Independent Living Oldest-Old and Their Primary Health Provider: A Mixed Method Examination of the Influence of Patient Personality Characteristics

This convergent mixed methods study examined 35 healthy, independent living individuals\u27 (over 85 years) perceptions of their relationship with their primary health provider (PHP) and health practices. The relationship between PHP relationship perceptions and locus of control (LOC), resilience, and self-efficacy was explored through surveys and interviews. The majority indicated they visited their PHP just for preventative care; the number of PHP visits per year was significantly lower than reported for individuals over 85 by the CDC, possible reasons for this finding are provided. A positive relationship between LOC, resiliency, and self-efficacy for the oldest-old was found. Few participants indicated their PHP had discussed normal changes with aging. This study has deepened understanding of the complexity inherent to the healthy oldest-olds\u27 relationship with their PHP. The findings suggest this relationship relates to the PHP\u27s personal characteristics, the elderly patients\u27 personality, and the influence of the accompanying patient escort

Independent Living Oldest-Old and Their Primary Health Provider: A Mixed Method Examination of the Influence of Patient Personality Characteristics

This convergent mixed methods study examined 35 healthy, independent living individuals\u27 (over 85 years) perceptions of their relationship with their primary health provider (PHP) and health practices. The relationship between PHP relationship perceptions and locus of control (LOC), resilience, and self-efficacy was explored through surveys and interviews. The majority indicated they visited their PHP just for preventative care; the number of PHP visits per year was significantly lower than reported for individuals over 85 by the CDC, possible reasons for this finding are provided. A positive relationship between LOC, resiliency, and self-efficacy for the oldest-old was found. Few participants indicated their PHP had discussed normal changes with aging. This study has deepened understanding of the complexity inherent to the healthy oldest-olds\u27 relationship with their PHP. The findings suggest this relationship relates to the PHP\u27s personal characteristics, the elderly patients\u27 personality, and the influence of the accompanying patient escort

Emergency Medicine Resident Self-Assessment of Clinical Teaching Compared to Student Evaluation Using a Previously Validated Rubric.

PURPOSE: The quality of clinical teaching in the emergency department from the students\u27 perspective has not been previously described in the literature. Our goals were to assess senior residents\u27 teaching ability from the resident/teacher and student/learner viewpoints for any correlation, and to explore any gender association. The secondary goal was to evaluate the possible impact of gender on the resident/student dyad, an interaction that has previously been studied only in the faculty/student pairing. METHODS: After approval by an institutional review board, a 1-year, grant-funded, single-site, prospective study was implemented at a regional medical campus that sponsors a 4-year dually approved emergency medicine residency. The residency hosts both medical school students (MSs) and physician\u27s assistant students (PAs). Each student and senior resident working concurrently completed a previously validated ER Scale, which measured residents\u27 teaching performance in 4 categories: Didactic, Clinical, Approachable, and Helpful. Students evaluated residents\u27 teaching, while residents self-assessed their performance. The participants\u27 demographic characteristics gathered included prior knowledge of or exposure to clinical teaching models. Gender was self-reported by participants. The analysis accounted for multiple observations by comparing participants\u27 mean scores. FINDINGS: Ninety-nine subjects were enrolled; none withdrew consent. Thirty-seven residents (11 women) and 62 students (39 women) from 25 MSs and 6 PA schools were enrolled, completing 517 teaching assessments. Students evaluated residents more favorably in all ER Scale categories than did residents on self-assessments (P \u3c 0.0001). This difference was significant in all subgroup comparisons (types of school versus postgraduate years [PGYs]). Residents\u27 evaluations by type of student (MS vs PA) did not show a significant difference. PGY 3 residents assessed themselves higher in all categories than did PGY 4 residents, with Approachability reaching significance (P = 0.0105). Male residents self-assessed their teaching consistently higher than did female residents, significantly so on Clinical (P = 0.0300). Students\u27 evaluations of the residents\u27 teaching skills by residents\u27 gender did not reveal gender differences. IMPLICATIONS: MS and PA students evaluated teaching by EM senior residents statistically significantly higher than did EM residents on self-evaluation when using the ER Scale. Students did not evaluate residents\u27 teaching with any difference by gender, although male residents routinely self-assessed their teaching abilities more positively than did female residents. These findings suggest that, if residency programs utilize resident self-evaluation for programmatic evaluation, the gender of the resident may impact self-scoring. This cohort may inform future study of resident teaching in the emergency department, such as the design of future resident-as-teacher curricula