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Medical education autonomy

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https://www.readbyqxmd.com/read/28612650/pediatric-nurses-ethical-difficulties-in-the-bedside-care-of-children
#1
Kwisoon Choe, Yoonjung Kim, Yoonseo Yang
BACKGROUND: Pediatric nurses experience ethically difficult situations in their everyday work. Several studies have been conducted to reveal ethical issues among pediatric nurses; we do not think their ethical difficulties have been explored sufficiently from their own perspective. OBJECTIVES: This study aimed to explore the ethical difficulties faced by pediatric nurses during bedside care for hospitalized children. METHODS: A phenomenological approach was used to collect and analyze interview data from 14 female pediatric nurses in South Korea...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28607848/progressive-surgical-autonomy-in-a-plastic-surgery-resident-clinic
#2
Kristopher M Day, Jillian K Scott, Lani Gao, Tara M Lee, Jimmy L Waldrop, Larry A Sargent, J Woody Kennedy, Jason P Rehm, Mark A Brzezienski
BACKGROUND: Resident clinics are thought to catalyze educational milestone achievement through opportunities for progressively autonomous surgical care, but studies are lacking for general plastic surgery resident clinics (PSRCs). We demonstrate the achievement of increased surgical autonomy and continuity of care in a PSRC. METHODS: A retrospective review of all patients seen in a PSRC from October 1, 2010, to October 1, 2015, was conducted. Our PSRC is supervised by faculty plastic surgery attendings, though primarily run by chief residents in an accredited independent plastic surgery training program...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28581878/what-happens-when-the-doctor-denies-a-patient-s-request-a-qualitative-interview-study-among-general-practitioners-in-norway
#3
Stein Nilsen, Kirsti Malterud
OBJECTIVE: To explore general practitioners (GPs') experiences from consultations when a patient's request is denied, and outcomes of such incidents. DESIGN AND PARTICIPANTS: We conducted a qualitative study with semi-structured individual interviews with six GPs in Norway. We asked them to tell about experiences from specific encounters where they had refused a patient's request. The texts were analysed with Systematic Text Condensation, a method for thematic cross-case analysis...
June 5, 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28579040/autonomy-and-self-esteem-of-women-who-donate-to-an-oocyte-cryopreservation-bank-in-the-netherlands
#4
Marjolein R Bakker, Joyce Maas, Marrie H Bekker, Annelien L Bredenoord, Bart C Fauser, Annelies M Bos
Worldwide, oocyte donors donate voluntarily or receive varying amounts of money for donation. This raises ethical questions regarding the appropriateness of financial compensation, and the possibility of undue inducement and exploitation of oocyte donors. Are these donors capable of making an independent, well-considered decision? Regarding this matter, it is important to examine aspects such as autonomy-connectedness and self-esteem. In this cross-sectional study, demographic characteristics and donation motivations were assessed in 92 women who attended the University Medical Center (UMC) Utrecht as potential oocyte donors between June 2012 and July 2016...
May 17, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28570292/difficulties-in-surgical-decision-making-and-associated-factors-among-elective-surgical-patients-in-taiwan
#5
Mei-Ling Lin, Ching-Huey Chen
BACKGROUND: Respect for the autonomy of patients is essential in life-threatening medical decisions such as surgery. Even if a patient has the competency to make decisions, many obstacles exist that may influence his or her willingness to participate in the surgical decision-making process. PURPOSE: The aim of this study was to explore the perceived difficulties in surgical decision making and related factors among elective surgical patients. METHODS: This was a cross-sectional correlational study...
June 1, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28549405/twelve-tips-for-the-implementation-of-epas-for-assessment-and-entrustment-decisions
#6
Harm Peters, Ylva Holzhausen, Christy Boscardin, Olle Ten Cate, H Carrie Chen
The concept of entrustable professional activities (EPAs) reframes the approach to assessment in competency-based medical education. Key to this concept is the linking of assessment to decision making about entrusting learners with clinical responsibilities. Based on recent literature and the authors' experiences with implementing EPAs, this article provides practical recommendations for how to implement EPAs for assessment and entrustment decisions in the workplace. Tips for supervising clinicians include talking to learners about trust, using EPA descriptions to guide learning and teaching, providing learners with greater ad hoc responsibilities, using EPAs to identify/create opportunities for assessment and feedback, including case-based discussions and acknowledging gut feelings about learner readiness for more autonomy...
May 26, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28529124/shared-decision-making-in-spain-supportive-policies-and-research-initiatives-trends-and-directions-for-future
#7
Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Yolanda Alvarez-Perez, Pablo Alonso-Coello, Carola Orrego, Pedro Serrano-Aguilar
Patients' rights to autonomy, information and participation in their own health care are recognized in the Spanish legal system from the early 2000's. Public institutions have progressively launched several initiatives to promote and improve patients' empowerment and self-care. However, the concept of Shared Decision Making (SDM), although embedded in the more general concept of "active/empowered patient", usually has not been specifically advocated as an essential requisite for improving the quality of health services, either in the legal normative or the existing educational proposals...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28501031/-analysis-of-the-cochrane-review-non-medical-prescribing-versus-medical-prescribing-for-acute-and-chronic-disease-management-in-primary-and-secondary-care-cochrane-database-syst-rev-2016-11-cd011227
#8
Gonçalo Silva Duarte, Ricardo Martins Delgado, João Costa, António Vaz-Carneiro
In countries with diverse socioeconomic levels, in order to address the health care demands, the consideration of a wide array of strategies is needed; among these, non-medical prescription can be included. The objective of this revision was to ascertain whether non-medical prescription results in comparable clinical and patient-related outcomes to medical prescription. This systematic review was conducted in compliance with the standard Cochrane methodology. Clinical outcomes were compared between prescription carried out by non-medical health professionals and doctors, provided that the non-medical health professional prescribed with a high degree of autonomy, both in hospital and community practice, in countries with low, medium and high socioeconomic level...
January 31, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28428673/migrant-general-practitioners-experiences-of-using-interpreters-in-health-care-a-qualitative-explorative-study
#9
Ferid Krupic, Kristian Samuelsson, Nabi Fatahi, Olof Skoldenberg, Arkan S Sayed-Noor
BACKGROUND: According to the UNHCR, 250 million people currently live outside their country of birth. The growing multicultural population poses a major challenge to healthcare professionals who aim to provide individualized, holistic care, which respects the individual's autonomy. To ensure basic rights, healthcare interventions should be guided by the value of benefiting others; individuals should be treated honestly, equally, and impartially. OBJECTIVE: To investigate immigrant doctors' experiences of using interpreters in the Swedish health-care system...
February 2017: Medical Archives
https://www.readbyqxmd.com/read/28410992/ethical-issues-in-education-medical-trainees-and-the-global-health-experience
#10
REVIEW
Susan P Raine
With interest in global health experiences (GHEs) by medical trainees remaining high, the number of global health programs offering educational experiences in resource limited settings has proliferated. Development and implementation of GHEs has outpaced the critical evaluation of ethical considerations inherent in these programs. Global health programs must adhere to the four principles of beneficence, nonmaleficence, respect of autonomy, and justice in crafting a GHE focused on maximizing the experience of the learners, host country, and patients...
March 15, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28398961/accreditation-council-for-graduate-medical-education-acgme-surgery-resident-operative-logs-the-last-quarter-century
#11
COMPARATIVE STUDY
Frederick Thurston Drake, Shahram Aarabi, Brandon T Garland, Ciara R Huntington, Jarod P McAteer, Morgan K Richards, Nicole Kansier Zern, Kenneth W Gow
STUDY OBJECTIVE: To describe secular trends in operative experience for surgical trainees across an extended period using the most comprehensive data available, the Accreditation Council for Graduate Medical Education (ACGME) case logs. BACKGROUND: Some experts have expressed concern that current trainees are inadequately prepared for independent practice. One frequently mentioned factor is whether duty hours' restrictions (DHR) implemented in 2003 and 2004 contributed by reducing time spent in the operating room...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28384683/characterizing-18-years-of-the-death-with-dignity-act-in-oregon
#12
Charles Blanke, Michael LeBlanc, Dawn Hershman, Lee Ellis, Frank Meyskens
Importance: Numerous states have pending physician-aided dying (PAD) legislation. Little research has been done regarding use of PAD, or ways to improve the process and/or results. Objectives: To evaluate results of Oregon PAD, the longest running US program; to disseminate results; and to determine promising PAD research areas. Design, Setting, and Participants: A retrospective observational cohort study of 991 Oregon residents who had prescriptions written as part of the state's Death with Dignity Act...
April 6, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28363675/effect-of-ongoing-assessment-of-resident-operative-autonomy-on-the-operating-room-environment
#13
Jonathan P Fryer, Ezra N Teitelbaum, Brian C George, Mary C Schuller, Shari L Meyerson, Christina M Theodorou, Joseph Kang, Amy Yang, Lihui Zhao, Debra A DaRosa
OBJECTIVE: We have previously demonstrated the feasibility and validity of a smartphone-based system called Procedural Autonomy and Supervision System (PASS), which uses the Zwisch autonomy scale to facilitate assessment of the operative performances of surgical residents and promote progressive autonomy. To determine whether the use of PASS in a general surgery residency program is associated with any negative consequences, we tested the null hypothesis that PASS implementation at our institution would not negatively affect resident or faculty satisfaction in the operating room (OR) nor increase mean OR times for cases performed together by residents and faculty...
March 28, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28361810/educational-action-in-the-rehabilitation-of-severe-acquired-brain-injuries-the-role-of-self-awareness
#14
Daniela Silvestro, Maria Mazzetti, Chiara Melia, Maria Teresa Stagno, Giovanni Augusto Carlesimo, Umberto Bivona, Rita Formisano
Severe acquired brain injuries (ABI) cause a range of short-or long-term limitations in physical and neuropsychological abilities. The aim of rehabilitation is to promote the harmonious development of the individual through collaboration between medical and educational sciences, involved in the educability of the whole person, in which the aim is not only functional recovery but also social-reintegration. This "functional synergy" permits the development of the person, and establishes an indissoluble link between functions and attitudes, thus allowing the achievement of the greater possible autonomy...
January 2017: Annali Dell'Istituto Superiore di Sanità
https://www.readbyqxmd.com/read/28276614/adherence-to-confidentiality-principles-from-the-viewpoint-of-iranian-dental-students-a-multicenter-study
#15
A Ghodousi, M Abedzadeh, M Ketabi, Parichehr Zarean, Paridokht Zarean
INTRODUCTION: Confidentiality is a basic ethical principle appreciating human autonomy, relationships, and dignity and in medical research has a long history. In dental practice, it has the same importance as medical field. Therefore, providing patients with information about the confidentiality will promote their confidence in dental professionals and prevent legal conflicts. The present study sought to evaluate the knowledge and viewpoints of dental students about patient confidentiality...
March 9, 2017: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
https://www.readbyqxmd.com/read/28274376/natural-disaster-management-experience-of-an-academic-institution-after-a-7-8-magnitude-earthquake-in-ecuador
#16
A M Cordero-Reyes, I Palacios, D Ramia, R West, M Valencia, N Ramia, D Egas, P Rodas, M Bahamonde, M Grunauer
OBJECTIVES: This case study describes the implementation of an academic institution's disaster management plan. STUDY DESIGN: Case study. METHODS: USFQ's Medical School developed a six-phase disaster relief plan consisting of: induction, establishing a base camp, crisis management and mental health aid, creation of multidisciplinary teams and multi-agency teams, and reconstruction. Each phase uses a community-oriented approach to foster survivor autonomy and recovery...
March 2017: Public Health
https://www.readbyqxmd.com/read/28241994/quality-of-life-and-risk-of-malnutrition-in-a-home-dwelling-population-over-75%C3%A2-years-old
#17
Ana Hernández-Galiot, Isabel Goñi
OBJECTIVES: To evaluate the quality of life of a noninstitutionalized population aged older than 75 y by determining nutritional and health status, and to investigate the relationship between nutritional risk and quality of life. METHODS: A cross-sectional study of elderly people was conducted in Garrucha (Almería) in southern Spain. A total of 102 participants (61 women and 41 men) aged older than 75 y. The Mini Nutritional Assessment test was used to detect nutritional risk...
March 2017: Nutrition
https://www.readbyqxmd.com/read/28210318/asthma-in-intellectual-disability-are-we-managing-our-patients-appropriately
#18
Sharon Davis
People with intellectual disability are a vulnerable group of people with asthma that has, to date, largely been ignored in the medical literature. Although guidelines for medication management for people with intellectual disability suggest asthma is treated as for other populations, there are special considerations that should be taken into account when managing asthma in this group. Due to their cognitive impairment as well as comorbidities, they are likely to require support with asthma self-management, including inhaler use...
December 2016: Breathe
https://www.readbyqxmd.com/read/28166582/patient-centered-care-challenges-and-surprises-through-the-clerkship-students-eyes
#19
Victoria L Boggiano, Yufan Wu, Janine S Bruce, Sylvia Bereknyei Merrell, Erika Schillinger
BACKGROUND AND OBJECTIVES: The patient-centered care model for health care delivery encourages medical providers to respect patients' preferences and give patients more autonomy over their health care decisions. This approach has gained importance within US medical school curricula. Yet, little is known about student perspectives on both patient-centered care and the benefits and challenges that lie therein. This manuscript explores the greatest impediments to, as well as the benefits from, student engagement in patient-centered care from the perspectives of students participating in their family medicine outpatient clerkship...
January 2017: Family Medicine
https://www.readbyqxmd.com/read/28159121/mode-of-delivery-among-swedish-midwives-and-obstetricians-and-their-attitudes-towards-caesarean-section
#20
Maria Sahlin, Ellika Andolf, Gunnar Edman, Ingela Wiklund
BACKGROUND: A knowledge gap exists around midwives' and obstetricians' mode of delivery in comparison to the general population, and if their personal experience influences their attitudes towards different modes of delivery. OBJECTIVES: The aim of the present study was to investigate midwives' and obstetricians' mode of delivery compared to the population at large. The second aim was to see if their mode of delivery had been influenced by the expanded indications for caesarean section as described in medical literature...
March 2017: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
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