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Physician competence

Tami J France, Ronald Menaker, Kent R Thielen
Successful physician and administrator leader partnerships are a key differentiator in today's volatile, unpredictable, ever-changing health care landscape. Whether they are leading a division, a department, or an organization, intentional and mindful physician-administrator partnerships affect success from the micro individual level to the macro organizational level. Mayo Clinic's physician and administrative leaders are leveraging a long-held tradition of partnership by elevating their own competence as effective partners to ensure organizational sustainability...
December 12, 2018: Journal of the American College of Radiology: JACR
Mark S Komrad, Ronald W Pies, Annette L Hanson, Cynthia M A Geppert
No abstract text is available yet for this article.
November 27, 2018: Journal of Clinical Psychiatry
Laura E Hirshfield, Rachel Yudkowsky, Yoon Soo Park
CONTEXT: Medical school admissions committees use a variety of criteria to determine which candidates to admit to their programmes. Effective communication is increasingly considered a key requisite to the practice of effective medicine. Medical students with pre-medical backgrounds in the humanities and social sciences may be more likely to acquire skills relevant to patient-centred communication, either prior to or during medical school. OBJECTIVES: The purpose of this study was to investigate the relationship between pre-medical backgrounds in the humanities and social sciences and outcomes in medical school, including in communication and interpersonal skills (CIS), licensure examination results and postgraduate specialty choice (primary care versus non-primary care specialties)...
December 13, 2018: Medical Education
Peipei Zhao, Bolin Cao, Cedric H Bien-Gund, Weiming Tang, Jason J Ong, Yi Ding, Weiying Chen, Joseph D Tucker, Zhenzhou Luo
BACKGROUND: Men who have sex with men (MSM) are at high risk of human immunodeficiency virus (HIV) infection and sexually transmitted infection (STI) in China. Inadequate clinical services and poor clinical competency among physicians are major barriers to improving the sexual health of MSM. This study aims to understand physician clinical competency in providing MSM health services in China. METHODS: We conducted an online cross-sectional survey among Chinese physicians who have seen male patients for STI complaints in the past year...
December 13, 2018: BMC Health Services Research
Malin Knutsen Glette, Olav Røise, Tone Kringeland, Kate Churruca, Jeffrey Braithwaite, Siri Wiig
BACKGROUND: Thirty-day hospital readmissions represent an international challenge leading to increased prevalence of adverse events, reduced quality of care and pressure on healthcare service's resources and finances. There is a need for a broader understanding of hospital readmissions, how they manifest, and how resources in the primary healthcare service may affect hospital readmissions. The aim of the study was to examine how nurses and nursing home leaders experienced the resource situation, staffing and competence level in municipal healthcare services, and if and how they experienced these factors to influence hospital readmissions...
December 12, 2018: BMC Health Services Research
Jan-Ole Reichardt, Daniel R Friedrich
With its "Münsteraner Memorandum on Alternative Practitioners" the author collective "Münsteraner Kreis" has recently criticized current German double standards for physicians versus alternative practitioners with regard to minimal competency and to quality assurance. The authors' main goal was to attract attention to the problem and to provide systematic arguments in favor of a healthcare system that is serving patients' needs more appropriately. Reactions to the Memorandum were numerous, divergent in their evaluations, often constructive, and frequently emotionally heated...
November 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Anita Li, Alan Poling
People with autism spectrum disorder often receive psychotropic medications and two drugs, risperidone and aripiprazole, are approved for treating "irritability" in this population. A number of authors have suggested that behavior analysts can contribute to the prudent use of such drugs, but little is known regarding Board Certified Behavior Analysts' involvement in practices relevant to the use of psychotropic drugs. We e-mailed Board Certified Behavior Analysts an anonymous web-based survey regarding such practices...
December 31, 2018: Behavior Analysis in Practice
Rosemary Thomas-Mohtat, Craig Sable, Kristen Breslin, Jacqueline G Weinberg, Aparna Prasad, Lauren Zinns, Joanna S Cohen
BACKGROUND: Focused cardiac ultrasound (FOCUS) is a core competency for pediatric emergency medicine (PEM) fellows. The objectives of this study were (1) to evaluate test characteristics of PEM-fellow-performed FOCUS for pericardial effusion and diminished cardiac function and (2) to assess image interpretation independent of image acquisition. METHODS: PEM fellows performed and interpreted FOCUS on patients who also received cardiology service echocardiograms, the reference standard...
December 9, 2018: Critical Ultrasound Journal
Nicholas A Rattray, Mindy E Flanagan, Laura G Militello, Paul Barach, Zamal Franks, Patricia Ebright, Shakaib U Rehman, Howard S Gordon, Richard M Frankel
BACKGROUND: Poor communication during end-of-shift transfers of care (handoffs) is associated with safety risks and patient harm. Despite the common perception that handoffs are largely a one-way transfer of information, researchers have documented that they are complex interactions, guided by implicit social norms and mental frameworks. OBJECTIVES: We investigated communication strategies that resident physicians report deploying to tailor information during face-to-face handoffs that are often based on their implicit inferences about the perceived information needs and potential harm to patients...
December 10, 2018: Journal of General Internal Medicine
Nathan I Wood
"Code-switching"-the mixing of languages, dialects, tones, or lexicons within a single conversation-is a prevalent linguistic phenomenon that has been described thoroughly in the social science literature. However, it is relatively unknown to the medical community despite its clear implications for clinicians as they navigate their role in the physician-patient relationship. As multilingualism and other forms of mixed speech become increasingly common in the urban and globally minded populations of America's modern cities, physicians must be cognizant of how they use their language skills-such as code-switching-to communicate with their patients in an ethical, supportive, and non-offensive manner...
December 10, 2018: Journal of General Internal Medicine
Alex M Cressman, Derek R MacFadden, Amol A Verma, Fahad Razak, Nick Daneman
Background: Physicians face competing demands of maximizing pathogen coverage, while minimizing unnecessary use of broad-spectrum antibiotics when managing sepsis. We sought to identify physicians' perceived likelihood of coverage achieved by their usual empiric antibiotic regimen, along with minimum thresholds of coverage they would be willing to accept when managing these patients. Methods: We conducted a scenario-based survey of internal medicine physicians from across Canada using a 2 x 2 factorial design, varied by infection source (undifferentiated vs...
December 7, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Pamela Rojas, Carolina Rain, Victoria Cuadra, Carla Castañón
BACKGROUND: Considering the frequency of sexual abuse and domestic violence (SA-DV) in the population, the likelihood of a medical student meeting patients with this problem is substantial. However, most students do not consider SA-DV in their differential diagnoses. Since 2014, this team has been working in strengthening undergraduate curriculum in SA-DV. It has been a challenging and slow process. PURPOSE: To identify barriers and facilitators perceived by the undergraduate teaching team in order to suggest modifications in the curriculum in relation to the competencies required for screening and early intervention for victims of SA-DV...
August 2018: Revista Médica de Chile
Khodayar Goshtasbi, Brandon M Lehrich, Omid Moshtaghi, Mehdi Abouzari, Ronald Sahyouni, Kian Bagheri, Afsheen Moshtaghi, Sarah D Tajran, Lauren Lee, Harrison W Lin, Hamid R Djalilian
OBJECTIVES: To assess and characterize patients' online ratings and comments of neurotologists and determine factors that correlate with higher ratings. METHODS: All the American Neurotology Society members were queried on Healthgrades, Vitals, RateMDs, Yelp, and Google from March to June 2018. All ratings were normalized for comparison on a five-point Likert scale. All comments were categorized based on context and for positive/negative aspect. RESULTS: Of the 560 American Neurotology Society members, 465 (83%) were rated on at least one online platform...
January 2019: Otology & Neurotology
M Bartholomäus, B Zomorodbakhsch, O Micke, F J Prott, I Rudolph, E Seilacher, A Hochhaus, Jutta Huebner
BACKGROUND: Data on patients' needs with respect to physicians' ethical behavior and virtues are important but not available in most cases. PATIENTS AND METHODS: In an iterative process together with patients' representatives, we developed a standardized questionnaire which was distributed to the representatives of the Women's Self-Help after Cancer in Germany. We started with the classical ethical virtues and clustered them to characteristics. The patients' representatives were asked to rate in different communications settings...
December 6, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Yu Lysanets, O Bieliaieva, I Znamenska, N Nikolaieva, S Efendiieva, M Hutsol
The paper examines the narrative arrangement of the problem-oriented medical record (POMR) as an effective method of registering and assessing clinical data. The aim of the research is to examine the types of narrators and focalization, as well as the hierarchy and interaction of narrative levels in the analyzed discourse. The research has demonstrated the presence of several types of narrators within the analyzed discourse: (1) the omniscient hetero-extradiegetic narrator with transient internal focalization (the third-person narration, represented by the physician) and (2) homo-intradiegetic narration (patient's first-person narration) in the "Subjective Observation" section; (3) the "estranged" heterodiegetic narrator with external focalization (the "Objective Observation" part); (4) the "uncertain" type of narrator (the "Assessment" part); (5) and the imperative mode of narration (the "Plan" section)...
October 2018: Georgian Medical News
Bianca Senf, Jens Fettel, Christina Demmerle, Paula Maiwurm
OBJECTIVE: Clinical experience reveals a gap between recommended psychosocial care and actual support for psycho-oncology. Physicians' are essential for managing psychosocial distress and for the successful implementation of psycho-oncology. The aim was to explore physician's attitudes towards psycho-oncology, their self-perceived barriers towards referral to psycho-oncology, and their personal psychosocial competencies in a maximum-care hospital. METHOD: Semi-structured interviews informed the development of a questionnaire administered to a monocentric sample of 120 physicians at the University Hospital Frankfurt...
December 4, 2018: Psycho-oncology
Siegfried Lehrl, Peter Kardos, Heinrich Matthys, Wolfgang Kamin
Background: There are no validated standardised clinical procedures for severity measurement of acute bronchitis in children. The "BSS-ped", a short version of the physician-rated assessment scale BSS (Bronchitis Severity Scale), can fill this gap, if it is valid. Objective: To examine the scale´s validity. Methods: Investigations were planned according to classical clinical-psychometric validity criteria including a formal competence evaluation of the scale´s authors and statistical analyses of data from 78 patients aged 1-6 and diagnosed with "acute bronchitis"...
2018: Open Respiratory Medicine Journal
Prashant Parulekar, Ed Neil-Gallacher, Alex Harrison
Acute kidney injury is common in critically ill patients, with ultrasound recommended to exclude renal tract obstruction. Intensive care unit clinicians are skilled in acquiring and interpreting ultrasound examinations. Intensive Care Medicine Trainees wish to learn renal tract ultrasound. We sought to demonstrate that intensive care unit clinicians can competently perform renal tract ultrasound on critically ill patients. Thirty patients with acute kidney injury were scanned by two intensive care unit physicians using a standard intensive care unit ultrasound machine...
November 2018: Journal of the Intensive Care Society
Yvonne Ying, Christine Seabrook
OBJECTIVE: Being a strong health advocate is recognized as being an important part of being a good surgeon. Residency training programs have struggled with teaching health advocacy beyond didactic sessions, and in a way that encourages trainees to incorporate changes into their practice. This curriculum development aimed to incorporate reflective practice to encourage patient compassion and advocacy. DESIGN: Community service was incorporated as a mandatory component of a postgraduate surgical training program...
November 29, 2018: Journal of Surgical Education
Kartikeya Rajdev, Nina Loghmanieh, Maria A Farberov, Seleshi Demissie, Theodore Maniatis
It is important for health-care providers to be comfortable in providing end-of-life (EOL) care to critically ill patients and realizing when continuing aggressive measures would be futile. Therefore, there is a need to understand health-care providers' self-perceived skills and barriers to providing optimum EOL care. A total of 660 health-care providers from medicine and surgery departments were asked via e-mail to complete an anonymous survey assessing their self-reported EOL care competencies, of which 238 responses were received...
December 3, 2018: Journal of Intensive Care Medicine
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