Journal articles on the topic 'Physicians (General practice) Education (Continuing education) Victoria'
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Bashook, Philip, Dennis Levinson, Leslie Sandlow, Rita Cohen, Lewis Cohen, John Reinhard, and Sue Conneighton. "Rheumatology in primary care physicians' practice implications for continuing education." Möbius: A Journal for Continuing Education Professionals in Health Sciences 7, no. 2 (1987): 7–15. http://dx.doi.org/10.1002/chp.4760070203.
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Emiliani, Ermanno. "Continuing Medical Education in Radiation Oncology." Tumori Journal 84, no. 2 (March 1998): 96–100. http://dx.doi.org/10.1177/030089169808400202.
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Continuing medical education (CME) has always been considered very important in modern medical practice. Physicians should not be left completly free to continuously educate themselves, but they should receive at least a minimal level of education accreditated by scientific and/or Government Institutions. The main goal of CME is to improve the quality of medical practice. In order to adequately define programs and contents of CME in radiation oncology, we must first identify the professional profile of the radiation oncologist: he is a physician engaged in the clinical practice of oncology, and in particular in the loco-regional cure of cancer by sophisticated technologies; he has the responsibility of diagnosis, treatment, follow-up and supportive care of cancer patients, collaborating within a multidisciplinary approach with the radiologist, the medical oncologist, the surgeon and the medical physicist. The european core curriculum in radiotherapy and the procedures employed in the daily practice could be models to develop postgraduate teaching and CME for the radiation oncologists in Italy. In fact, many countries, such as the USA, France, Belgium and the United Kingdom, have already developed accreditated programs of CME. Unfortunately, Italy still lacks this type of program. What is mostly needed to implement CME activities is a close cooperation between representatives of radiation oncology associations and Government Institutions to define laws, programs, an Accreditation Council, a minimum of formative credits, accreditated categories of education regulating CME, as well as the resources devoted to it.
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Reddy, Suresh, Sriram Yennu, Kimberson Cochien Tanco, Aimee Elizabeth Anderson, Diana Guzman, Janet L. Williams, Diane D. Liu, and Eduardo Bruera. "Frequency of burn-out among palliative care physicians participating in continuing medical education." Journal of Clinical Oncology 37, no. 31_suppl (November 1, 2019): 77. http://dx.doi.org/10.1200/jco.2019.37.31_suppl.77.
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77 Background: There is a growing concern about high frequency of burn out (BO) among physicians, and higher among palliative care providers, reported to be in the range of 62%. There are very limited studies done among Palliative Care (PC) physicians. Objective: The main objective of our study was to determine the frequency of burnout among PC physicians participating in PC Continuing Medical Education (CME). Secondary objectives included determining characteristics of physicians who expressed higher BO and also to determine overall attitudes towards PC practice. Methods: During 2018 Annual Hospice & Palliative Medicine Board Review Course, we conducted a survey of 41 questions to determine the frequency of BO among physicians. This included Maslach Burn Inventory ( MBI )–General. The survey was given to both the in house and webinar participants. Results: Of 110 physicians who were given the surveys, 91/110 (83%) completed surveys. The median age was 48 years with 59 (65%) being females, 74 (81%) married. Majority, 41 (46%) were in community practice. 24 (38%) were in practice for more than 6 years, and 52 (57%) were board certified. 56 (62%) practiced PC for more than 50 % of time. Majority, 69 (76%) were doing clinical work. The median number of physician in the group practice was 3. 35 (38 %) of participants reported at least one symptom burnout based on MBI criteria. Only being single/separated correlated significantly with burn-out (p = 0.056). PC work is appreciated at their place of work by 73 (80%), 58 (64%) reported insurance was a burden, electronic medical record as a burden by 58 (64%), and 82 (90%) of physicians felt optimistic about continuing PC in future. Conclusions: BO among palliative care physicians who attended a board review course tends to be high, but lower than previously reported. Physicians who choose to attend CME may have unique motivating characteristics to cope better with stress and BO. More research is needed to better characterize BO among PC physicians.
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Haines, Carol S., and Zachariah Thomas. "Assessing Needs for Palliative Care Education of Primary Care Physicians: Results of a Mail Survey." Journal of Palliative Care 9, no. 1 (March 1993): 23–26. http://dx.doi.org/10.1177/082585979300900104.
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The purpose of this study was to determine continuing education needs in the area of palliative care, as defined by family practice physicians. The methodology consisted of an anonymous questionnaire mailed in October, 1991, to all family practitioners in the city of Regina, Saskatchewan having admission privileges at any of the city's three hospitals. Replies were received from 31.1% of that population; the worst-case estimate is that about half of the city's palliative care caseload in 1991 was under the care of these respondents. In a priority-ranking format, physicians rated pain assessment and management as the patients’ greatest need and their greatest continuing education need. Although emotional support and communication were highly ranked among other needs of patients, they were not highly ranked among education needs. Grand rounds was indicated as the educational venue of preference. Longer, more intensive educational formats were not selected. Communication of palliative status, including “Do not resuscitate” status, has reportedly become a routine practice. We have concluded that palliative care education should focus on the felt needs of family practice physicians for technical competence in pain assessment and management, using abbreviated formats. Cautious introduction of content areas and educational methods more likely to address patient needs is warranted. A one- or two-day workshop devoted to bereavement guidance might be a concrete focus for communication-oriented continuing education.
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Woolf, Colin R. "Personal continuing education relationships between perceived needs by individual physicians and practice profiles." Journal of Continuing Education in the Health Professions 8, no. 4 (1988): 271–76. http://dx.doi.org/10.1002/chp.4750080405.
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Hossain, M. Amir, and Shahena Akter. "Medical Education." Journal of Chittagong Medical College Teachers' Association 24, no. 1 (September 14, 2013): 1–4. http://dx.doi.org/10.3329/jcmcta.v24i1.57740.
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Course of study requirers to educate a legally qualified and licensed practitioner of medicine, concerned with maintaining or restoring human health through the study, diagnosis and treatment of disease and injury, through the science of medicine and the applied practice of that science. Medical education and envisions the production of physicians sensitive to the health needs of their country, capable of ministering to those needs, and aware of the necessity of continuing their own education. It also develops the methods and objectives appropriate to the study of the still unknown factors that produce disease or favour well-being. Although there may be basic elements common to all, the details should vary from place to place and from time to time. Whatever forms the curriculum takes, ideally it will be flexible enough to allow modification as circumstances alter, and medical knowledge grows, and needs change. It therefore follows that the plan of education, the medical curriculum, should not be the same in all countries. JCMCTA 2013; 24 (1):1-4
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Stacy, Sylvie, Sujit Sheth, Brandon Coleman, and Wendy Cerenzia. "An assessment of the continuing medical education needs of US physicians in the management of patients with beta thalassemia." Annals of Hematology 100, no. 1 (September 1, 2020): 27–35. http://dx.doi.org/10.1007/s00277-020-04246-5.
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AbstractPatients with beta thalassemia are benefitting from longer life expectancies, highlighting the importance of appropriate transition from pediatric to adult care. Data are limited regarding continuity of care and adult hematologists’ management of patients with beta thalassemia. We conducted a survey of practicing US hematologists to identify practice gaps, attitudes, and barriers to optimal patient management among US-practicing hematologists. A total of 42 responses were collected, with 19 (45%) practicing at a beta thalassemia center of excellence (CoE). Nearly 90% of CoE physicians said they had a transition protocol or plan in place versus 30% of non-CoE physicians. Most physicians said parents should remain actively involved in medical visits. Adherence was rated as the most important patient education topic during transition. The most significant barrier cited was patient reluctance to transition away from pediatric care. Physicians in CoEs as compared with non-CoE physicians reported greater knowledge of beta thalassemia and familiarity with butyrates, gene therapy, and luspatercept. Highly rated topics for beta thalassemia-focused CME activities included management of complications and clinical trial updates. These findings suggest practice gaps and barriers to optimal care in the transition from pediatric to adult care, the ongoing management of adult patients, knowledge of the disease state, and familiarity with emerging treatments. Differences CoE vs non-CoE physician responses suggest variations in knowledge, practice, and attitudes that may be helpful in tailoring CME activities to different learner audiences. The small sample size used in some sub-analyses may not be representative of all hematologists treating beta thalassemia patients.
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McBride, Mary E., Dorothy M. Beke, James D. Fortenberry, Annette Imprescia, Louise Callow, Lindsey Justice, and Ronald A. Bronicki. "Education and Training in Pediatric Cardiac Critical Care." World Journal for Pediatric and Congenital Heart Surgery 8, no. 6 (November 2017): 707–14. http://dx.doi.org/10.1177/2150135117727258.
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Pediatric cardiac critical care is a new and emerging field. There is no standardization to the current education provided, and high-quality patient outcomes require such standardization. For physicians, this includes fellowship training, specific competencies, and a certification process. For advanced practice providers, a standardized curriculum as well as a certification process is needed. There is evidence that supports a finding that critical care nursing experience may have a positive impact on outcomes from pediatric cardiac surgery. A rigorous orientation and meaningful continuing education may augment that. For all disciplines and levels of expertise, simulation is a useful modality in the education in pediatric cardiac critical care.
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Nisselle, Amy, Emily A. King, Belinda McClaren, Monika Janinski, Sylvia Metcalfe, and Clara Gaff. "Measuring physician practice, preparedness and preferences for genomic medicine: a national survey." BMJ Open 11, no. 7 (July 2021): e044408. http://dx.doi.org/10.1136/bmjopen-2020-044408.
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ObjectiveEven as genomic medicine is implemented globally, there remains a lack of rigorous, national assessments of physicians’ current genomic practice and continuing genomics education needs. The aim of this study was to address this gap.DesignA cross-sectional survey, informed by qualitative data and behaviour change theory, to assess the current landscape of Australian physicians’ genomic medicine practice, perceptions of proximity and individual preparedness, and preferred models of practice and continuing education. The survey was advertised nationally through 10 medical colleges, 24 societies, 62 hospitals, social media, professional networks and snowballing.Results409 medical specialists across Australia responded, representing 30 specialties (majority paediatricians, 20%), from mainly public hospitals (70%) in metropolitan areas (75%). Half (53%) had contacted their local genetics services and half (54%) had ordered or referred for a gene panel or exome/genome sequencing test in the last year. Two-thirds (67%) think genomics will soon impact their practice, with a significant preference for models that involved genetics services (p<0.0001). Currently, respondents mainly perform tasks associated with pretest family history taking and counselling, but more respondents expect to perform tasks at all stages of testing in the future, including tasks related to the test itself, and reporting results. While one-third (34%) recently completed education in genomics, only a quarter (25%) felt prepared to practise. Specialists would like (more) education, particularly on genomic technologies and clinical utility, and prefer this to be through varied educational strategies.ConclusionsThis survey provides data from a breadth of physician specialties that can inform models of genetic service delivery and genomics education. The findings support education providers designing and delivering education that best meet learner needs to build a competent, genomic-literate workforce. Further analyses are underway to characterise early adopters of genomic medicine to inform strategies to increase engagement.
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Mazmanian, Paul E., Robert Galbraith, Stephen H. Miller, Paul M. Schyve, Murray Kopelow, James N. Thompson, Alejandro Aparicio, David A. Davis, and Norman B. Kahn. "Accreditation, Certification, and Licensure: How Six General Competencies are Influencing Medical Education and Patient Care." Journal of Medical Regulation 94, no. 1 (March 1, 2008): 8–15. http://dx.doi.org/10.30770/2572-1852-94.1.8.
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ABSTRACT Lifelong learning and self-assessment are tenets of medical education and health care improvement; quality and patient safety care are essential to the accreditation of organizations providing either continuing medical education (CME) or patient care; accredited CME providers must assess the learning needs of physicians: Accredited health care organizations must document physician participation in education that relates to the nature of care, treatment and services provided by the hospital. The credentialing and privileging of medical staff requires ongoing focused professional practice evaluation based on six general competencies, including compassionate care, medical knowledge, practice-based learning and improvement, effective communication, demonstrated professionalism and coordinated systems-based practice. As those charged with assessment and program evaluation are challenged to produce valid and reliable results to improve education and health care, United States licensing authorities are defining good medical practice and considering competency-based maintenance of licenses. The present paper offers a framework to advance the discussion of relative value credits for gains assessed in knowledge, competence and performance of physicians. A more synchronized and aligned consortium of medical licensing boards, specialty boards and organizations granting practice privileges is recommended to inform the design of education and physician assessment to assure quality and patient safety.
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Stafford, Renae E., Elizabeth B. Dreesen, Anthony Charles, Harry Marshall, Michele Rudisill, and Eithiel Estes. "Free and Local Continuing Medical Education Does Not Guarantee Surgeon Participation in Maintenance of Certification Learning Activities." American Surgeon 76, no. 7 (July 2010): 692–96. http://dx.doi.org/10.1177/000313481007600721.
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The American Board of Surgery has adopted the Maintenance of Certification requirement for surgeons. It requires continuous professional development (CPD) using active and passive learning modalities in contrast to traditional continuing medical education (CME). The Rural Trauma Team Development Course developed by the American College of Surgeons Committee on Trauma is a CPD learning activity. We provided 22 free courses between May 2007 and June 2009 to trauma care providers at 11 affiliated community and critical access hospitals. The course was taught on-site by an interdisciplinary group and at least one trauma surgeon was faculty. Free Category I CME credits and continuing education units were provided. Two hundred thirty-four providers attended and the majority were RNs (60%) and emergency medical technicians (21.8%). Only 18 were physicians (7.7%) and none were surgeons. The majority felt that they would change their practice as a result of the course but cited the lack of attendance at the course by emergency physicians and surgeons as a deficit. It may be that surgeons have barriers such as time away from a practice to attending these newer types of educational opportunities. Those who develop and offer these courses may need to develop different strategies to reach this target audience.
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Huijer, Huda Abu-Saad, Hani Dimassi, and Sarah Abboud. "Perspectives on palliative care in Lebanon: Knowledge, attitudes, and practices of medical and nursing specialties." Palliative and Supportive Care 7, no. 3 (September 2009): 339–47. http://dx.doi.org/10.1017/s1478951509990277.
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AbstractObjective:Our objective was to determine the knowledge, attitudes, and practices of physicians and nurses on Palliative Care (PC) in Lebanon, across specialties.Method:We performed a cross-sectional descriptive survey using a self-administered questionnaire; the total number of completed and returned questionnaires was 868, giving a 23% response rate, including 74.31% nurses (645) and 25.69% physicians (223).Results:Significant differences were found between medical and surgical nurses and physicians concerning their perceptions of patients' and families' outbursts, concerns, and questions. Knowledge scores were statistically associated with practice scores and degree. Practice scores were positively associated with continuing education in PC, exposure to terminally ill patients, and knowledge and attitude scores. Acute critical care and oncology were found to have lower practice scores than other specialties.Significance of results:Formal education in palliative care and development of palliative care services are very much needed in Lebanon to provide holistic care to terminally ill patients.
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Girard, Donald E., Patrick Brunett, Andrea Cedfeldt, Elizabeth A. Bower, Christine Flores, Uma Rajhbeharrysingh, and Dongseok Choi. "Plug the Leak: Align Public Spending With Public Need." Journal of Graduate Medical Education 4, no. 3 (September 1, 2012): 293–95. http://dx.doi.org/10.4300/jgme-d-11-00199.1.
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Abstract We explore the history behind the current structure of graduate medical education funding and the problems with continuing along the current funding path. We then offer suggestions for change that could potentially manage this health care spill. Some of these changes include attracting more students into primary care, aligning federal graduate medical education spending with future workforce needs, and training physicians with skills they will require to practice in systems of the future.
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Hilmi, Marc, Anna Pellat, Olivier Benoit, Aude-Marie Foucaut, Jean-Christophe Mino, Agnes Kauffmann, Fanny Rochet, et al. "Nutrition and physical activity professional education in gastrointestinal oncology: a national multidisciplinary survey." BMJ Supportive & Palliative Care 10, no. 3 (July 14, 2020): 324–30. http://dx.doi.org/10.1136/bmjspcare-2020-002342.
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ObjectivesSarcopenia, present in more than 50% of digestive oncology patients, has a negative impact on clinical outcomes. Nutrition and adapted physical activity are two major interventions for the management of sarcopenia. However, young hepato-gastroenterologists, oncologists and surgeons in France have limited awareness on these topics. We aimed to evaluate the need for training programmes of physicians (residents and senior doctors) involved in digestive oncology on nutrition and adapted physical activity.MethodsA 42-question survey was developed, by a working group of clinicians, dieticians and adapted physical activity teachers, to assess five areas related to demographics of respondents, nutrition practices, nutrition training, adapted physical activity practices and adapted physical activity training. The national survey was undertaken between April and July of 2019.Results230 physicians participated in the survey; 34% were hepato-gastroenterologists, 31% were oncologists, 23% were surgeons and 40% were residents. Sixty-one per cent of participants had received training in nutrition and only 21% in adapted physical activity. Ninety per cent of the physicians expressed their desire for more effective training on these two topics. Disparities in clinical practices were observed between hepato-gastroenterologists, oncologists and surgeons.ConclusionsMore initial and continuing training on nutrition and adapted physical activity is needed for French physicians in the current digestive oncology clinical practice.
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Ghosh, Amit. "Continuous professional development for physicians." MedUNAB 16, no. 2 (July 31, 2013): 71–76. http://dx.doi.org/10.29375/01237047.2083.
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Maintenance of professional competence remains an exercise of permament learning and an essential requirement for evidence –based medical practice. Physicians attend continuing professional development (CPD) programs to acquire new knowledge. Often CPD programs remain the main source for updates of information. CPD organizers have a considerable responsibility in determining appropriate curriculum for their conferences. Organizing an effective CPD activity often requires understanding of the principles of adult education. Prior to deciding on the curriculum for a CPD, course organizers should conduct needs assessment of physicians. CPD planners should create activities that would consistently improve physician competence. CPD sessions that are interactive, using multiple methods of instructions for small groups of physicians from a single specialty are more likely to change physician knowledge and behavior. The effectiveness of a CPD program should be evaluated at a level beyond measuring physician satisfaction. CPD planners should incorporate methods to determine the course attendees’ improvement of knowledge, skills and attitudes during the CPD activities. Pre and post conference evaluations of physicians using multiple choice questions may form a useful method of assessment.
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Moskaleva, P. V., N. A. Shnayder, M. M. Petrova, and R. F. Nasyrova. "Convulsive syndrome. Part 1." Siberian Medical Review, no. 4 (2021): 98–105. http://dx.doi.org/10.20333/25000136-2021-4-98-105.
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Convulsive syndrome is an urgent, potentially life-threatening condition in neurological, paediatric and general practice. Over the past decade, reconsideration has been committed in relation to the defi nition of epilepsy, epileptic syndromes, including convulsive syndrome with simultaneous expansion of the arsenal of medicinal products for cessation of convulsive seizures in children and adults. In this connection, we have prepared this lecture comprising two parts: the first part considers the defi nition, pathogenesis, aetiology and diagnosis of the convulsive syndrome. The lecture is designed for neurologists, paediatricians, general practitioners, ambulance physicians and anaesthesiologists-reanimatologists. Th e system of continuing medical education (CME) considers convulsive syndrome within the framework of the programme for postgraduate training of physicians in these specialities.
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Hooten, MD, W. Michael, and Barbara K. Bruce, PhD. "Beliefs and attitudes about prescribing opioids among healthcare providers seeking continuing medical education." Journal of Opioid Management 7, no. 6 (November 1, 2017): 417–24. http://dx.doi.org/10.5055/jom.2011.0082.
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Objective: The purpose of this study was to assess the beliefs and attitudes of healthcare providers about prescribing opioids for chronic pain.Setting: The setting was a continuing medical education conference that was specifically designed to deliver content about chronic pain and prescription opioids to providers without specialty expertise in pain medicine.Participants: Conference attendees with prescribing privileges were eligible to participate, including physicians, physician assistants, and advance practice nurses.Intervention: Study participants completed a questionnaire using an electronic response system.Main outcome measures: Study participants completed a validated questionnaire that was specifically developed to measure the beliefs and attitudes of healthcare providers about prescribing opioids for chronic pain.Results: The questionnaire was completed by 128 healthcare providers. The majority (58 percent) indicated that they were “likely” to prescribe opioids for chronic pain. A significant proportion of respondents had favorable beliefs and attitudes toward improvements in pain (p 0.001) and quality of life (p 0.001) attributed to prescribing opioids. However, a significant proportion had negative beliefs and attitudes about medication abuse (p 0.001) and addiction (p 0.001). Respondents also indicated that prescribing opioids could significantly increase the complexity of patient care and could unfavorably impact several administrative aspects of clinical practice.Conclusions: The beliefs and attitudes identified in this study highlight important educational gaps that exist among healthcare providers about prescribing opioids. Knowledge of these educational gaps could build the capacity of medical educators to develop targeted educational materials that could improve the opioid prescribing practices of healthcare providers.
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Pardhan, K., R. Clark, C. Filipowska, W. Thomas-Boaz, M. Hillier, M. Romano, N. Farkhani, K. Anchala, and Z. Alsharafi. "P109: Education innovation: pediatric emergencies curriculum for emergency physicians." CJEM 20, S1 (May 2018): S95. http://dx.doi.org/10.1017/cem.2018.307.
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Introduction: Tertiary care emergency departments (EDs) in large urban environments may have a low volume of high acuity pediatric presentations due to their proximity to dedicated childrens hospitals or large community centres. This may lead to discomfort among emergency physicians (EPs) and registered nurses (RNs) in managing these patients and a waning of knowledge and skills for this unique population. Among the EP group at our institution, 68% indicated they managed pediatric patients in less than 25% of their shifts, 68% also indicated they were uncomfortable managing an undifferentiated critically unwell neonate and only 32% indicated they would be comfortable teaching pediatric topics to emergency medicine residents. At our institution, our innovation was to create a useful curriculum for certified EPs and RNs to improve the interdisciplinary teams comfort level, knowledge and skill set when managing pediatric emergencies. Methods: A needs assessment was undertaken of the EPs and RNs working in our centre. This information was used to develop intended learning outcomes in a collaborative manner with the clinical nursing educator and physician curriculum leads. The team further collaborated with the local simulation centre and a pediatric emergency physician from the local childrens hospital. Results: A one-year, three-module curriculum was developed to cover the areas felt to be highest yield by the EP group: febrile illness, respiratory disease and critically ill neonates and infants. Each module contains three components: an in person interactive lecture delivered by an EP who routinely manages pediatric patients, either at a childrens hospital or large community centre; an online component with e-mail blasts of high yield pediatric content; and, culminating in an interdisciplinary interdepartmental simulation held in situ. This latter is particularly important so that all members of the interdisciplinary team can practice finding and using equipment based on its actual location within the ED. Each component of each module is then evaluated by the participants to ensure improvement for subsequent delivery. Conclusion: Well delivered continuing professional development (CPD) will become increasingly important as competence by design becomes the model for maintenance of certification. Maintaining skills for pediatric patients is an important component of CPD for physicians working in general emergency departments that see a low volume of high acuity pediatric presentations. Our curriculum seeks to address this identified need in an innovative manner using a modular and interdisciplinary approach with a diversity of teaching methods to appeal to the learning styles among our health care team.
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Ausman, James I., and Ronald P. Pawl. "What neurosurgeons should do to succeed in tomorrow's scientific and socioeconomic environment." Neurosurgical Focus 12, no. 4 (April 2002): 1–7. http://dx.doi.org/10.3171/foc.2002.12.4.10.
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There will be major scientific advances and socioeconomic changes in the 21st century that will influence the development of medicine and neurosurgery. These changes will affect those in academic medical centers and the private practitioners of medicine and neurosurgery. Neurosurgeons' philosophy and practice methods must adapt to these trends. Because of the continuing growth in scientific knowledge and the rapid spread of communications of all types, physicians will best work in groups and teams. These group forces will require the physicians to surrender some independence to gain the power of the integrated knowledge and political and social force of a group. Graduate and postgraduate education programs will also change to adapt to these new realities. Those who understand these new shifts will be the most successful in establishing and conducting practices in academic centers and private practice.
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Ory, PhD, Marcia G., Shinduk Lee, DrPH, Deborah Vollmer Dahlke, DrPH, Nicole Pardo, MD, Lixian Zhong, PhD, Carly E. McCord, PhD, Joy P. Alonzo, PharmD, and Matthew Lee Smith, PhD. "Physicians’ interest in different strategies for supporting pain management and opioid prescribing: A cross-sectional study." Journal of Opioid Management 18, no. 6 (November 1, 2022): 511–21. http://dx.doi.org/10.5055/jom.2022.0746.
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Objective: The purpose of this study was to explore physicians’ attitudes toward different strategies for supporting pain management and opioid prescribing and to identify factors related to their attitudes toward the support strategies.Design/setting/participants/measures: This preliminary cross-sectional study collected and analyzed online survey responses from physicians in Texas and Minnesota (N = 69) between December 2017 and February 2018. Primary outcomes were physicians’ interest in online continuing medical education (CME), mHealth patient monitoring system, and short, non-CME YouTube informational briefs about pain management and opioid prescribing. Multiple logistic regression models were used to examine the associations between physicians’ characteristics, attitudes, training, experience, practice setting, and their interest in three different support strategies.Results: About 51-58 percent of physicians indicated moderate-to-extreme interest in online CME (54 percent), mHealth monitoring (58 percent), and short, non-CME YouTube informational briefs (51 percent). Physicians, who practiced in a medium or large practice setting, were less likely to be interested in online CME or short, non-CME YouTube informational briefs. Physicians who prescribed a small number of Schedule II opioids were more likely to be interested in short, non-CME YouTube informational briefs and mHealth monitoring.Conclusions: Findings suggest that physicians may have different preferences in strategies for supporting their pain management and opioid prescribing practices. Future studies are needed to better understand the mechanisms underlying physicians’ interest in different support strategies.
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Alsheikh, Sultan, Hesham AlGhofili, Reema Alageel, Omar Ababtain, Ghadah Alarify, Nasser Alwehaibi, and Abdulmajeed Altoijry. "Diabetic Foot Care: A Screening on Primary Care Providers’ Attitude and Practice in Riyadh, Saudi Arabia." Medicina 59, no. 1 (December 28, 2022): 64. http://dx.doi.org/10.3390/medicina59010064.
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Background and Objectives: Diabetic foot (DF) disease is one of the myriad complications of diabetes. Positive outcomes are expected through a multidisciplinary approach as provided by primary care providers (PCPs). This study aimed to assess the knowledge of DF and attitude of physicians in primary healthcare settings toward DF diagnosis and prevention in Saudi Arabia. Materials and Methods: This observational cross-sectional study used a self-administered questionnaire that was completed by family medicine consultants, residents, and general practitioners working in primary care settings in Riyadh. Results: Of the 152 physicians who completed the survey, (43.4%) completed more than 10 h of diabetes continuing medical education (CME) over the past three years. Most (96.1%) PCPs educate patients about foot self-inspection, and only (64.5%) perform foot inspection at every visit in high-risk diabetic foot patients. PCP knowledge about diagnosing and managing diabetic foot infection was suboptimal. Only 53.9% of participants reported performing a probe-to-bone in DF patients with open wounds. Conclusions: We identified knowledge and action gaps among PCPs. Physicians had acceptable knowledge about preventive measures. However, deficits were found regarding diagnosing and management of DF infections. We recommend addressing these knowledge gaps by incorporating DF lectures and workshops within family medicine conferences and residency programs.
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Goida, Nina, and Olena Shcherbyns’ka. "Medical Personnel and Their Professional Level is the Main Component of Family Medicine." Family Medicine, no. 5 (December 30, 2016): 126–28. http://dx.doi.org/10.30841/2307-5112.5.2016.248817.
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The paper focuses on new approaches to the development of family medicine in Ukraine. There has been made a brief historical overview of stages of family medicine development. The main component of the successful development of general practice–family medicine is stated to be human resources: personnel availability, personnel staffing, professional level. The medical education, including continuing professional development, plays an important role in the professional development of family physicians. The modern educational technologies are widely used in Shupyk NMAPE. The paper describes one-day scientific workshops in the format of the off-site training and videoconferences that are conducted under the methodical direction of the Academy.
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Reis, Evelyn Cohen, Julius G. Goepp, Scott Katz, and Mathuram Santosham. "Barriers To Use of Oral Rehydration Therapy." Pediatrics 93, no. 5 (May 1, 1994): 708–11. http://dx.doi.org/10.1542/peds.93.5.708.
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Objective. To identify potential barriers to the use of oral rehydration therapy (ORT) by pediatric practitioners. Design. Cross-sectional, anonymous, self-administered survey of physicians' ORT knowledge, attitudes, and practice. Setting. A national continuing medical education conference. Participants. One hundred four general pediatricians primarily in private practice (66%) who completed training after 1980 (76%). Measurements and results. Most respondents (83%) reported that ORT plays an important role in their management of dehydration. However, compliance with guidelines from the American Academy of Pediatrics for use of oral therapy is limited: 30% withhold ORT in children with vomiting or moderate dehydration, 50% fail to advise prompt refeeding, and only 3% advise use of a spoon or syringe. The degree of importance of ORT in physicians' practice was negatively associated with reported lack of convenience of ORT administration in the practice setting (P < .001), support staff preference for intravenous versus ORT (P < .001), need for additional training of support staff to implement ORT (P < .01), and likelihood of reimbursement for intravenous versus ORT (P = .07). Notably, degree of importance of ORT was not associated with physician ORT knowledge. Conclusion. Efforts to improve use of ORT should be expanded beyond physician education and focus on such barriers as support staff limitations and financial constraints.
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Fenikilé, Tsehaiwork Sunny, Kathryn Ellerbeck, Melissa K. Filippi, and Christine M. Daley. "Barriers to autism screening in family medicine practice: a qualitative study." Primary Health Care Research & Development 16, no. 04 (November 4, 2014): 356–66. http://dx.doi.org/10.1017/s1463423614000449.
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AimWe explored potential barriers to adoption of recommended screening for autism by family physicians at 18- and 24-month well-child visits.BackgroundThe American Academy of Pediatrics recommends early detection and intervention of autism through the use of a standardized autism-specific screening tool on all children at the 18- and 24-month well-child visits. However, not all family physicians screen for autism.MethodsThree focus groups and six semi-structured interviews were conducted with 15 family physicians in the Kansas City metropolitan area. Verbatim transcripts were inductively coded; data were analyzed using standard text analysis.FindingsParticipants had differing views on the increased incidence of autism. Most participants attributed the increase to changes in diagnostic criteria. There was no consensus on the benefit of implementing universal screening for autism during the 18- or 24-month visit. Many preferred to identify potential problems through general developmental assessments and observations. No participants used specific screening tools for autism, and only one participant was aware of such a tool (M-CHAT). Lack of adequate training on child development and screening methods as well as limited availability of community-based resources to manage children with autism was seen as major barriers to routine screening. Suggested solutions included working toward a stronger evidence base, improving physician training and continuing education, and making systemic changes in healthcare. In conclusion, universal screening for autism at the 18- and 24-month visits is not widely accepted, nor is it implemented by family physicians.
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Tyszka, Emily E., Nina Bozinov, and Farren B. S. Briggs. "Characterizing Relationships Between Cognitive, Mental, and Physical Health and Physical Activity Levels in Persons With Multiple Sclerosis." International Journal of MS Care 24, no. 5 (September 1, 2022): 242–49. http://dx.doi.org/10.7224/1537-2073.2021-108.
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CE INFORMATION ACTIVITY AVAILABLE ONLINE: To access the article and evaluation online, go to https://www.highmarksce.com/mscare. TARGET AUDIENCE: The target audience for this activity is physicians, advanced practice clinicians, nursing professionals, mental health professionals, rehabilitation professionals, and other health care providers involved in the management of patients with multiple sclerosis (MS). LEARNING OBJECTIVES: After completing this activity, the learner should be able to describe the attributes associated with engagement in physical activity in persons with MS across multiple definitions of physical activity. ACCREDITATION: In support of improving patient care, this activity has been planned and implemented by the Consortium of Multiple Sclerosis Centers (CMSC) and Intellisphere, LLC. The CMSC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. This activity was planned by and for the healthcare team, and learners will receive 0.75 Interprofessional Continuing Education (IPCE) credit for learning and change. PHYSICIANS: The CMSC designates this journal-based activity for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. NURSES: The CMSC designates this enduring material for 0.75 contact hour of nursing continuing professional development (NCPD) (none in the area of pharmacology). PSYCHOLOGISTS: This activity is awarded 0.75 CE credits. SOCIAL WORKERS: As a Jointly Accredited Organization, the CMSC is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 0.75 continuing education general credits. DISCLOSURES: It is the policy of the Consortium of Multiple Sclerosis Centers to mitigate all relevant financial disclosures from planners, faculty, and other persons that can affect the content of this CE activity. For this activity, all relevant disclosures have been mitigated. Francois Bethoux, MD, editor in chief of the International Journal of MS Care (IJMSC), has served as physician planner for this activity. He has disclosed no relevant financial relationships. Alissa Mary Willis, MD, associate editor of IJMSC, has disclosed no relevant financial relationships. Authors Nina Bozinov, MD MS, Farren B. S. Briggs, PhD, ScM, and Emily E. Tyszka, MPH, have disclosed no relevant financial relationships. The staff at IJMSC, CMSC, and Intellisphere, LLC who are in a position to influence content have disclosed no relevant financial relationships. Laurie Scudder, DNP, NP, continuing education director CMSC, has served as a planner and reviewer for this activity. She has disclosed no relevant financial relationships. METHOD OF PARTICIPATION: Release Date: September 1, 2022; Valid for Credit through: September 1, 2023 In order to receive CE credit, participants must: 1) Review the continuing education information, including learning objectives and author disclosures.2) Study the educational content.3) Complete the evaluation, which is available at https://www.highmarksce.com/mscare. Statements of Credit are awarded upon successful completion of the evaluation. There is no fee to participate in this activity. DISCLOSURE OF UNLABELED USE: This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the FDA. The CMSC and Intellisphere, LLC do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the CMSC or Intellisphere, LLC. DISCLAIMER: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any medications, diagnostic procedures, or treatments discussed in this publication should not be used by clinicians or other health care professionals without first evaluating their patients’ conditions, considering possible contraindications or risks, reviewing any applicable manufacturer’s product information, and comparing any therapeutic approach with the recommendations of other authorities.
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Lucena, Ricardo J. M., Alain Lesage, Robert Élie, Yves Lamontagne, and Marc Corbière. "Strategies of Collaboration between General Practitioners and Psychiatrists: A Survey of Practitioners' Opinions and Characteristics." Canadian Journal of Psychiatry 47, no. 8 (October 2002): 750–58. http://dx.doi.org/10.1177/070674370204700806.
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Background: The description of collaboration models and the key underlying principles provide important information for designing services. However, to apply this broad corpus of information to clinical services and policymaking, we need to know which key principles (or strategies) of collaboration are the most accepted by local physicians. Method: In this context, we designed a survey that included 2 objectives: 1) to collect the opinions of practising general practitioners (GPs) and psychiatrists in Montreal with respect to strategies for improving collaboration between these 2 groups and 2) to identify demographic and practice characteristics of those physicians associated with the acceptance of such strategies. We designed a questionnaire to specifically elicit physicians' opinions about strategies involving communication, continuing medical education (CME) for GPs in psychiatry, and access to consulting psychiatrists, as well as to identify the profiles of the respondent physicians. We mailed the questionnaire to 203 GPs and 203 psychiatrists who were randomly selected. Results: The response rate was 86% for GPs and 87% for psychiatrists. Physicians expressed favourable opinions about most strategies involving 1) the improvement of communication and 2) the organization of CME activities concerning GP practices in the field of psychiatry. On the other hand, they did not indicate acceptance of the strategies involving on-site collaboration between GPs and psychiatrists. Physician age, sex, place of practice, type of practice (such as seeing patients with or without appointments), and responsibility for administrative duties associated significantly with the degree of acceptance of the proposed strategies Conclusion: Communication and CME strategies for GPs in psychiatry can be an option to improve collaboration between GPs and psychiatrists. However, strategies of access to consulting psychiatrists require significant alterations to established clinical routines and professional roles.
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Cunningham, Natalie, Lynette Reid, Sarah MacSwain, and James R. Clarke. "Ethics in Radiology: Wait Lists Queue Jumping." Canadian Association of Radiologists Journal 64, no. 3 (August 2013): 170–75. http://dx.doi.org/10.1016/j.carj.2011.12.006.
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Education in ethics is a requirement for all Royal College residency training programs as laid out in the General Standards of Accreditation for residency programs in Canada. The ethical challenges that face radiologists in clinical practice are often different from those that face other physicians, because the nature of the physician-patient interaction is unlike that of many other specialties. Ethics education for radiologists and radiology residents will benefit from the development of teaching materials and resources that focus on the issues that are specific to the specialty. This article is intended to serve as an educational resource for radiology training programs to facilitate teaching ethics to residents and also as a continuing medical education resource for practicing radiologists. In an environment of limited health care resources, radiologists are frequently asked to expedite imaging studies for patients and, in some respects, act as gatekeepers for specialty care. The issues of wait lists, queue jumping, and balancing the needs of individuals and society are explored from the perspective of a radiologist.
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Grace, Elizabeth S., Elizabeth J. Korinek, Lindsay B. Weitzel, and Dennis K. Wentz. "Erratum for “Physicians Reentering Clinical Practice: Characteristics and Clinical Abilities” from the Journal of Continuing Education in the Health Professions, Summer 2010, Volume 30, Number 3, pages 180-186." Journal of Continuing Education in the Health Professions 31, no. 1 (2011): 56. http://dx.doi.org/10.1002/chp.20107.
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Binstadt, Emily, Rachel Dahms, Amanda Carlson, Cullen Hegarty, and Jessie Nelson. "When the Learner Is the Expert: A Simulation-Based Curriculum for Emergency Medicine Faculty." Western Journal of Emergency Medicine 21, no. 1 (December 19, 2019): 141–44. http://dx.doi.org/10.5811/westjem.2019.11.45513.
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Emergency physicians supervise residents performing rare clinical procedures, but they infrequently perform those procedures independently. Simulation offers a forum to practice procedural skills, but simulation labs often target resident learners, and barriers exist to faculty as learners in simulation-based training. Simulation-based curricula focused on improving emergency medicine (EM) faculty’s rare procedure skills were not discovered on review of published literature. Our objective was to create a sustainable, simulation-based faculty education curriculum for rare procedural skills in EM. Between 2012 and 2019, most EM teaching faculty at a single, urban, Level 1 trauma center completed an annual two-hour simulation-based rare procedure lab with small-group learning and guided hands-on instruction, covering 30 different procedural education sessions for faculty learners. A questionnaire administered before and after each session assessed EM faculty physicians’ self-perceived ability to perform these rare procedures. Participants’ self-reported confidence in their performance improved for all procedures, regardless of prior procedural experience. Faculty participation was initially mandatory, but is now voluntary. Diverse strategies were used to address barriers in this learner group including eliciting learner feedback, offering continuing medical education credits, gradual roll-out of checklist assessments, and welcoming expertise of faculty leaders from EM and other specialties and professions. Participants perceived training to be most helpful for the most rarely-encountered clinical procedures. Similar curricula could be implemented with minimal risk at other institutions.
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Flottorp, Signe, Andrew Oxman, and Arild Bjørndal. "The Limits of Leadership: Opinion Leaders in General Practice." Journal of Health Services Research & Policy 3, no. 4 (October 1998): 197–202. http://dx.doi.org/10.1177/135581969800300403.
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Objective: To explore the importance and characteristics of opinion leaders in general practice, particularly in relationship to the use of laboratory tests. Design: Focus group discussions and a mailed survey. Subjects: Five focus groups ( n = 29 participants) in four different municipalities and a random sample of 85 general practitioners (GPs) in Norway. Results: While Norwegian GPs recognised colleagues who were influential in determining how they practised, they found it difficult to identify opinion leaders specifically with respect to the use of laboratory tests. Opinion leaders were thought to be less important in influencing the use of laboratory tests than continuing medical education activities and practice guidelines, but more important than industry, patients or personal financial interests. Norwegian GPs recognised and characterised opinion leaders in much the same way as physicians in the USA. Influential colleagues were characterised as being good conveyers of information and willing to take time, as well as being up-to-date and having a high level of clinical expertise. GPs expressed a negative attitude towards ‘superspecialists’ who give advice without knowing the epidemiology of general practice, people who are arrogant and people who do not show respect towards GPs. Conclusions: The potential to identify and use opinion leaders to improve the use of laboratory tests by GPs in Norway appears to be limited.
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Umoren, Rachel, Veronica Chinyere Ezeaka, Ireti B. Fajolu, Beatrice N. Ezenwa, Patricia Akintan, Emeka Chukwu, and Chuck Spiekerman. "Perspectives on simulation-based training from paediatric healthcare providers in Nigeria: a national survey." BMJ Open 10, no. 2 (February 2020): e034029. http://dx.doi.org/10.1136/bmjopen-2019-034029.
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ObjectivesThe objective of this study was to explore the access to, and perceived utility of, various simulation modalities by in-service healthcare providers in a resource-scarce setting.SettingPaediatric training workshops at a national paediatric conference in Nigeria.ParticipantsAll 200 healthcare workers who attended the workshop sessions were eligible to participate. A total of 161 surveys were completed (response rate 81%).Primary and secondary outcome measuresA paper-based 25-item cross-sectional survey on simulation-based training (SBT) was administered to a convenience sample of healthcare workers from secondary and tertiary healthcare facilities.ResultsRespondents were mostly 31–40 years of age (79, 49%) and women (127, 79%). Consultant physicians (26, 16%) and nurses (56, 35%) were in both general (98, 61%) and subspecialty (56, 35%) practice. Most had 5–10 years of experience (62, 37%) in a tertiary care setting (72, 43%). Exposure to SBT varied by profession with physicians more likely to be exposed to manikin-based (29, 30% physicians vs 12, 19% nurses, p<0.001) or online training (7, 7% physician vs 3, 5% nurses, p<0.05). Despite perceived barriers to SBT, respondents thought that SBT should be expanded for continuing education (84, 88% physician vs 39, 63% nurses, p<0.001), teaching (73, 76% physicians vs 16, 26% nurses, p<0.001) and research (65, 68% physicians vs 14, 23% nurses, p<0.001). If facilities were available, nearly all respondents (92, 98% physicians; 52, 96% nurses) would recommend the use of online simulation for their centre.ConclusionsThe access of healthcare workers to SBT is limited in resource-scarce settings. While acknowledging the challenges, respondents identified many areas in which SBT may be useful, including skills acquisition, skills practice and communication training. Healthcare workers were open to the use of online SBT and expressed the need to expand SBT beyond the current scope for health professional training in Nigeria.
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Trachtenberg, Felicia, David Pober, Lisa Welch, and John McKinlay. "Physician Styles of Decision Making for a Complex Condition: Type 2 Diabetes with Comorbid Mental Illness." European Journal for Person Centered Healthcare 2, no. 4 (October 13, 2014): 465. http://dx.doi.org/10.5750/ejpch.v2i4.831.
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Rationale, aims, and objectives: Variation in physician decisions may reflect personal styles of decision making, as opposed to singular clinical actions, and these styles may be applied differently depending on patient complexity. The objective of this study is to examine clusters of physician decision making for type 2 diabetes, overall and in the presence of a mental health comorbidity. Method: This randomized balanced factorial experiment presented video vignettes of a “patient” with diagnosed but uncontrolled type 2 diabetes. “Patients” were systematically varied by age, sex, race, and comorbidity (depression, schizophrenia with normal or bizarre affect, eczema as control). 256 primary care physicians, balanced by gender and experience level, completed a structured interview about clinical management. Results: Cluster analysis identified three styles of diabetes management. “Minimalists” (N=84) performed fewer exams or tests compared to “middle of the road” physicians (N=84). “Interventionists” (N=88) suggested more medications and referrals. A second cluster analysis, without control for comorbidities, identified an additional cluster of “information seekers” (N=15) who requested more additional information and referrals. Physicians ranking schizophrenia higher than diabetes on their problem list were more likely “minimalists” and none were “interventionists” or “information seekers”. Conclusions: Variations in clinical management encompass multiple clinical actions, and physicians subtly shift these decision making styles depending on patient comorbidities. Physicians’ practice styles may help explain persistent differences in patient care. Training and continuing education efforts to encourage physicians to implement evidence-based clinical practice should account for general styles of decision making and for how physicians process complicating comorbidities.
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Panda, Mukta, and Norman A. Desbiens. "An “Education for Life” Requirement to Promote Lifelong Learning in an Internal Medicine Residency Program." Journal of Graduate Medical Education 2, no. 4 (December 1, 2010): 562–65. http://dx.doi.org/10.4300/jgme-d-09-00068.1.
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Abstract Background Lifelong learning is an integral component of practice-based learning and improvement. Physicians need to be lifelong learners to provide timely, efficient, and state-of-the-art patient care in an environment where knowledge, technology, and social requirements are rapidly changing. Objectives To assess graduates' self-reported perception of the usefulness of a residency program requirement to submit a narrative report describing their planned educational modalities for their future continued medical learning (“Education for Life” requirement), and to compare the modalities residents intended to use with their reported educational activities. Materials and Methods Data was compiled from the Education for Life reports submitted by internal medicine residents at the University of Tennessee College of Medicine Chattanooga from 1998 to 2000, and from a survey sent to the same 27 graduates 2 to 4 years later from 2000 to 2004. Results Twenty-four surveys (89%) were returned. Of the responding graduates, 58% (14/24) found the Education for Life requirement useful for their future continued medical learning. Graduates intended to keep up with a mean of 3.4 educational modalities, and they reported keeping up with 4.2. In a multivariable analysis, the number of modalities graduates used was significantly associated with the number they had planned to use before graduation (P = .04) but not with their career choice of subspecialization. Conclusion The majority of residents found the Education for Life requirement useful for their future continued medical learning. Graduates, regardless of specialty, reported using more modalities for continuing their medical education than they thought they would as residents. Considering lifelong learning early in training and then requiring residents to identify ways to practice lifelong learning as a requirement for graduation may be dispositive.
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Byrne, Lauren M., Kathleen D. Holt, Thomas Richter, Rebecca S. Miller, and Thomas J. Nasca. "Tracking Residents Through Multiple Residency Programs: A Different Approach for Measuring Residents' Rates of Continuing Graduate Medical Education in ACGME-Accredited Programs." Journal of Graduate Medical Education 2, no. 4 (December 1, 2010): 616–23. http://dx.doi.org/10.4300/jgme-d-10-00105.1.
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Abstract Background Increased focus on the number and type of physicians delivering health care in the United States necessitates a better understanding of changes in graduate medical education (GME). Data collected by the Accreditation Council for Graduate Medical Education (ACGME) allow longitudinal tracking of residents, revealing the number and type of residents who continue GME following completion of an initial residency. We examined trends in the percent of graduates pursuing additional clinical education following graduation from ACGME-accredited pipeline specialty programs (specialties leading to initial board certification). Methods Using data collected annually by the ACGME, we tracked residents graduating from ACGME-accredited pipeline specialty programs between academic year (AY) 2002–2003 and AY 2006–2007 and those pursuing additional ACGME-accredited training within 2 years. We examined changes in the number of graduates and the percent of graduates continuing GME by specialty, by type of medical school, and overall. Results The number of pipeline specialty graduates increased by 1171 (5.3%) between AY 2002–2003 and AY 2006–2007. During the same period, the number of graduates pursuing additional GME increased by 1059 (16.7%). The overall rate of continuing GME increased each year, from 28.5% (6331/22229) in AY 2002–2003 to 31.6% (7390/23400) in AY 2006–2007. Rates differed by specialty and for US medical school graduates (26.4% [3896/14752] in AY 2002–2003 to 31.6% [4718/14941] in AY 2006–2007) versus international medical graduates (35.2% [2118/6023] to 33.8% [2246/6647]). Conclusion The number of graduates and the rate of continuing GME increased from AY 2002–2003 to AY 2006–2007. Our findings show a recent increase in the rate of continued training for US medical school graduates compared to international medical graduates. Our results differ from previously reported rates of subspecialization in the literature. Tracking individual residents through residency and fellowship programs provides a better understanding of residents' pathways to practice.
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Hallinan, Christine Mary, Jane Maree Gunn, and Yvonne Ann Bonomo. "Implementation of medicinal cannabis in Australia: innovation or upheaval? Perspectives from physicians as key informants, a qualitative analysis." BMJ Open 11, no. 10 (October 2021): e054044. http://dx.doi.org/10.1136/bmjopen-2021-054044.
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Objective We sought to explore physician perspectives on the prescribing of cannabinoids to patients to gain a deeper understanding of the issues faced by prescriber and public health advisors in the rollout of medicinal cannabis. Design A thematic qualitative analysis of 21 in-depth interviews was undertaken to explore the narrative on the policy and practice of medicinal cannabis prescribing. The analysis used the Diffusion of Innovations (DoI) theoretical framework to model the conceptualisation of the rollout of medicinal cannabis in the Australian context. Setting Informants from the states and territories of Victoria, New South Wales, Tasmania, Australian Capital Territory, and Queensland in Australia were invited to participate in interviews to explore the policy and practice of medicinal cannabis prescribing. Participants Participants included 21 prescribing and non-prescribing key informants working in the area of neurology, rheumatology, oncology, pain medicine, psychiatry, public health, and general practice. Results There was an agreement among many informants that medicinal cannabis is, indeed, a pharmaceutical innovation. From the analysis of the informant interviews, the factors that facilitate the diffusion of medicinal cannabis into clincal practice include the adoption of appropriate regulation, the use of data to evaluate safety and efficacy, improved prescriber education, and the continuous monitoring of product quality and cost. Most informants asserted the widespread assimilation of medicinal cannabis into practice is impeded by a lack of health system antecedents that are required to facilitate safe, effective, and equitable access to medicinal cannabis as a therapeutic. Conclusions This research highlights the tensions that arise and the factors that influence the rollout of cannabis as an unregistered medicine. Addressing these factors is essential for the safe and effective prescribing in contemporary medical practice. The findings from this research provides important evidence on medicinal cannabis as a therapeutic, and also informs the rollout of potential novel therapeutics in the future.
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Glover Takahashi, Susan, Marla Nayer, and Lisa Michelle Marie St. Amant. "Epidemiology of competence: a scoping review to understand the risks and supports to competence of four health professions." BMJ Open 7, no. 9 (September 2017): e014823. http://dx.doi.org/10.1136/bmjopen-2016-014823.
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ObjectivesThis study examined the risks and supports to competence discussed in the literature related to occupational therapists, pharmacists, physical therapists and physicians, using epidemiology as a conceptual model.DesignArticles from a scoping literature review, published from 1975 to 2014 inclusive, were included if they were about a risk or support to the professional or clinical competence of one of four health professions. Descriptive and regression analyses identified potential associations between risks and supports to competence and the location of study, type of health profession, competence life-cycle and the domain(s) of competence (organised around the CanMEDS framework).ResultsA total of 3572 abstracts were reviewed and 943 articles analysed. Most focused on physicians (n=810, 86.0%) and ‘practice’ (n=642, 68.0%). Fewer articles discussed risks to competence (n=418, 44.3%) than supports (n=750, 79.5%). The top four risks, each discussed in over 15% of articles, were: transitions in practice, being an international graduate, lack of clinical exposure/experience (ie, insufficient volume of procedures or patients) and age. The top two supports (over 35%) were continuing education participation and educational information/programme features. About 60% of all the articles discussed medical expert and about 25% applied to all roles. Articles focusing on residents had a greater probability of reporting on risks.ConclusionsArticles about physicians were dominant. The majority of articles were written in the last decade and more discussed supports than risks to competence. An epidemiology-based conceptual model offers a helpful organising framework for exploring and explaining the competence of health professions.
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Brown, Torrance T., Suzanne E. Proctor, Ronda L. Sinkowitz-Cochran, Theresa L. Smith, and William R. Jarvis. "Physician Preferences for Continuing Medical Education With a Focus on the Topic of Antimicrobial Resistance: Society for Healthcare Epidemiology of America." Infection Control & Hospital Epidemiology 22, no. 10 (October 2001): 656–60. http://dx.doi.org/10.1086/501841.
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AbstractObjective:To determine the type of media preferred for continuing medical education (CME) and to assess the factors that affect physician preferences for CME in general and on the special topic of antimicrobial resistance.Design:A voluntary survey of the membership of the Society for Healthcare Epidemiology of America, Inc. (SHEA).Methods:SHEA in collaboration with other medical societies and with technical assistance from the Centers for Disease Control and Prevention, designed and mailed the survey to its membership. The survey included questions about media used, preferred, and of interest to try for CME delivery in general and on the topic of antimicrobial resistance in specific. The survey also included demographic and general questions, such as work environment, percentage of time in direct patient care, and experience treating patients with antimicrobial-resistant pathogens.Results:225 SHEA members completed the survey. The majority of physicians were in clinical practice (59%) and worked in a hospital (57%). The median year of graduation from medical school was 1979 (range, 1951-1999). CME subject matter (46%) was ranked as the most important factor affecting media preference. Journal articles (52%) were the most frequently used educational medium; local grand rounds (53%) and regional meetings (53%) were the most preferred media. CD-ROM (56%) and the Internet (46%) were selected as media of greatest interest to try. On the topic of antimicrobial resistance, the most frequently used and the preferred medium was journal articles (67% and 87%, respectively). Most (94%) had received an educational update on current antimicrobial resistance issues within the past year. Stratification of the data by graduation date revealed no significant differences in the medical education media used most (F=0.59, degrees of freedom [df]=4, P=.6715) or preferred by SHEA members in general or on the topic of antimicrobial resistance (F=1.99, df=4, P=.0982).Conclusions:This study provides an understanding of how physicians learn, prefer to learn, and implement best practices for optimal patient outcomes in decreasing the spread of antimicrobial resistance.
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Al-Jurdabi, Fatima Ahmed, and Huda Al-Ebraheem. "Asthma knowledge, attitude and prescribing behavior of primary health care physicians in the Kingdom of Bahrain." Journal of the Bahrain Medical Society 25, no. 2 (2022): 80–86. http://dx.doi.org/10.26715/jbms.25_2_4.
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Background: Asthma is a serious public health problem, affecting people of all ages. When uncontrolled it can cause significant morbidity and mortality. Poor implementation of the guidelines is considered one of several barriers for achieving asthma control. Objectives: To determine the asthma knowledge, attitude and prescribing behavior of primary health care physicians in the Kingdom of Bahrain. Methods: A cross–sectional survey was carried out from March 2012 to March 2013 among primary health care physicians (PHC) attending asthma workshops as part of a continuing medical education program. During the study period 5 workshops were conducted which were attended by PHC physicians. A self-administered questionnaire was designed to achieve the research objective. The questionnaire was based primarily on a previous study carried out by the Chicago Asthma Surveillance Initiative (CASI) in the USA; a similar questionnaire was used in a study conducted in 2004, and permission was taken from the investigators to use it in our study. Questionnaires were distributed to the study groups at the beginning of each workshop and 192 of the 240 attending doctors completed the questionnaire, an 80% response rate. Results: The responders were mainly family physicians (66.7%), of whom 73.4% were following asthma guidelines. The study showed that slightly more than half of PHC physicians (56.8%) were able to assess the level of asthma control appropriately and the majority of them reported scheduling regular follow-ups for their patients. However, only 39.1% of PHC physicians were aware of the appropriate medication recommended for step 1 and only 37.3% of them reported that they provided written plans for their patients. Conclusion: Various aspects of GINA guidelines appear to have been integrated into clinical practice by primary care physicians in the Kingdom of Bahrain, whereas other recommendations do not seem to have been readily implemented.
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Hudon, G., R. Laprise, and L. Guindon. "46. Did the CME/CPD train leave with half the passengers? A needs assessment of Québec specialist associations' CPD units." Clinical & Investigative Medicine 30, no. 4 (August 1, 2007): 52. http://dx.doi.org/10.25011/cim.v30i4.2806.
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This presentation reports on the results of a needs assessment conducted amongst the 34 Quebec specialist associations, which are accredited as CME/CPD providers by Quebec’s College of Physicians, in accordance with the Canadian Association of Continuing Medical Education’s criteria.
In 2006, a mix of methods (survey, semi-structured interviews and program documentation review) were used to assess CPD units’ learning needs in the areas of CME and CPD, the extent to which they carried out a list of specific tasks associated to providers’ responsibilities, barriers encountered in meeting standards, and the kind of help needed to improve performance.
Although CME/CPD fields have evolved considerably in the past 20 years, results indicate that few of the advances have made their way down to the associations. The majority still provides education in the form of traditional CME, where speakers talk about new developments in medicine. Whereas the systematic approach of CME is well integrated in most units, few go beyond perceptions in their needs assessments, use problem-based learning methods, enablers, reinforcement and outcome evaluations, or help specialists self-evaluate and reflect on their practice. These methods and approaches are believed to increase CME effectiveness.
Most Canadian specialists get a large proportion of their CE from non academic medical organizations such as professional associations and learned societies. However, information available in the literature does not allow generalization of our observations to other organizations of this nature. Since non academic organizations are important CME/CPD providers, we propose that more attention be given on the way trainers are trained and innovations are shared in our CE system. What minimal knowledge and skills should be required of a CME/CPD professional today? Together with its affiliated associations and academic partners, the Federation of Medical Specialists of Quebec (FMSQ) has decided to tackle this important issue in the coming years.
Olson CA, Tooman TR, Leist JC. Contents of a core library in continuing medical education: a delphi study. JCEHP 2005; 25:278-88.
Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance: a systematic review of the effect of continuing medical education strategies. JAMA 1995; 274:700-5.
Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients' care. Lancet 2003; 362:1225-30.
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Liptak, Gregory S., and Gail M. Revell. "Community Physician's Role in Case Management of Children With Chronic Illnesses." Pediatrics 84, no. 3 (September 1, 1989): 465–71. http://dx.doi.org/10.1542/peds.84.3.465.
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There is general agreement that case management should be provided to children with chronic illnesses, yet it is not clear who should provide this service. A survey of physicians and parents of children with chronic illnesses was conducted to evaluate the practice and views of pediatricians and compare their assessments with those of parents. Surveys were mailed to 360 physicians and 519 families with response rates of 39% and 63%, respectively. The majority of physicians (74%) thought that the primary care physician should provide case management. When compared with parents, physicians underestimated the parental need for information about the child's diagnosis (8% vs 52%, P < .001), treatments (3% vs 54%, P < .01), and prognosis (30% vs 78%, P < .01). They also overestimated parental needs for information regarding financial aid (70% vs 58%, P < .01), vocations (78% vs 54%, P < .01), and insurance (62% vs 51%, P < .05). Four services ranked by need by parents in the top 10 were not ranked in the top 10 by physicians. Rural physicians noted that services were more difficult to obtain than did those in nonrural areas. The physicians surveyed made several recommendations for steps that could be implemented to facilitate their role as case manageers. If primary care physicians are to be effective case managers, alterations in the current system of care will be required including continuing education related to chronic illness, information about community resources, reimbursement for the time required to perform case management, and better communication between physician and parents.
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Hameed, Usman, Cheryl Dellasega, and Anna Scandinaro. "Assessment of irritability in school-aged children by pediatric, family practice, and psychiatric providers." Clinical Child Psychology and Psychiatry 25, no. 2 (July 29, 2019): 333–45. http://dx.doi.org/10.1177/1359104519865591.
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Background: Irritability, a common behavioral problem for school-aged children, is often first assessed by primary care providers, who manage about a third of mental health conditions in children. Until recent changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM), irritability was often associated with mood disorders, which may have led to increases in bipolar disorder diagnosis and prescription of mood stabilizing medication. Objective: Our aim was to explore differences between the approaches psychiatric and primary care providers use to assess irritability. Methods: A single trained interviewer conducted detailed interviews and collected demographic data from a homogeneous group of physicians that saturated with a sample size of 17 pediatric, family medicine, and psychiatric providers who evaluate and treat school-aged children. Qualitative and quantitative data were collected and analyzed. Results: In general, primary care providers chose to refer children with irritability to mental health specialists when medication management became complex, while the psychiatric providers chose behavior modification and parent education strategies rather than medications. The psychiatric group had a significantly higher caseload mix, prior experience with irritability, and more confidence in their assessment capabilities. There was lack of continuing medical education about irritability in all groups. Conclusion: This preliminary study highlights the importance of collaboration between primary care and subspecialties to promote accurate assessment and subsequent treatment of school-aged children with irritability, who can represent a safety concern for self and others. More research is needed to establish an efficient method of assessing and managing irritability in primary care and better utilization of specialists.
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Mastoras, G. N., W. J. Cheung, A. Krywenky, S. Addleman, B. Weitzman, and J. R. Frank. "LO10: Faculty sim: a simulation-based continuing professional development curriculum for academic emergency physicians." CJEM 20, S1 (May 2018): S10. http://dx.doi.org/10.1017/cem.2018.72.
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Introduction: Maintaining and enhancing competence in the breadth of Emergency Medicine (EM) is an ongoing challenge for all clinicians. In particular, resuscitative care in EM involves high-stakes clinical encounters that demand strong procedural skills, effective leadership, and up-to-date knowledge. However, Canadian emergency physicians are not required to complete any specific ongoing training for these encounters beyond general CPD requirements of professional colleges. Simulation-based medical education (SBME) is an effective modality for enhancing technical (e.g. procedural) and non-technical (i.e. Crisis Resource Management) skills in crisis situations, and has been embedded in undergraduate and postgraduate medical curricula worldwide. We present a novel comprehensive curriculum of simulation-based CPD designed specifically for academic emergency physicians (AEPs) at our centre. Methods: The curriculum development involved a departmental needs assessment survey, focus groups with AEPs, data from safety metrics and critical incidents, and consultations with senior departmental leadership. Institutional support was provided in the form of a $25,000 grant to fund a physician Program Lead, monthly session instructors, and simulation centre operating costs. Based on the results of the needs assessment, a two-year curriculum was mapped out and tailored to the available resources. Results: CPD simulation commenced in January 2017 and occurs monthly for three hours, immediately following departmental Grand Rounds to provide convenient scheduling. Our needs assessment identified two key types of educational needs: (1) Crisis Resource Management skills and (2) frequent practice of high-stakes critical care procedures (e.g. central lines). The first six months of implementation was dedicated to low-fidelity skills labs to facilitate the transition to SBME. After this, the program transitioned to a hybrid model involving two high-fidelity simulated resuscitations and one skills lab per session. Conclusion: We have introduced a comprehensive curriculum of ongoing simulation-based CPD in our department based on the educational needs of our AEPs. Key to our successful implementation has been support from educational and administrative leadership within our department. Ongoing challenges include securing adequate protected time from clinical duties for program facilitators and participants. Future work will include establishing permanent funding, CPD accreditation, and a formal program evaluation.
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Tenn-Lyn, N., S. Verma, and R. Zulla. "68. The resident experience in a large urban teaching setting: Results of the 2005-2006 resident exit survey, University of Torontos." Clinical & Investigative Medicine 30, no. 4 (August 1, 2007): 66. http://dx.doi.org/10.25011/cim.v30i4.2829.
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We developed and implemented an annual online survey to administer to residents exiting residency training in order to (1) assess the quality of the residency experience and (2) identify areas of strength and areas requiring improvement. Long-term goals include program planning, policy-making and maintenance of quality control. Survey content was developed from an environmental scan, pre-existing survey instruments, examination of training criteria established by the CFPC and the CanMEDS criteria established by the RCPSC. The survey included evaluation benchmarks and satisfaction ratings of program director and faculty, preparation for certification and practice, quality of life, quality of education, and work environment.
The response rate was 28%. Seventy-five percent of respondents were exiting from Royal College training programs. Results of descriptive statistics determined that the overall educational experience was rated highly, with 98.9% of respondents satisfied or very satisfied with their overall patient care experience. Ninety-six percent of respondents were satisfied or very satisfied with the overall quality of teaching. Preparation for practice was identified as needing improvement, with 26% and 34% of respondents giving an unsatisfactory rating to career guidance and assistance with finding employment, respectively. Although 80% of respondents reported receiving ongoing feedback and 84% discussed their evaluations with their supervisors, only 38% of evaluations were completed by the end of the rotation.
The results indicate that residents are generally satisfied with their experiences during residency training, especially with their overall educational experience. Areas of improvement include preparation for practice and timeliness of evaluations. Further iterations of this survey are needed to refine the instrument, identify data trends and maintain quality control in residency training programs.
Frank JR (ed.). The CanMEDS competency framework: better standards, better physicians, better care. Ottawa: The Royal College of Physicians and Surgeons of Canada, 2005.
Merritt, Hawkins and Associates. Summary Report: 2003 Survey of final-year medical residents. http://www.merritthawkins.com/pdf/MHA2003residentsurv.pdf. Accessed May 1, 2006.
Regnier K, Kopelow M, Lane D, Alden A. Accreditation for learning and change: Quality and improvement as the outcome. The Journal of Continuing Education in the Health Professions 2005; 25:174-182.
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Ilori, Temitope, and Oladipo Odeyinka. "Drug Prescription Pattern in a Primary Care Clinic, Southwest, Nigeria." Journal of Drug Delivery and Therapeutics 12, no. 3 (May 15, 2022): 74–79. http://dx.doi.org/10.22270/jddt.v12i3.5329.
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Background: Rational drug use is of the utmost importance in a region such as West Africa, where the prevalence of drug resistance is increasing due to inappropriate use of medications.
Objective: This study aimed to assess the pattern of prescription drug use at the General Outpatient Clinic of the University College Hospital, Ibadan. This study also assessed the knowledge and attitude toward rational drug use among prescribing physicians in the Clinic.
Design: The study was a retrospective cross-sectional review of patients' records over three years. The medical records were selected by systematic random sampling and subjected to the WHO core drug use indicators. Prescribers at the study site had their knowledge, attitude, and practice (KAP) of rational drug use assessed with a self-administered questionnaire.
Results: A total of 795 medical records were analyzed for drug use indicators. The mean number of drugs per encounter was 2.64 ±1.23. The percentage of encounters in which an antibiotic was prescribed was 20.4%, while 71.6% of all drugs prescribed were in the generic form. From the KAP survey, 64% of physicians routinely prescribed both generic and brand names, and 68% admitted they needed further education on rational drug use.
Conclusion: Using the WHO core drug use indicators, this study identified some degree of polypharmacy and poor adherence to the generic prescription of drugs. Continuing Medical Education for health workers is encouraged to stem the irrational prescription of medications in the African sub-region.
Keywords: Prescription Drugs Use, Rational Use of Medicines, Physician's knowledge, Nigeria
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Vazquez-Lago, Juan, Cristian Gonzalez-Gonzalez, Maruxa Zapata-Cachafeiro, Paula Lopez-Vazquez, Margarita Taracido, Ana López, and Adolfo Figueiras. "Knowledge, attitudes, perceptions and habits towards antibiotics dispensed without medical prescription: a qualitative study of Spanish pharmacists." BMJ Open 7, no. 10 (October 2017): e015674. http://dx.doi.org/10.1136/bmjopen-2016-015674.
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ObjectiveTo investigate community pharmacists’ knowledge, attitudes, perceptions and habits with regard to antibiotic dispensing without medical prescription in Spain.MethodsA qualitative research using focus group method (FG) in Galicia (north-west Spain). FG sessions were conducted in the presence of a moderator. A topic script was developed to lead the discussions, which were audiorecorded to facilitate data interpretation and transcription. Proceedings were transcribed by an independent researcher and interpreted by two researchers working independently. We used the Grounded Theory approach.SettingCommunity pharmacies in Galicia, region Norwest of Spain.ParticipantsThirty pharmacists agreed to participate in the study, and a total of five FG sessions were conducted with 2–11 pharmacists. We sought to ensure a high degree of heterogeneity in the composition of the groups to improve our study’s external validity. Pharmacists’ participation had no gender or age restrictions, and an effort was made to form FGs with pharmacists who were both owners and non-owners, provided in all cases that they were Official Colleges of Pharmacists-registered community pharmacists. For the purpose of conducting FG discussions, the basic methodological principle of allowing groups to attain their ‘own structural identity’ was applied.Main outcome measurementsCommunity pharmacists’ habits and knowledge with regard to antibiotics and identification of the attitudes and/or factors that influence antibiotic dispensing without medical prescription.ResultsPharmacists attributed the problem of antibiotics dispensed without medical prescription and its relationship to antibiotic resistance to the following attitudes: external responsibility (doctors, dentists and the National Health Service (NHS)); acquiescence; indifference and lack of continuing education.ConclusionsDespite being a problem, antibiotic dispensing without a medical prescription is still a common practice in community pharmacies in Galicia, Spain. This practice is attributed to acquiescence, indifference and lack of continuing education. The problem of resistance was ascribed to external responsibility, including that of patients, physicians, dentists and the NHS.
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Coppola, Noemi, Stefania Baldares, Andrea Blasi, Rosaria Bucci, Gianrico Spagnuolo, Michele Davide Mignogna, and Stefania Leuci. "Referral Patterns in Oral Medicine: A Retrospective Analysis of an Oral Medicine University Center in Southern Italy." International Journal of Environmental Research and Public Health 18, no. 22 (November 19, 2021): 12161. http://dx.doi.org/10.3390/ijerph182212161.
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Referral of a patient from one healthcare provider to another is an important part of the medical practice. The aim of this study was to analyze the referral process to the Oral Medicine Unit in a university-based tertiary center in Southern Italy. A chart review of new referrals to the Oral Medicine Unit during a 24-month period was conducted. The following data were recorded: demographic characteristics, medical history, number of physicians seen prior to Oral Medicine assessment, referral source, diagnostic procedures ordered by referrals, reason for referral, site of lesion/condition, final diagnosis. Then, the rates of correct identification for health-care professionals and the appropriateness of the reference diagnosis based on the disease were calculated with descriptive statistic indicators. There were 583 new first consultations. A total of 62.9% of patients were referred by general dental practitioners, 27.4% by physicians, and 9.7% did not have a referral. The most common diseases for referral were immune-mediated diseases (39.6%) and oro-facial pain disorders (25.2%). Only 28.5% of patients had a correct provisional diagnosis. The results of this study show the need to implement curricula in the field of oral medicine among dentistry and medical students, and to support the continuing education among healthcare providers to reduce diagnostic delay for oral diseases.
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Kang, Sung-Yoon, and Taek Ki Min. "Principles of the use of inhaler devices in asthma treatment." Journal of the Korean Medical Association 65, no. 9 (September 10, 2022): 606–15. http://dx.doi.org/10.5124/jkma.2022.65.9.606.
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Background: Inhaler therapy is the most critical route of administering drugs in the management of asthma due to its rapid onset of action, better pulmonary efficacy, and reduced risk of side effects, compared with other routes of administration.Current Concepts: Although many physicians and patients believe they know how to use inhaler devices, most do not know the correct techniques. To achieve better and more effective treatment results, the inhalation device should be appropriate for the characteristics and wishes of each patient. Available inhaler devices include pressurized metered dose inhalers, dry powder inhalers, soft mist inhalers, and nebulizers. To improve disease outcomes and treatment adherence, a personalized stepwise approach, based on each patient’s conscious inhalation, inspiratory flow, and hand-lung coordination, is recommended in the selection of the most appropriate device.Discussion and Conclusion: Common problems with inhaler usage include failure to exhale completely before inhaling, insufficient inhalation efforts, and inadequate breath-hold after inhalation. Therefore, continuing education and support are warranted to ensure optimal outcomes and enable patients to improve inhaler usage techniques. Health care providers should also know the devices and develop systems in order to provide comprehensive support to patients in clinical practice.
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Anishchenko, Kseniya, Tracy Cushing, Celia Lenarz-Geisen, and Adane Wogu. "The Knowledge and Attitudes of Pediatricians Toward Plant-Based Diets." Current Developments in Nutrition 6, Supplement_1 (June 2022): 421. http://dx.doi.org/10.1093/cdn/nzac056.001.
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Abstract Objectives There has been abundant evidence showing the health benefits of a plant-based diet, yet many physicians do not stress the importance these diets as an aspect of chronic disease prevention and treatment. Pediatricians have an important role in dietary education of children, and there is scarce data focused specifically on pediatricians’ knowledge regarding plant-based nutrition. Our study addresses this gap by assessing pediatrician's general nutritional knowledge and attitudes regarding plant-based diets. Methods A cross-sectional study was done using a previously implemented questionnaire that was distributed among a sample of pediatricians in the United States. Survey items were scored as a percentage of correct answers based on nutrition knowledge and attitudes toward plant-based diets, and then analyzed and compared among participants. Results Of 112 respondents surveyed, 86 (76.8%) were general pediatricians and 71 (63.4%) were following a vegetarian or plant-based diet. 57 (50.9%) of the participants had been in medical practice for more than 10 years. 92 (82.1%) of participants received ≤ 10 hours nutrition education in medical school, and 76 (67.9%) of participants had ≤ 10 hours of nutrition-specific continuing medical education since residency training. The mean medical knowledge score was found to be 57.1% ± 20.1%, and participants who followed a whole-foods plant-based diet had significantly higher scores than those who did not follow any specific diet (70.5% ± 13.5 vs. 46.5% ± 20.0) (p < 0.001). The mean attitude score was 49.2% ± 27.6, with participants who had at least one child having significantly higher attitude scores than those without children (53.7% ± 28.1 vs. 41.2% ± 24.9) (p = 0.028). There was a strong positive correlation between participants’ medical knowledge and their attitude score (p < 0.001). Conclusions Pediatricians are exposed to very little nutrition education hours during medical school and in their continued education training. A significant portion of pediatricians in our survey had low average medical knowledge base in vegetarian nutrition and did not hold positive attitudes concerning plant-based diets. Increasing education hours for pediatricians regarding plant-based diets may help them better counsel their patients on their dietary decisions. Funding Sources Physicians Association for Nutrition.
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Hengartner, Michael P., and Martin Plöderl. "False Beliefs in Academic Psychiatry: The Case of Antidepressant Drugs." Ethical Human Psychology and Psychiatry 20, no. 1 (July 2018): 6–16. http://dx.doi.org/10.1891/1559-4343.20.1.6.
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Antidepressant drugs are the mainstay of depression treatment in both primary and specialized mental health care. However, academic psychiatry holds false beliefs about antidepressants and we expose two of them in this essay. First, recent attitude surveys conducted among psychiatrists and general practitioners have revealed that physicians attribute antidepressants’ effects mostly to the drugs’ pharmacologic action and less so to placebo effects. Second, academic psychiatry maintains that physical dependence to antidepressant drugs does not exist and that “discontinuation symptoms” upon stopping maintenance pharmacotherapy are benign and affect only a small minority of antidepressant users. As we review in this essay, these beliefs are at odds with the scientific literature. The largest and most comprehensive meta-analysis of antidepressant trials conducted to date indicates that 88% of the drugs’ treatment outcome is accounted for by placebo effect. Furthermore, physical dependence appears to be a serious issue, as severe and persistent withdrawal reactions affect up to 50% of antidepressant users according to several studies. Correcting false beliefs prevailing in academic psychiatry is needed and has important implications for psychiatric training, continuing medical education, and practice.
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Sakallaris, BR, LS Halpin, M. Knapp, and MJ Sheridan. "Same-day transfer of patients to the cardiac telemetry unit after surgery: the Rapid after Bypass Back into Telemetry (RABBIT) program." Critical Care Nurse 20, no. 2 (April 1, 2000): 50–55. http://dx.doi.org/10.4037/ccn2000.20.2.50.
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Early data from this project suggest that the RABBIT program fulfilled the process improvement goals of decreasing costs of cardiac surgery and maintaining high quality. Decreased cost was achieved by decreasing time to extubation and decreasing length of stay in the ICU and the total length of stay in the hospital. The cost savings were achieved without compromising the quality of care, which was assessed by measuring rates of readmission to the ICU and to the hospital and by surveying patients about their level of satisfaction. The success of the RABBIT program can be attributed to several factors. First, members of the cardiac surgery quality improvement team worked well together to solve problems and overcome obstacles, particularly after the pilot program. Second, naming the program helped to motivate staff, physicians, and patients. Outcome data was shared with the staff quarterly, and successes were celebrated. Finally, the use of a facilitator early in the process to establish the process with the surgeons and the staff was invaluable. Opportunities for continued improvement include resolving operational difficulties related to availability of beds and staffing, continuing work with physicians in changing practice patterns, increasing efficiency in scheduling operating rooms, and adjusting the preoperative education provided to patients and their families about the length of stay to expect. Quarterly outcome analysis continues, with reports to the cardiac surgery quality improvement team. The team continues to explore creative solutions to the aforementioned issues, as the goal of having 25% of patients who undergo cardiac surgery be transferred to the CTU on the day of surgery has remained elusive.