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Physician competence

Fadi Bouri, Walid El Ansari, Shady Mahmoud, Ahmed Elhessy, Abdulla Al-Ansari, Mohamed Al Ateeq Al-Dosari
Pain is a challenge for orthopedic healthcare professionals (OHCP). However, pain studies examined the competencies of a single OHCP category, did not consider various pain management domains or barriers to optimal pain service, and are deficient across the Arabic Eastern Mediterranean region. We surveyed OHCP's recognition and knowledge of pain and perceived barriers to optimal pain service (361 OHCP, five hospitals). Chi square compared doctors' ( n = 63) vs. nurses/physiotherapists' ( n = 187) views. In terms of pain recognition, more nurses had pain management training, confidently assessed pediatric/elderly pain, were aware of their departments' pain protocols, and felt that their patients receive proper pain management...
August 13, 2018: Healthcare (Basel, Switzerland)
Julia Köppen, Claudia B Maier, Reinhard Busse
BACKGROUND: Many European countries experience health workforce skill-mix changes due to population ageing, multimorbidity and medical technology. Yet, there is limited cross-country research in hospitals. METHODS: Cross-sectional, observational study on staff role changes and contributing factors in nine European countries. Survey of physicians, nurses and managers (n = 1524) in 112 hospitals treating patients with breast cancer or acute myocardial infarction...
July 26, 2018: Health Policy
Jacqueline Wiltshire, Jeroan J Allison, Roger Brown, Keith Elder
Background/Objective: Physical concordance between physicians and patients is advocated as a solution to improve trust and health outcomes for racial/ethnic minorities, but the empirical evidence is mixed. We assessed women's perceptions of physician trustworthiness based on physician physical characteristics and context of medical visit. Methods: A factorial survey design was used in which a community-based sample of 313 African American (AA) women aged 45+ years responded to vignettes of contrived medical visits (routine versus serious medical concern visit) where the physician's race/ethnicity, gender, and age were randomly manipulated...
2018: AIMS Public Health
Melissa Barnett, M Tyson Pillow, Jennifer Carnell, Anita Rohra, Stephanie DeSandro, Aimee K Gardner
PURPOSE: We performed a needs assessment to understand how existing physician assistant (PA) program curricula and clinical training affect students' ultrasound knowledge, skills, and competence and prepare students for performing ultrasound techniques in clinical practice. METHODS: Students graduating from a PA program completed a 23-item questionnaire examining their ultrasound training experiences, their self-assessment of competency, and their demographics. Students also completed a 15-item ultrasound knowledge assessment...
August 6, 2018: Journal of Physician Assistant Education
Rasmus K B Richelsen, Signe B Jensen, Henrik Nielsen
To assess the incidence, predictive factors, and prognosis of acyclovir-induced nephrotoxicity. We conducted a historical prospective cohort study of patients treated with intravenous acyclovir in North Denmark Region from 2009 to 2016. Information on baseline demographics, co-morbidities, plasma creatinine, and treatment was obtained from the medical records. The primary outcome was an increase of ≥ 40 μmol/L in plasma creatinine level from baseline. We included 276 patients treated with intravenous acyclovir of which 29 (10...
August 7, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Jeffrey A Marbach, Aws Almufleh, Michael Froeschl, Benjamin Hibbert
More than 3 decades ago, Wyngaarden and Gill first warned of the challenges facing physician-scientists in their seminal papers "The Clinical Investigator as an Endangered Species" and "The End of the Physician-Scientist." In the years since these papers were published, there has been expansion of stage I-II preclinical research focusing on discovery and exploratory studies. Expansion has often come at the expense of physician-scientists whose traditional role has been to bridge the gap between early preclinical research (stage I-II) and clinical trials (stage IV)...
August 2, 2018: Canadian Journal of Cardiology
Saisanjana Kalagara, Adam E M Eltorai, J Mason DePasse, Alan H Daniels
BACKGROUND: Online physician rating websites are increasingly utilized by patients to evaluate their doctors. The purpose of this investigation was to evaluate factors associated with better spine surgeon ratings. METHODS: Orthopedic spine surgeons were randomly selected from the North American Spine Society directory utilizing a random number generator. Surgeon profiles on three physician rating websites,,, and, were analyzed to gather qualitative and quantitative data on patients' perceptions of the surgeons...
August 1, 2018: Spine Journal: Official Journal of the North American Spine Society
Soolmaz Moosavi, Camelia Rohani, Fariba Borhani, Mohammad Esmaeel Akbari
PURPOSE: Spiritual care is a component of the holistic nursing approach. But in practice, nurses face many challenges during the implementation of spirituality care. Thus, the aim of this study was to explore the barriers and facilitators affecting spiritual care practices by oncology nurses. METHODS: This qualitative study was conducted using a conventional content analysis based on semi-structured interviews with 25 participants, including cancer patients and their family members, oncology nurses, physicians, psychologist, and spiritual researcher-therapists...
July 31, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Edvin Schei, Ruth E Johnsrud, Thomas Mildestvedt, Reidar Pedersen, Stefán Hjörleifsson
BACKGROUND: Traditional preclinical curricula based on memorization of scientific facts constitute learning environments which may negatively influence both factual understanding and professional identity development in medical students. Little is known of how students themselves experience and interpret such educational milieus. OBJECTIVE: To investigate first-year medical students' view of the physician role, and their perception of the relevance and quality of teaching in a science-based preclinical curriculum...
December 2018: Medical Education Online
Maria Wamsley, Jason M Satterfield, Alexa Curtis, Lena Lundgren, Derek D Satre
OBJECTIVES: Screening, Brief Intervention, and Referral to Treatment (SBIRT) can effectively identify and address substance misuse and substance use disorders (SUDs), and can be delivered by a range of trained health professionals. Yet, barriers remain to effective training and implementation of SBIRT in health and social service settings, and models of interprofessional collaboration in SBIRT delivery are underdeveloped. METHODS: We reviewed current literature regarding SBIRT effectiveness, training, and implementation by physicians, nurses, psychologists, and social workers...
July 2018: Journal of Addiction Medicine
Simone Stenekes, Jamie L Penner, Michael Harlos, Marie-Claude Proulx, Erin Shepherd, Stephen Liben, Genevieve Thompson, Grace MacConnell, Marie-Claude Grégoire, Harold Hal Siden
Perinatal palliative care is an emerging area of health care. To date, no published tools assess health-care provider's knowledge and level of comfort in providing such care. A 2-phase study was undertaken to develop and implement a survey to evaluate the self-assessed competency, attitudes, and knowledge of health-care providers working in perinatal palliative care. Phase 1 included a review of the literature and appraisal of palliative and death-related instruments to inform the initial draft of the Perinatal Palliative Care Survey (PPCS)...
July 31, 2018: Journal of Palliative Care
Juan Valdes-Stauber
BACKGROUND: Whereas from a professional point of view, a medical treatment might seem necessary, this treatment might be refused by the patient. In such cases, the patient's ability to determine his will is the key. Any substitutive medical decision is justified by a specific normative framework. OBJECTIVE: The dialectic between a patient's inability to determine his will and the conviction of physicians about the necessity of a medical intervention is reformulated from a medical-anthropological point of view...
July 30, 2018: Fortschritte der Neurologie-Psychiatrie
Yen-Yi Juo, Catherine Lewis, Christina Hanna, Howard A Reber, Areti Tillou
OBJECTIVE: Familiarize surgery residents with medicolegal knowledge and skills required when facing the prospect of being sued through a simulation session. DESIGN: The general surgery residency, hospital risk management, and malpractice attorneys collaboratively organized an educational intervention, consisting of an introductory lecture followed by a mock lawsuit. Two medical malpractice attorneys acted as defense and plaintiff attorneys while an attending surgeon experienced in litigation acted as defendant...
July 26, 2018: Journal of Surgical Education
Sachin Wani, Rajesh N Keswani, Samuel Han, Eva Aagaard, Matthew Hall, Violette Simon, Wasif M Abidi, Subhas Banerjee, Todd H Baron, Michael Bartel, Erik Bowman, Brian C Brauer, Jonathan M Buscaglia, Linda Carlin, Amitabh Chak, Hemant Chatrath, Abhishek Choudhary, Bradley Confer, Gregory A Coté, Koushik K Das, Christopher J DiMaio, Andrew M Dries, Steven A Edmundowicz, Abdul Hamid El Chafic, Ihab El Hajj, Swan Ellert, Jason Ferreira, Anthony Gamboa, Ian S Gan, Lisa Gangarosa, Bhargava Gannavarapu, Stuart R Gordon, Nalini M Guda, Hazem T Hammad, Cynthia Harris, Sujai Jalaj, Paul Jowell, Sana Kenshil, Jason Klapman, Michael L Kochman, Sri Komanduri, Gabriel Lang, Linda S Lee, David E Loren, Frank Lukens, Daniel Mullady, Raman V Muthusamy, Andrew S Nett, Mojtaba S Olyaee, Kavous Pakseresht, Pranith Perera, Patrick Pfau, Cyrus Piraka, John M Poneros, Amit Rastogi, Anthony Razzak, Brian Riff, Shreyas Saligram, James M Scheiman, Isaiah Schuster, Raj J Shah, Rishi Sharma, Joshua P Spaete, Ajaypal Singh, Muhammad Sohail, Jayaprakash Sreenarasimhaiah, Tyler Stevens, James H Tabibian, Demetrios Tzimas, Dushant Uppal, Shiro Urayama, Domenico Vitterbo, Andrew Y Wang, Wahid Wassef, Patrick Yachimski, Sergio Zepeda-Gomez, Tobias Zuchelli, Dayna Early
BACKGROUND & AIMS: It is unclear whether participation in competency-based fellowship programs for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) result in high-quality care in independent practice. We aimed to measure quality indicator (QI) adherence during the first year of independent practice among physicians who completed endoscopic training with a systematic assessment of competence. METHODS: We performed a prospective multicenter cohort study, inviting participants from 62 training programs...
July 26, 2018: Gastroenterology
Jan Shoenberger, Sangeeta Lamba, Rebecca Goett, Paul DeSandre, Kate Aberger, Suzanne Bigelow, Todd Brandtman, Garrett K Chan, Robert Zalenski, David Wang, Mark Rosenberg, Karen Jubanyik
Objectives: Emergency medicine (EM) physicians commonly care for patients with serious life-limiting illness. Hospice and palliative medicine (HPM) is a subspecialty pathway of EM. Although a subspecialty level of practice requires additional training, primary-level skills of HPM such as effective communication and symptom management are part of routine clinical care and expected of EM residents. However, unlike EM residency curricula in disciplines like trauma and ultrasound, there is no nationally defined HPM curriculum for EM resident training...
April 2018: AEM education and training
Kelly Williamson, Patrick M Lank, Elise O Lovell
Burnout, the triad of emotional exhaustion, depersonalization, and low personal accomplishment, begins early in medical education and the prevalence continues to increase over time among U.S. physicians. The Accreditation Council for Graduate Medical Education (ACGME) now requires that programs and sponsoring institutions have the same responsibility to address well-being as they do other aspects of resident competence. Yet, there are no studies published in the emergency medicine (EM) literature that discuss the development and institution of a formal wellness curriculum...
January 2018: AEM education and training
Delia L Gold, Jennifer R Marin, Demetris Haritos, L Melissa Skaugset, Jennifer M Kline, Rachel M Stanley, David P Way, David P Bahner
Objectives: Point-of-care ultrasound (POCUS) has been identified as a critical skill for pediatric emergency medicine (PEM) physicians. The purpose of this study was to profile the current status of PEM POCUS in pediatric emergency departments (EDs). Methods: An electronic survey was distributed to PEM fellows and attending physicians at four major pediatric academic health centers. The 24-item questionnaire covered professional demographics, POCUS experience and proficiency, and barriers to the use of POCUS in pediatric EDs...
October 2017: AEM education and training
Michael Scholz, Friedrich Paulsen, Axel Ropohl, Pascal H Burger
In order to get admission to study medicine at a German university, the most important criterion is the proof of an excellent final college prep school examination (Abitur) in order to get an adequate study place without time loss. For the purpose of a suitable selection for admission of candidates, however, the best qualified and suitable applicants should be found to be distributed to the limited available university places for medicine. The final examination mark alone can represent such a suitability - if at all - only to a very limited extent...
July 23, 2018: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Alison E Turnbull, Sarina K Sahetya, E Lee Daugherty Biddison, Christiane S Hartog, Gordon D Rubenfeld, Dominique D Benoit, Bertrand Guidet, Rik T Gerritsen, Mark R Tonelli, J Randall Curtis
Medical professionals are expected to prioritize patient interests, and most patients trust physicians to act in their best interest. However, a single patient is never a physician's sole concern. The competing interests of other patients, clinicians, family members, hospital administrators, regulators, insurers, and trainees are omnipresent. While prioritizing patient interests is always a struggle, it is especially challenging and important in the ICU setting where most patients lack the ability to advocate for themselves or seek alternative sources of care...
July 25, 2018: Intensive Care Medicine
Megan Delisle, Courtney Chernos, Jason Park, Krista Hardy, Ashley Vergis
INTRODUCTION: Methods of developing and determining General Surgery (GS) residents' competency in gastrointestinal endoscopy in Canada are not currently standardized. This study aimed to assess the status of gastrointestinal endoscopy training in Royal College of Physicians and Surgeons of Canada (RCPSC) GS residency programs. METHODS: A 35-question survey was developed using GS gastrointestinal endoscopy curricula guidelines. All 17 RCPSC GS program directors were contacted to complete the questionnaire via the web-based SurveyMonkey...
July 24, 2018: Surgical Endoscopy
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