73 research outputs found
Is Content Really King? An Objective Analysis of the Public's Response to Medical Videos on YouTube
Medical educators and patients are turning to YouTube to teach and learn about medical conditions. These videos are from authors whose credibility cannot be verified & are not peer reviewed. As a result, studies that have analyzed the educational content of YouTube have reported dismal results. These studies have been unable to exclude videos created by questionable sources and for non-educational purposes. We hypothesize that medical education YouTube videos, authored by credible sources, are of high educational value and appropriately suited to educate the public. Credible videos about cardiovascular diseases were identified using the Mayo Clinic's Center for Social Media Health network. Content in each video was assessed by the presence/absence of 7 factors. Each video was also evaluated for understandability using the Suitability Assessment of Materials (SAM). User engagement measurements were obtained for each video. A total of 607 videos (35 hours) were analyzed. Half of all videos contained 3 educational factors: treatment, screening, or prevention. There was no difference between the number of educational factors present & any user engagement measurement (p NS). SAM scores were higher in videos whose content discussed more educational factors (p<0.0001). However, none of the user engagement measurements correlated with higher SAM scores. Videos with greater educational content are more suitable for patient education but unable to engage users more than lower quality videos. It is unclear if the notion ĂąâŹĆcontent is kingĂąâŹïżœ applies to medical videos authored by credible organizations for the purposes of patient education on YouTube
Employment Services Utilization and Outcomes among Substance Abusing Offenders Participating in Californiaâs Proposition 36 Drug Treatment Initiative
California drug treatment programs may use funds to address barriers to work faced by Proposition 36 offenders, most of whom are not working at treatment entry, but employment services utilization and related behavioral outcomes have never been studied. This study examined primary data collected on 1,453 offenders by 30 programs during 2004 to explore the characteristics, employment services utilization, and outcomes of those who did and did not receive employment services while in drug treatment. One-year outcomes were mostly similar across groups, however, increases in the proportion of offenders employed, receiving income from employment and family or friends, and being paid for work were significantly greater among the received-employment-services group, and a greater proportion of this group also completed drug treatment. Employment services utilization was less likely for persons recruited from outpatient settings and more likely with greater severity of family/social problems and desire for services. Odds of employment one-year post-treatment entry were higher for those of Hispanic race/ethnicity (vs. White) and for those with treatment completion/longer retention but lower for those who were older, lived in specific counties, had greater employment problem severity at intake, and received other income-related services. Strategies for improving employment services utilization and outcomes among Proposition 36 offenders are discussed
Lâapprentissage autorĂ©gulĂ© et expĂ©rientiel des comportements professionnels et ses effets transformationnels chez les rĂ©sidents
Purpose: Postgraduate trainees (âresidentsâ) are required to convey professional behaviours as they navigate complex clinical environments. However, little is known about experiential learning for professionalism. Thus, we asked residents about professionalism challenges within the clinical learning environment: 1) how challenges were identified, 2) what supported successfully addressing challenges and 3) the impact of addressing challenges to further inform resident education.
Method: From 2015-2016, twenty-five residents across specialties and multiple university affiliated teaching hospitals participated in appreciative inquiry informed audio-taped semi-structured interviews. Transcripts were categorized deductively for the 2015 CanMEDS Professional Role element addressed (commitment to patients, society, the profession, and physician health). A pragmatic research paradigm focussed descriptive data analysis on actions and outcomes.Â
Results: Residents actively identify opportunities for experiential learning of professionalism within the clinical workplaceâ addressing conflicting priorities with interprofessional clinicians to ensure excellent patient care, providing informal feedback regarding peersâ and other healthcare cliniciansâ professionalism lapses and by gaining self-awareness and maintaining wellness. There were no descriptions of commitment to society. Values, relationships, and reflection supported professional behaviours. Many described transformative personal and professional growth as an outcome of addressing professionalism challenges.
Conclusions: Residents self-regulated experiential learning for professionalism often results in transformational changes personally and professionally. Elucidation of how residents
successfully navigate power dynamics and conflict to provide excellent patient care and feedback for professional regulatory behaviour will support professionalism education. An interprofessional research lens will be valuable to explore how best to incorporate commitment to society within clinical environments. Résumé
Objectif : Il est attendu des stagiaires postdoctoraux (rĂ©sidents) dâadopter des comportements professionnels dans les environnements cliniques complexes dans lesquels ils Ă©voluent. Cependant, on sait peu de choses sur lâapprentissage expĂ©rientiel des comportements professionnels. Nous avons donc interrogĂ© les rĂ©sidents sur les dĂ©fis quâils rencontrent en lien avec le professionnalisme dans leur environnement dâapprentissage clinique : 1) quels sont les problĂšmes quâils considĂšrent comme Ă©tant liĂ©s au professionnalisme, 2) quâest-ce qui les a aidĂ©s Ă relever ces dĂ©fis avec succĂšs et 3) quels sont les effets de leur rĂ©action Ă ces problĂ©matiques et quelles leçons peut-on tirer de ces rĂ©sultats pour mieux adapter la formation des rĂ©sidents.
MĂ©thode : Entre 2015 et 2016, 25 rĂ©sidents de diverses spĂ©cialitĂ©s et hĂŽpitaux universitaires ont participĂ© Ă des entretiens semi-structurĂ©s qui ont Ă©tĂ© menĂ©s selon une mĂ©thode dâinterrogation apprĂ©ciative et qui ont Ă©tĂ© enregistrĂ©s sur bande audio. Les transcriptions ont Ă©tĂ© catĂ©gorisĂ©es de maniĂšre dĂ©ductive par rapport au rĂŽle du professionnel du rĂ©fĂ©rentiel CanMEDS 2015 (engagement envers les patients, la sociĂ©tĂ©, la profession et la santĂ© des mĂ©decins). FondĂ©e sur un paradigme de recherche pragmatique, lâanalyse des donnĂ©es descriptives ciblait les actions et les rĂ©sultats.
RĂ©sultats : Les rĂ©sidents dĂ©cĂšlent activement les occasions dâapprentissage expĂ©rientiel du professionnalisme dans le milieu de travail clinique et ils rĂ©agissent par exemple en abordant les prioritĂ©s divergentes avec les cliniciens dâĂ©quipes interprofessionnelles de façon Ă assurer lâexcellence des soins aux patients, en fournissant des commentaires informels Ă leurs pairs et Ă dâautres cliniciens sur les comportements non professionnels de ces derniers, en prenant conscience dâeux-mĂȘmes et en privilĂ©giant le bien-ĂȘtre. Ils nâont pas proposĂ© de description de lâengagement envers la sociĂ©tĂ©. Les valeurs, les relations et la rĂ©flexion sont les facteurs qui ont soutenu lâadoption de comportements professionnels. Un grand nombre de rĂ©pondants ont dĂ©clarĂ© avoir vĂ©cu une croissance personnelle et professionnelle transformatrice grĂące Ă lâaction quâils ont prise pour rĂ©soudre un problĂšme de professionnalisme.
Conclusions : Lâapprentissage expĂ©rientiel autorĂ©gulĂ© du professionnalisme par les rĂ©sidents entraĂźne souvent des changements transformationnels pour eux sur les plans personnel et professionnel. Une comprĂ©hension approfondie de la gestion rĂ©ussie des rapports de pouvoir et des conflits par les rĂ©sidents leur permettant dâassurer la qualitĂ© des soins aux patients et de donner une rĂ©troaction Ă leurs collĂšgues sur la conformitĂ© de leur comportement professionnel contribuerait grandement Ă lâenseignement du professionnalisme. Lâadoption dâune approche de recherche interprofessionnelle serait utile pour explorer la meilleure façon dâintĂ©grer lâengagement envers la sociĂ©tĂ© dans lâenvironnement clinique
Improvement of emergency surgical clerking documentation following instigation of an emergency clerking proforma
Residentsâ transformational changes through self-regulated, experiential learning for professionalism
Purpose: Postgraduate trainees (âresidentsâ) are required to convey professional behaviours as they navigate complex clinical environments. However, little is known about experiential learning for professionalism. Thus, we asked residents about professionalism challenges within the clinical learning environment: 1) how challenges were identified, 2) what supported successfully addressing challenges and 3) the impact of addressing challenges to further inform resident education.Method: From 2015-2016, twenty-five residents across specialties and multiple university affiliated teaching hospitals participated in appreciative inquiry informed audio-taped semi-structured interviews. Transcripts were categorized deductively for the 2015 CanMEDS Professional Role element addressed (commitment to patients, society, the profession, and physician health). A pragmatic research paradigm focussed descriptive data analysis on actions and outcomes. Results: Residents actively identify opportunities for experiential learning of professionalism within the clinical workplaceâ addressing conflicting priorities with interprofessional clinicians to ensure excellent patient care, providing informal feedback regarding peersâ and other healthcare cliniciansâ professionalism lapses and by gaining self-awareness and maintaining wellness. There were no descriptions of commitment to society. Values, relationships, and reflection supported professional behaviours. Many described transformative personal and professional growth as an outcome of addressing professionalism challenges.Conclusions: Residents self-regulated experiential learning for professionalism often results in transformational changes personally and professionally. Elucidation of how residents successfully navigate power dynamics and conflict to provide excellent patient care and feedback for professional regulatory behaviour will support professionalism education. An interprofessional research lens will be valuable to explore how best to incorporate commitment to society within clinical environments.Objectif : Il est attendu des stagiaires postdoctoraux (rĂ©sidents) dâadopter des comportements professionnels dans les environnements cliniques complexes dans lesquels ils Ă©voluent. Cependant, on sait peu de choses sur lâapprentissage expĂ©rientiel des comportements professionnels. Nous avons donc interrogĂ© les rĂ©sidents sur les dĂ©fis quâils rencontrent en lien avec le professionnalisme dans leur environnement dâapprentissage clinique : 1) quels sont les problĂšmes quâils considĂšrent comme Ă©tant liĂ©s au professionnalisme, 2) quâest-ce qui les a aidĂ©s Ă relever ces dĂ©fis avec succĂšs et 3) quels sont les effets de leur rĂ©action Ă ces problĂ©matiques et quelles leçons peut-on tirer de ces rĂ©sultats pour mieux adapter la formation des rĂ©sidents.MĂ©thode : Entre 2015 et 2016, 25 rĂ©sidents de diverses spĂ©cialitĂ©s et hĂŽpitaux universitaires ont participĂ© Ă des entretiens semi-structurĂ©s qui ont Ă©tĂ© menĂ©s selon une mĂ©thode dâinterrogation apprĂ©ciative et qui ont Ă©tĂ© enregistrĂ©s sur bande audio. Les transcriptions ont Ă©tĂ© catĂ©gorisĂ©es de maniĂšre dĂ©ductive par rapport au rĂŽle du professionnel du rĂ©fĂ©rentiel CanMEDS 2015 (engagement envers les patients, la sociĂ©tĂ©, la profession et la santĂ© des mĂ©decins). FondĂ©e sur un paradigme de recherche pragmatique, lâanalyse des donnĂ©es descriptives ciblait les actions et les rĂ©sultats.RĂ©sultats : Les rĂ©sidents dĂ©cĂšlent activement les occasions dâapprentissage expĂ©rientiel du professionnalisme dans le milieu de travail clinique et ils rĂ©agissent par exemple en abordant les prioritĂ©s divergentes avec les cliniciens dâĂ©quipes interprofessionnelles de façon Ă assurer lâexcellence des soins aux patients, en fournissant des commentaires informels Ă leurs pairs et Ă dâautres cliniciens sur les comportements non professionnels de ces derniers, en prenant conscience dâeux-mĂȘmes et en privilĂ©giant le bien-ĂȘtre. Ils nâont pas proposĂ© de description de lâengagement envers la sociĂ©tĂ©. Les valeurs, les relations et la rĂ©flexion sont les facteurs qui ont soutenu lâadoption de comportements professionnels. Un grand nombre de rĂ©pondants ont dĂ©clarĂ© avoir vĂ©cu une croissance personnelle et professionnelle transformatrice grĂące Ă lâaction quâils ont prise pour rĂ©soudre un problĂšme de professionnalisme.Conclusions : Lâapprentissage expĂ©rientiel autorĂ©gulĂ© du professionnalisme par les rĂ©sidents entraĂźne souvent des changements transformationnels pour eux sur les plans personnel et professionnel. Une comprĂ©hension approfondie de la gestion rĂ©ussie des rapports de pouvoir et des conflits par les rĂ©sidents leur permettant dâassurer la qualitĂ© des soins aux patients et de donner une rĂ©troaction Ă leurs collĂšgues sur la conformitĂ© de leur comportement professionnel contribuerait grandement Ă lâenseignement du professionnalisme. Lâadoption dâune approche de recherche interprofessionnelle serait utile pour explorer la meilleure façon dâintĂ©grer lâengagement envers la sociĂ©tĂ© dans lâenvironnement clinique
The sensitivity of pre-operative axillary staging in breast cancer: comparison of invasive lobular and ductal carcinoma.
Contextual Competence: How residents develop competent performance in new settings
Introduction Medical education continues to diversify its settings. For postgraduate trainees, moving across diverse settings, especially community-based rotations, can be challenging personally and professionally. Competent performance is embedded in context; as a result, trainees who move to new contexts are challenged to use their knowledge, skills and experience to adjust. What trainees need to adapt to and what that requires of them are poorly understood. This research takes a capability approach to understand how trainees entering a new setting develop awareness of specific contextual changes that they need to navigate and learn from.Methods We used constructivist grounded theory with in-depth interviews. A total of 29 trainees and recent graduates from three internal medicine training programmes in Canada participated. All participants had completed at least one community-based rotation geographically far from their home training site. Interviews were recorded, transcribed and anonymised. The interview framework was adjusted several times following initial data analysis.Results Contextual competence results from trainees' ability to attend to five key stages. Participants had first to meet their physiological and practical needs, followed by developing a sense of belonging and legitimacy, which paved the way for a re-constitution of competence and appropriate autonomy. Trainee's attention to these stages of adaptation was facilitated by a process of continuously moving between using their knowledge and skill foundation and recognising where and when contextual differences required new learning and adaptations.Discussion An ability to recognise contextual change and adapt accordingly is part of Nussbaum and Sen's concept of capability development. We argue this key skill has not received the attention it deserves in current training models and in the support postgraduate trainees receive in practice. Recommendations include supporting residents in their capability development by debriefing their experiences of moving between settings and supporting clinical teachers as they actively coach residents through this process
Predicting the Chemical composition of herbaceous legumes using Near Infrared Reflectance Spectroscopy
(Journal of Applied Science in Southern Africa: 2000 6(2): 107-114
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