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Drew M Keister, Susan E Hansen, Julie Dostal
PROBLEM: To accurately determine one's ability in any clinical competency, an individual must be able to self-assess performance and identify personal limitations. Existing research demonstrates that physicians of all levels are unreliable self-assessors. This poses a concern in medical practice, which requires continuous updates to clinical competencies and awareness of personal limitations. Few published studies examine graduate medical education curricula designed to develop self-assessment skills...
December 21, 2016: Teaching and Learning in Medicine
Giovanna Artioli, Chiara Foà, Chiara Taffurelli
In the traditional biomedical model of clinical practice, which assumes a medicine focused on disease, diseases are considered as biological or psycho-physiological universal entities. This explanation, although necessary, is not enough. Several authors have recently become interested in the use of narrative practices in the medical care setting, underlining the increasing importance of "a patient-centered approach", a "relationship -centered care" and "narrative medicine". Even in Nursing, the challenge was to combine two models that seemed incompatible: the Evidence-Based Nursing Model and the Narrative-Based Nursing Model...
November 22, 2016: Acta Bio-medica: Atenei Parmensis
Dianne Goeman, Tracy Comans, Joanne C Enticott, Emma Renehan, Elizabeth Beattie, Susan Kurrle, Susan Koch
INTRODUCTION: Assistance provided to support people living with dementia and carers is highly valued by them. However, current support systems in Australia are disjointed, inaccessible to all, poorly coordinated, and focus on dysfunction rather than ability. Support workers for people with dementia are in short supply, and there is little consistency in their roles. To address this large service gap and unmet need, we have developed an evidence-based optimized model of holistic support for people with dementia and their carers and families...
2016: Frontiers in Public Health
Suzanne E Mitchell, Gabriela M Weigel, Sabrina K A Stewart, Morgan Mako, John F Loughnane
BACKGROUND: Despite frequent encounters with the healthcare system and high risk for secondary conditions, it is unclear how frequently individuals living with serious physical disabilities document advance directives (AD) or engage in advance care planning (ACP). Their perspectives on these topics are largely unknown. OBJECTIVE: We aimed to characterize the perspectives of individuals with serious physical disabilities receiving care from two different healthcare delivery settings on the value of AD and ACP...
February 2017: Journal of Palliative Medicine
Anna E Kersh, Maiko Sasaki, Lee A Cooper, Haydn T Kissick, Brian P Pollack
Advances in molecular pathology have changed the landscape of oncology. The ability to interrogate tissue samples for oncogene amplification, driver mutations, and other molecular alterations provides clinicians with an enormous level of detail about their patient's cancer. In some cases, this information informs treatment decisions, especially those related to targeted anti-cancer therapies. However, in terms of immune-based therapies, it is less clear how to use such information. Likewise, despite studies demonstrating the pivotal role of neoantigens in predicting responsiveness to immune checkpoint blockade, it is not known if the expression of neoantigens impacts the response to targeted therapies despite a growing recognition of their diverse effects on immunity...
2016: Frontiers in Pharmacology
Elisa Kallioniemi, Minna Pitkänen, Mervi Könönen, Ritva Vanninen, Petro Julkunen
BACKGROUND: Although the relationship between neuronavigated transcranial magnetic stimulation (nTMS) and functional magnetic resonance imaging (fMRI) has been widely studied in motor mapping, it is unknown how the motor response type or the choice of motor task affect this relationship. NEW METHOD: Centers of gravity (CoGs) and response maxima were measured with blood-oxygen-level dependent (BOLD) and arterial spin labeling (ASL) fMRI during motor tasks against nTMS CoGs and response maxima, which were mapped with motor evoked potentials (MEPs) and silent periods (SPs)...
September 8, 2016: Journal of Neuroscience Methods
Kaitlin Ostrander
No abstract text is available yet for this article.
July 2016: Family Medicine
Ilany Kogan
This essay presents material from the second analysis of an offspring of two Holocaust survivors, each of whom lost a child during the war. The first analysis (Kogan ) focused primarily on the patient's relationship with her mother. This second analysis revolves around the elaboration of the complex and painful father-daughter relationship, centering on the events surrounding the death of the patient's father. The discussion includes an exploration of the father's deferred action on account of his Holocaust trauma, which he passed on to the next generation; the break in the idealized paternal representation; and the daughter's identification with her father's disavowed aggressive aspects...
July 2016: Psychoanalytic Quarterly
Natasha M Chida, Khalil G Ghanem, Paul G Auwaerter, Scott M Wright, Michael T Melia
Clinical excellence should be recognized, particularly in the current climate that appropriately prioritizes relationship-centered care. In order to develop a recognition model, a definition of clinical excellence must be created and agreed upon. A paradigm recently suggested by C. Christmas describes clinical excellence through the following domains: diagnostic acumen, professionalism and humanism, communication and interpersonal skills, skillful negotiation of the healthcare system, knowledge, taking a scholarly approach to clinical practice, and having passion for clinical medicine...
September 2016: Open Forum Infectious Diseases
Richard C Waters, Mark Stoltenberg, Lauren S Hughes
The 2015 G. Gayle Stephens Keystone conference convened a cohort of primary care professionals to discuss what promises personal physicians will make to their patients going forward. New physicians were prompted to rediscover the foundational values of and historic context for family medicine. At the heart of this rediscovery was learning of the writings and teachings of Dr. G. Gayle Stephens, a founder of family medicine who emphasized the essentiality of relationship-centered care and social justice to the new specialty...
July 2016: Journal of the American Board of Family Medicine: JABFM
Neda Ratanawongsa, Jennifer L Barton, Courtney R Lyles, Michael Wu, Edward H Yelin, Diana Martinez, Dean Schillinger
OBJECTIVE: Patients with limited health literacy (LHL) and limited English proficiency (LEP) experience suboptimal communication and health outcomes. Electronic health record implementation in safety net clinics may affect communication with LHL and LEP patients.We investigated the associations between safety net clinician computer use and patient-provider communication for patients with LEP and LHL. MATERIALS AND METHODS: We video-recorded encounters at 5 academically affiliated US public hospital clinics between English- and Spanish-speaking patients with chronic conditions and their primary and specialty care clinicians...
January 2017: Journal of the American Medical Informatics Association: JAMIA
Charles Glisson, Nathaniel J Williams, Anthony Hemmelgarn, Enola Proctor, Philip Green
OBJECTIVE: The Availability, Responsiveness, and Continuity (ARC) organizational intervention is designed to improve community-based youth mental health services by aligning organizational priorities with 5 principles of effective service organizations (i.e., mission driven, results oriented, improvement directed, relationship centered, participation based). This study assessed the effect of the ARC intervention on youth outcomes and the mediating role of organizational priorities as a mechanism linking the ARC intervention to outcomes...
August 2016: Journal of Consulting and Clinical Psychology
S L Manne, E J Coups, D A Kashy
Individuals may be more motivated to adopt health practices if they consider the benefits of these behaviors for their close relationships. The goal of this study was to examine couple concordance with sun protection and use the interdependence and communal coping theory to evaluate the role of relationship factors in sun protection. One hundred and eighty-four married couples aged 50 years and older completed measures of objective skin cancer risk, perceived risk, sun protection benefits, relationship-centered motivations for sun protection, discussions about sun protection, and sun protection...
August 2016: Health Education Research
Martin A Cake, Melinda A Bell, Julie C Williams, Fiona J L Brown, Marshall Dozier, Susan M Rhind, Sarah Baillie
BACKGROUND: Despite the growing prominence of professional (non-technical) competencies in veterinary education, the evidence to support their importance to veterinary graduates is unclear. AIM: To summarize current evidence within the veterinary literature for the importance of professional competencies to graduate success. METHODS: A systematic search of electronic databases was conducted (CAB Abstracts, Web of Science, PubMed, PsycINFO, ERIC, Australian and British Education Index, Dissertations & Theses) from 1988 to 2015 and limited to the veterinary discipline (veterinar* term required)...
June 2016: Medical Teacher
Tzipi Weiss, Marci J Swede
ISSUE: The Institute of Medicine identified health care education reform as a key to improving the error prone, costly, and unsatisfying U.S. health care system. It called for health care education that no longer focuses exclusively on the mastery of technical skills but teaches students the human dimensions of care and develops their ability to collaborate with patients and colleagues to alleviate suffering and improve health. When should this educational reform begin, by what frameworks should it be guided, and which methods should it employ are important questions to explore...
May 4, 2016: Teaching and Learning in Medicine
Johanna Shapiro, Diane Ortiz, You Ye Ree, Minha Sarwar
BACKGROUND: Increasingly, medical educators are incorporating reflective writing and original creative work into educational practices with the goals of stimulating student self-awareness, appreciation of multiple perspectives, and comfort with ambiguity and uncertainty. This study investigated students' creative projects to assess the extent to which they adopted a patient/relationship-centered, emotionally connected position toward patients and families. METHODS: Over a 10 year period, students on a required third year pediatrics clerkship individually or in groups completed either a reflection or an education project using a creative medium...
March 16, 2016: BMC Medical Education
Signe Peterson Flieger
BACKGROUND: This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. PURPOSE: The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH...
March 2, 2016: Health Care Management Review
Rita A Jablonski-Jaudon, Ann M Kolanowski, Vicki Winstead, Corteza Jones-Townsend, Andres Azuero
The purpose of the current article is to describe a personalized practice originally conceived as a way to prevent and minimize care-resistant behavior to provide mouth care to older adults with dementia. The original intervention, Managing Oral Hygiene Using Threat Reduction Strategies (MOUTh), matured during the clinical trial study into a relationship-centered intervention, with emphasis on developing strategies that support residents' behavioral health and staff involved in care. Relationships that were initially pragmatic (i...
March 2016: Journal of Gerontological Nursing
Adrienne Boissy, Amy K Windover, Dan Bokar, Matthew Karafa, Katie Neuendorf, Richard M Frankel, James Merlino, Michael B Rothberg
BACKGROUND: Skilled physician communication is a key component of patient experience. Large-scale studies of exposure to communication skills training and its impact on patient satisfaction have not been conducted. OBJECTIVE: We aimed to examine the impact of experiential relationship-centered physician communication skills training on patient satisfaction and physician experience. DESIGN: This was an observational study. SETTING: The study was conducted at a large, multispecialty academic medical center...
July 2016: Journal of General Internal Medicine
Shreena Unadkat, Paul M Camic, Trish Vella-Burrows
PURPOSE OF STUDY: There is a continuing interest around the use of group singing in dementia care. Although studies generally indicate positive outcomes, limited research has been carried out from a relational perspective, which places the couple relationship in a central position. This study aimed to better understand how group singing benefits people with dementia and their partners. DESIGN AND METHODS: Interview data from 17 couples (N = 34) with one member having dementia, who participated in a range of different types of singing groups, were analyzed using grounded theory methodology...
January 18, 2016: Gerontologist
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