camp for Children with Disabilities

University students who experience real‐world service tend to develop a more inclusive world view and enhanced understandings outside of their personal perspectives. This project combined course objectives, community collaboration, and service provision to identify the impact of students’ understanding of social justice and disability access realities. The purpose of this study was to explore the impact of a service‐learning university course on social justice education. The study explored how constructs including empathy, attitudes towards diversity, self‐efficacy, and personal communication (of undergraduate university students) were impacted by interactions with children with disabilities in a summer camp setting that included various activities (e.g., art, equestrian). The study utilized surveys completed by university students prior to a service‐learning experience and again after the project. Pre‐ and during‐ camp reflection data were also analyzed

Pragmatic cluster randomised controlled trial of contextualised grammar teaching and small group teaching to improve the writing skills of 11 year old children

Introduction: We evaluated two interventions: a contextualised grammar teaching intervention – Grammar for Writing - to assess whether it improved 11 year old children’s writing skills; and a small group literacy intervention to assess whether or not this was effective. Design and method: We used a pragmatic cluster randomised trial with partial split plot design. Independent concealed randomisation was undertaken at the class level, and, within the intervention group, children were also individually randomised to receive the whole class intervention plus a small group intervention or to receive the intervention in a whole class setting only. The main outcomes were writing and reading assessed by the Progress in English 11 (Long Form) test (GL Assessment). Results: In 2013, 55 schools in England, each with two classes, were recruited and randomised. Within each school, the two classes were randomly allocated to receive either the intervention or the control condition. After randomisation, 2 schools withdrew, leaving 53 schools, 106 classes and 2510 pupils. We observed an effect size (ES) of 0.10 favouring the Grammar for Writing classes; however, this was not statistically significant (95% confidence interval (CI) -0.10 to 0.31). Pupils randomised to the small groups had an increased literacy score when compared with the control classes (ES = 0.24, 95% CI 0.00 to 0.49) and when compared with the intervention children taught in the whole class (ES = 0.21, 95% CI 0.04 to 0.38). Conclusion: There is little evidence that this form of contextualised grammar teaching had an effect on 11 year old children’s writing skills. There was some evidence of an effect for small group teaching