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Autonomy and supervision

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https://www.readbyqxmd.com/read/29765825/early-career-surgical-practice-for-cerebellopontine-angle-tumors-in-the-era-of-radiosurgery
#1
Giannantonio Spena, Tommaso Sorrentino, Roberto Altieri, Luca Redaelli de Zinis, Roberto Stefini, Pier Paolo Panciani, Marco Fontanella
We analyzed the outcomes of patients with large cerebellopontine angle (CPA) tumors treated by a skull-base team in which two surgeons (one neurosurgeon and one otological surgeon) were in the beginning of their careers (<40 years old). Data of patients operated on between April 2012 and March 2016 were reviewed. All factors related to surgical training were considered. Thirty-one patients had vestibular schwannomas, while 26 had meningiomas. Mean tumor diameter was 30.6 mm (range, 23-49 mm) for schwannomas and 35 mm (range, 22-51 mm) for meningiomas...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29574896/resident-hesitation-in-the-operating-room-does-uncertainty-equal-incompetence
#2
Michael Ott, Alan Schwartz, Mark Goldszmidt, Georges Bordage, Lorelei Lingard
CONTEXT: In postgraduate medical programmes, the progressive development of autonomy places residents in situations in which they must cope with uncertainty. We explored the phenomenon of hesitation, triggered by uncertainty, in the context of the operating room in order to understand the social behaviours surrounding supervision and progressive autonomy. METHODS: Nine surgical residents and their supervising surgeons at a Canadian medical school were selected. Each resident-supervisor pair was observed during a surgical procedure and subsequently participated in separate post-observation, semi-structured interviews...
March 25, 2018: Medical Education
https://www.readbyqxmd.com/read/29574017/what-makes-a-good-endoscopic-teacher-a-qualitative-analysis
#3
Kamron Pourmand, Justin L Sewell, Brijen J Shah
OBJECTIVE: Teaching learners to perform endoscopic procedures is challenging, yet effective endoscopy teaching practices are not well-described in the literature, and prior studies have focused on perspectives of supervising physicians rather than learners. We sought to characterize, from the perspective of endoscopy learners, endoscopic teaching behaviors perceived as beneficial and detrimental to learning using qualitative methods. DESIGN: This is a prospective qualitative content analysis...
March 21, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29561691/dual-autonomies-divergent-approaches-how-stratification-in-medical-education-shapes-approaches-to-patient-care
#4
Tania M Jenkins
The United States relies on international and osteopathic medical graduates ("non-USMDs") to fill one third of residency positions because of a shortage of American MD graduates ("USMDs"). Non-USMDs are often informally excluded from top residency positions, while USMDs tend to fill the most prestigious residencies. Little is known, however, about whether the training in these different settings is comparable or how it impacts patients. Drawing on 23 months of ethnographic fieldwork and 123 interviews, I compare training at two internal medicine programs: a community hospital staffing 90% non-USMDs and a university hospital staffing 99% USMDs...
March 1, 2018: Journal of Health and Social Behavior
https://www.readbyqxmd.com/read/29537661/consensus-based-perspectives-of-pediatric-inpatient-eating-disorder-services
#5
Amy O'Brien, Julie McCormack, Kimberley J Hoiles, Hunna J Watson, Rebecca A Anderson, Phillipa Hay, Sarah J Egan
OBJECTIVE: There are few evidence-based guidelines for inpatient pediatric eating disorders. The aim was to gain perspectives from those providing and receiving inpatient pediatric eating disorder care on the essential components treatment. METHOD: A modified Delphi technique was used to develop consensus-based opinions. Participants (N = 74) were recruited for three panels: clinicians (n = 24), carers (n = 31), and patients (n = 19), who endorsed three rounds of statements online...
March 14, 2018: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/29524100/-all-by-myself-interns-reports-of-their-experiences-taking-consent-in-irish-hospitals
#6
Roisin M Heaney, Michael Murray, Aine M Heaney, Eva M Doherty
BACKGROUND: Obtaining patient consent is a fundamental process in surgical practice and is integral in respecting and safeguarding patient autonomy. It has been reported that the task of consenting patients frequently lies with junior doctors, who have the least experience of the procedure. AIM: To examine the role of interns in the consent process in the Irish context as well as to identify their concerns. METHODS: A 12-point questionnaire, assessing interns' experience with surgical consent, was circulated to interns in three Irish university teaching hospitals based in different geographical locations...
March 9, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29466559/association-of-faculty-entrustment-with-resident-autonomy-in-the-operating-room
#7
Gurjit Sandhu, Julie Thompson-Burdine, Vahagn C Nikolian, Danielle C Sutzko, Kaustubh A Prabhu, Niki Matusko, Rebecca M Minter
Importance: A critical balance is sought between faculty supervision, appropriate resident autonomy, and patient safety in the operating room. Variability in the release of supervision during surgery represents a potential safety hazard to patients. A better understanding of intraoperative faculty-resident interactions is needed to determine what factors influence entrustment. Objective: To assess faculty and resident intraoperative entrustment behaviors and to determine whether faculty behaviors drive resident entrustability in the operating room...
February 21, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29444364/a-cross-sectional-analysis-of-the-effects-of-increased-resident-autonomy-on-practice-patterns-and-patient-satisfaction
#8
LETTER
S Cao, S T Chen
No abstract text is available yet for this article.
February 14, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29398631/enhancing-confidence-in-graduating-general-surgery-residents-establishing-a-chief-surgery-resident-service-at-an-independent-academic-medical-center
#9
Benjamin T Jarman, Colette T O'Heron, Kara J Kallies, Thomas H Cogbill
OBJECTIVE: Providing opportunities for autonomy to enhance the development of independence and confidence during surgery residency remains among the greatest challenges of the current training paradigm. The objective of this study was to evaluate the implementation and outcomes of a chief resident service (CRS). DESIGN: A CRS was designed with operative, call and office responsibilities. Supervision and evaluation were consistent with institutional guidelines. CRS operative logs from 2011 to 2014 were compared with logs from the participants' first year in practice...
February 2, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29368978/experiences-of-a-student-run-clinic-in-primary-care-a-mixed-method-study-with-students-patients-and-supervisors
#10
Maria Fröberg, Charlotte Leanderson, Birgitta Fläckman, Erik Hedman-Lagerlöf, Karin Björklund, Gunnar H Nilsson, Terese Stenfors
OBJECTIVE: To explore how a student-run clinic (SRC) in primary health care (PHC) was perceived by students, patients and supervisors. DESIGN: A mixed methods study. Clinical learning environment, supervision and nurse teacher evaluation scale (CLES + T) assessed student satisfaction. Client satisfaction questionnaire-8 (CSQ-8) assessed patient satisfaction. Semi-structured interviews were conducted with supervisors. SETTING: Gustavsberg PHC Center, Stockholm County, Sweden...
January 25, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29355817/the-healthy-worker-effect-do-healthy-people-climb-the-occupational-ladder
#11
Joan Costa-Font, Martin Ljunge
The association between occupational status and health has been taken to reveal the presence of occupational health inequalities. However, that interpretation assumes no influence of health status in climbing the occupational ladder. This paper documents evidence of non-negligible returns to occupation status on health (which we refer as 'healthy worker effect'). We use a unique empirical strategy that addresses the problem of reverse causality. That is, an instrumental variable strategy using the variation in average health in the migrant's country of origin, a health measure plausibly not determined by the migrant's occupational status...
February 2018: Economics and Human Biology
https://www.readbyqxmd.com/read/29344003/a-medical-student-in-private-practice-for-a-1-month-clerkship-a-qualitative-exploration-of-the-challenges-for-primary-care-clinical-teachers
#12
Virginie Muller-Juge, Anne Catherine Pereira Miozzari, Arabelle Rieder, Jennifer Hasselgård-Rowe, Johanna Sommer, Marie-Claude Audétat
Purpose: The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians' private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva. Methods: Data were collected via a focus group using a semistructured interview guide...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29306768/desire-to-institutionalize-in-alzheimer-s-caregivers-an-empirical-analysis-on-italian-data
#13
Luisa Colucci, Ivana Molino, Francesco Amenta, Giuseppe Lucio Gaeta
OBJECTIVE: Families choice to institutionalize an Alzheimer's disease (AD)-affected relative is hard and possibly painful. Recent literature contributions have investigated the causes of the emergence of desire to institutionalize (DI) who is affected by AD. This paper contributes to the topic by providing an Italy-based empirical analysis of factors correlated with DI in primary informal caregivers of patients affected by AD. METHODS: Data were drawn from an original survey carried out over 2009...
March 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29273491/supervision-autonomy-and-medical-error-in-the-teaching-clinic
#14
Jack P Cossman, Miaoyuan Wang, Alison A Fischer
No abstract text is available yet for this article.
December 19, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29248798/fear-an-unpleasant-experience-among-undergraduate-midwifery-students-a-qualitative-study
#15
Golnoosh Ahmadi, Mohsen Shahriari, Shahnaz Kohan, Mahmood Keyvanara
Fear is a normal emotion that can evoke an appropriate response when facing threat. However, sometimes the consequences of fear can lead to responses that are maladaptive. Fear can have negative effects on learning. Research has focused on the experience of fear and its consequences among midwifery students during their undergraduate program. A qualitative analysis was conducted of interviews with ten midwifery students in different years of an undergraduate program. The data was analyzed through a content analysis approach...
March 2018: Nurse Education in Practice
https://www.readbyqxmd.com/read/29148326/understanding-professional-jurisdiction-changes-in-the-field-of-anesthesiology
#16
Scott Feyereisen, Joseph P Broschak, Beth Goodrick
We further our understanding of jurisdictional disputes between established professional groups through a 10-year longitudinal analysis of the differential adoption by U.S. states of policies expanding Certified Registered Nurse Anesthetists' (CRNAs) autonomy. In the United States, CRNAs are trained to deliver anesthetics to patients in the same way as physician anesthesiologists but have more restrictions in practice. Following a 2001 federal decision regarding Medicare reimbursement, states were permitted but not required to allow CRNAs to practice without physician supervision, potentially reducing health care costs...
January 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29140863/practice-patterns-and-job-satisfaction-of-mohs-surgeons
#17
Nita Kohli, Nicholas Golda
BACKGROUND: There is a paucity of data on Mohs surgery workforce patterns. OBJECTIVE: To identify if gender differences exist in practice patterns of Mohs surgeons, factors that influence these differences, and factors influencing job satisfaction among Mohs surgeons. MATERIALS AND METHODS: An electronic survey was distributed to dermatology organizations targeting members of the American College of Mohs Surgery (ACMS), from October 2015 to April 2016...
November 14, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/29138140/david-oliver-supervision-and-clinical-autonomy-for-junior-doctors-have-we-gone-too-far
#18
REVIEW
David Oliver
No abstract text is available yet for this article.
November 14, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29063389/building-psychosocial-capacity-through-training-of-front-line-health-professionals-to-provide-brief-therapy-lessons-learned-from-the-prompt-study
#19
Jane Turner, Lisa Mackenzie, Brian Kelly, David Clarke, Patsy Yates, Sanchia Aranda
PURPOSE: This report describes the views of front-line health professionals who participated in a randomised controlled trial examining a model of care in which depressed cancer patients received a brief psychosocial intervention. Health professionals from four cancer centres received focused training, skill development and clinical supervision in order to deliver the intervention. METHODS: We interviewed 20 health professionals asking them about their perceptions of participation in the study and their views about more widespread implementation of this model of care...
April 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29034694/on-being-supervised-getting-value-from-a-clinical-supervisor-and-making-the-relationship-work-when-it-is-not
#20
Stephen Parker, Shuichi Suetani, Balaji Motamarri
OBJECTIVE: The importance of clinical supervision is emphasised in psychiatric training programs. Despite this, the purpose and processes of supervision are often poorly defined. There is limited guidance available for trainees about their role in making supervision work. This paper considers the nature of supervision in psychiatric training and provides practical advice to help supervisees take active steps to make supervision work. CONCLUSIONS: In obtaining value from supervision, the active role of the supervisee in seeking feedback, finding value in criticism and building autonomy is emphasised...
December 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
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