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Barriers Evidence Based Medicine

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https://www.readbyqxmd.com/read/28333607/understanding-faculty-and-trainee-needs-related-to-scholarly-activity-in-a-large-nonuniversity-graduate-medical-education-program
#1
Davida Becker, Hanna Garth, Rachel Hollander, Felice Klein, Marc Klau
CONTEXT: Graduate medical education (GME) programs must develop curriculum to ensure scholarly activity among trainees and faculty to meet accreditation requirements and to support evidence-based medicine. OBJECTIVE: Test whether research-related needs and interests varied across four groups: primary care trainees, specialty trainees, primary care faculty, and specialty faculty. DESIGN: We surveyed a random sample of trainees and faculty in Kaiser Permanente Southern California's GME programs...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28327170/critical-attitudes-and-beliefs-towards-guidelines-amongst-palliative-care-professionals-results-from-a-national-survey
#2
Helen Kalies, Rieke Schöttmer, Steffen T Simon, Raymond Voltz, Alexander Crispin, Claudia Bausewein
BACKGROUND: Little is known about palliative care professionals' attitudes towards guidelines. In 2015, the German Association for Palliative Medicine (DGP) published an evidence based guideline for palliative care in adults with incurable cancer. Before publication we conducted a national survey among members of the DGP to detect possible barriers and facilitators for its implementation. The aim of the present publication was to evaluate critical attitudes and beliefs which could hinder the effective implementation of the new guideline and to evaluate differences within professional groups and medical specialisations...
March 21, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28281832/outcomes-of-introducing-early-learners-to-interprofessional-competencies-in-a-classroom-setting
#3
Kelly S Lockeman, Sharon K Lanning, Alan W Dow, Joseph A Zorek, Deborah DiazGranados, Carole K Ivey, Shawne Soper
PROBLEM: Although interprofessional practice is important for improving healthcare delivery, there is little evidence describing interprofessional education (IPE) outcomes beyond changes in attitudes and knowledge of prelicensure learners. More rigorous evaluation of early IPE is needed to determine its impact on teaching interprofessional collaborative practice and providing a solid foundation for applying collaborative skills in the clinical environment. INTERVENTION: First-year students (N = 679) in 7 health professions programs participated in a 4-session series focusing on professional roles and responsibilities, teams and teamwork, and the healthcare system...
March 10, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28271658/integrating-acupuncture-are-there-positive-health-outcomes-for-women
#4
Nicola Robinson
The key health issues for women tend to be primarily associated with the female reproductive system. There are also other gender priorities and consequences associated with ageing, which require effective interventions. Acupuncture is used worldwide and its evidence base is increasing on both mechanisms of action and its effectiveness in clinical care. Although acupuncture may be a valuable addition to healthcare for some conditions, it is rarely fully integrated into mainstream Western medicine clinical practice...
2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28261487/drug-pricing-and-reimbursement-decision-making-systems-in-mongolia
#5
Gereltuya Dorj, Bruce Sunderland, Tsetsegmaa Sanjjav, Gantuya Dorj, Byambatsogt Gendenragchaa
BACKGROUND: It is essential to allocate available resources equitably in order to ensure accessibility and affordability of essential medicines, especially in less fortunate nations with limited health funding. Currently, transparent and evidence based research is required to evaluate decision making regarding drug registration, drug pricing and reimbursement processes in Mongolia. OBJECTIVE: To assess the drug reimbursement system and discuss challenges faced by policy-makers and stakeholders...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28224458/bridging-the-training-practice-gap-in-interprofessional-student-supervision
#6
Priya Martin, Saravana Kumar, LuJuana Abernathy
BACKGROUND: Workforce recruitment and retention issues are common in highly dispersed regions such as Queensland in Australia. Provision of student placements in these non-metropolitan areas is one way of promoting staff recruitment. However, healthcare professionals in these areas face a number of challenges in accessing training opportunities including student supervision training. Funding was made available to develop and run a series of targeted, evidence-based, interprofessional student supervision workshops in non-metropolitan Queensland...
February 21, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/28220317/role-of-narrative-based-medicine-in-proper-patient-assessment
#7
Giovanni Rosti
Improving patient-physician communication is an area of medicine that deserves greater attention. Narrative medicine can be considered as one tool that can aid in fostering better communication. Current medical practice is dominated by evidence-based medicine, and dictates what therapies the clinician will offer in a given circumstance, ideally supported by (evidence-based) guidelines. However, when taken alone it tends to decentralize the patient. There are many different approaches that can be used to understand the patient and what he or she is experiencing as a result of their illness...
February 21, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28208807/telehealth-increasing-access-to-high-quality-care-by-expanding-the-role-of-technology-in-correctional-medicine
#8
REVIEW
Jeremy D Young, Melissa E Badowski
The United States (US) has a large correctional population. However, many incarcerated persons lack access to evidence-based, up-to-date medical care, particularly by subspecialty providers, due to limitations of geography, travel, cost and other resources. The use of telehealth technologies can remove these barriers, increasing access to high quality, multidisciplinary care. Studies have shown that, with telemedicine, timely triage and medical management can be provided across many disciplines, which may lead to improved clinical outcomes and significant cost savings...
February 13, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28207415/attitudes-skill-and-use-of-evidence-based-practice-among-us-western-herbal-medicine-providers-a-national-survey
#9
James E Snow, Matthew J Leach, Bevin A Clare
Background Evidence-based practice (EBP) has been the focus of increasing attention in the teaching and delivery of both complementary and conventional healthcare. Western herbal medicine (WHM) is a system of complementary healthcare rooted in tradition. How WHM practitioners perceive, are prepared for, and use EBP, has to date been largely ignored. We therefore examined the use, opinion, skills, and training in EBP, and barriers and facilitators of EBP uptake, among herbal practitioners in the United States (US)...
March 1, 2017: Journal of Complementary & Integrative Medicine
https://www.readbyqxmd.com/read/28196947/cohort-profile-the-welsh-geriatric-registrar-led-research-network-wegen-rationale-design-and-description
#10
Benjamin Jelley, Sara Long, John Butler, Jonathan Hewitt
PURPOSE: Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28188191/payer-coverage-for-hereditary-cancer-panels-barriers-opportunities-and-implications-for-the-precision-medicine-initiative
#11
Julia R Trosman, Christine B Weldon, Michael P Douglas, Allison W Kurian, R Kate Kelley, Patricia A Deverka, Kathryn A Phillips
Background: Hereditary cancer panels (HCPs), testing for multiple genes and syndromes, are rapidly transforming cancer risk assessment but are controversial and lack formal insurance coverage. We aimed to identify payers' perspectives on barriers to HCP coverage and opportunities to address them. Comprehensive cancer risk assessment is highly relevant to the Precision Medicine Initiative (PMI), and payers' considerations could inform PMI's efforts. We describe our findings and discuss them in the context of PMI priorities...
February 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28187718/an-education-programme-influencing-health-professionals-to-recommend-exercise-to-their-type-2-diabetes-patients-understanding-the-processes-a-case-study-from-oxfordshire-uk
#12
Anne Matthews, Natasha Jones, Alastair Thomas, Perdy van den Berg, Charlie Foster
BACKGROUND: Increasing levels of physical activity decreases the risk of premature mortality associated with chronic diseases e.g., coronary heart disease, type 2 diabetes, stroke. Despite this, most adults in England do not meet physical activity guidelines. Physical activity advice and signposting offered to at-risk patients by primary care providers is recommended. However, exercise medicine education is sparse, leading to poor practitioner knowledge of the risk reduction evidence and strategies to implement effective patient behaviour change...
February 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28186480/-evidence-based-practice-of-nurses-working-in-university-hospitals-in-the-french-speaking-part-of-switzerland-a-descriptive-and-correlational-study
#13
Jenny Gentizon, Patricia Borrero, Sonja Vincent-Suter, Pierluigi Ballabeni, Diane Morin, Manuela Eicher
Introduction : evidence-based practice (EBP) is too scarcely applied in nursing and is a key contemporary challenge for the discipline. Method and objective : This descriptive and correlational study invited 221 nurses working in three different clinical settings of university hospitals in Switzerland. The objective of this study was to describe their level of knowledge, beliefs and implementation of EBP. Results : of the 221 nurses in this study, only 67 were familiar EBP (30%). These demonstrate favorable beliefs and attitudes towards EBP, but indicate a lack of skills and knowledge to implement it...
2016: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28178913/training-us-health-care-professionals-on-human-trafficking-where-do-we-go-from-here
#14
Clydette Powell, Kirsten Dickins, Hanni Stoklosa
Some 21 million adults and children are labor-trafficked or sex-trafficked through force, fraud, or coercion. In recognition of the interface between trafficking victims and the healthcare setting, over the last 10 years there has been a notable increase in training of health care professionals (HCPs) on human trafficking (HT) and its health implications. Many organizations have developed curricula and offered training in various clinical settings. However, methods and content of this education on trafficking vary widely, and there is little evaluation of the impact of the training...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28144123/state-of-simulation-in-healthcare-education-an-initial-survey-in-beijing
#15
Zichen Zhao, Pengfei Niu, Xiang Ji, Robert M Sweet
BACKGROUND AND OBJECTIVES: In 2013, medical error was the third leading cause of death in the United States.(1) In China, as in the case with the United States, training and assessment are developing as a strategy to reduce the occurrence of such errors. The objective of this study was to assess the current state of the use of simulation-based training in Beijing and to explore the barriers to further development. METHODS: This study included hospitals in Beijing accredited by the Standardized Residency Training (SRT) program...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28143942/bridging-the-education-action-gap-a-near-peer-case-based-undergraduate-ethics-teaching-programme
#16
Wing May Kong, Selena Knight
Undergraduate ethics teaching has made significant progress in the past decade, with evidence showing that students and trainee doctors feel more confident in identifying and analysing ethical issues. There is general consensus that ethics education should enable students and doctors to take ethically appropriate actions, and nurture moral integrity. However, the literature reports that doctors continue to find it difficult to take action when faced with perceived unethical behaviour. This has been evident in recent healthcare scandals, in which care has fallen below acceptable ethical standards, despite the presence of professional ethical guidelines and competencies...
January 31, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28125828/characteristics-and-outcomes-of-fasting-orders-among-medical-inpatients
#17
Atsushi Sorita, Charat Thongprayoon, John T Ratelle, Ruth E Bates, Katie M Rieck, Aditya P Devalapalli, Adil Ahmed, Deanne T Kashiwagi
While many hospitalized patients have orders to fast in preparation for interventions, the extent to which these orders are necessary or adhere to evidence-based durations is unknown. In this study, we analyzed the length, indication, and associated outcomes of nil per os (NPO) orders for general medicine patients at an academic institution in the United States, and compared them to the best available evidence for recommended length of NPO. Of 924 NPO orders assessed, the indicated intervention was not performed for 183 (19...
January 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28116028/characteristics-of-real-time-non-critical-incident-debriefing-practices-in-the-emergency-department
#18
Nur-Ain Nadir, Suzanne Bentley, Dimitrios Papanagnou, Komal Bajaj, Stephan Rinnert, Richard Sinert
INTRODUCTION: Benefits of post-simulation debriefings as an educational and feedback tool have been widely accepted for nearly a decade. Real-time, non-critical incident debriefing is similar to post-simulation debriefing; however, data on its practice in academic emergency departments (ED), is limited. Although tools such as TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) suggest debriefing after complicated medical situations, they do not teach debriefing skills suited to this purpose...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28114925/two-birds-with-one-stone-experiences-of-combining-clinical-and-research-training-in-addiction-medicine
#19
J Klimas, R McNeil, K Ahamad, A Mead, L Rieb, W Cullen, E Wood, W Small
BACKGROUND: Despite a large evidence-base upon which to base clinical practice, most health systems have not combined the training of healthcare providers in addiction medicine and research. As such, addiction care is often lacking, or not based on evidence or best practices. We undertook a qualitative study to assess the experiences of physicians who completed a clinician-scientist training programme in addiction medicine within a hospital setting. METHODS: We interviewed physicians from the St...
January 23, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28103931/developing-a-framework-to-guide-the-de-adoption-of-low-value-clinical-practices-in-acute-care-medicine-a-study-protocol
#20
Jeanna Parsons Leigh, Daniel J Niven, Jamie M Boyd, Henry T Stelfox
BACKGROUND: Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-value clinical practices (i.e. de-adoption). This study will develop a comprehensive list of barriers and facilitators to the de-adoption of low-value clinical practices in acute care facilities to inform the development of a framework to guide the de-adoption process...
January 19, 2017: BMC Health Services Research
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