Journal articles: 'Physicians (General practice) Education'

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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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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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Jin, Robert, Bernard CK Choi, Benjamin TB Chan, Louise McRae, Felix Li, Lisa Cicutto, Louis-Philippe Boulet, Ian Mitchell, Robert Beveridge, and Eric Leith. "Physician Asthma Management Practices in Canada." Canadian Respiratory Journal 7, no. 6 (2000): 456–65. http://dx.doi.org/10.1155/2000/587151.

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OBJECTIVES: To establish national baseline information on asthma management practices of physicians, to compare the reported practices with the Canadian Consensus recommendations and to identify results potentially useful for interventions that improve physician asthma management practices.DESIGN: National, stratified cross-sectional survey.SETTINGS: The 10 provinces and two territories of Canada, from 1996 to 1997.PARTICIPANTS: Questionnaires were sent to 4489 physicians stratified by province/territory and specialty group (family/general practice, respirology, internal medicine, pediatrics and allergy/immunology); 2605 responses were received.OUTCOME MEASURES: Methods for the diagnosis, treatment, education and follow-up of patients with asthma ('asthma management practices').RESULTS: Significant variations existed among the five specialty groups in asthma management practices. A low use of objective measures of airflow limitation to assist with diagnosis was found among some respondents (mostly family physicians). Up to 40% of physicians regarded the daily fixed dosing (three or four times a day) of inhaled, short acting beta2-agonist as 'first-line therapy' for moderate to severe asthma. A minority of physicians reported using written action plans for patients or referring them to other health professionals for asthma education. Insufficient time during appointments and a perceived lack of appropriate educational materials were frequently cited as reasons for not providing asthma education. The perceived knowledge of the Canadian Consensus recommendations varied among physicians but was lowest among nonspecialists.CONCLUSIONS: The survey showed variations in certain aspects of the management of asthma by physicians. The findings will help to target specific areas for future physician education programs and other behavioural change strategies.

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Moran, Patrick G., and Roxanna Lynn Fredrickson. "Colorado personalized education for physicians (CPEP): Physiciansʼ communication skills and medical practice." Journal of Continuing Education in the Health Professions 13, no. 4 (1993): 289–98. http://dx.doi.org/10.1002/chp.4750130404.

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Tinkle, JD. "AIDS and the podiatric medical practice." Journal of the American Podiatric Medical Association 85, no. 8 (August 1, 1995): 420–27. http://dx.doi.org/10.7547/87507315-85-8-420.

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The number of patients with HIV (human immunodeficiency virus) and AIDS (acquired immune deficiency syndrome) has increased to the point that every podiatric physician in this country will be treating patients who are HIV positive, knowingly or not. Podiatric physicians continue to be part of the medical team that must bear responsibility for the rapid changes in HIV education. Attention must be focused on educating physicians about all aspects of this disease, especially the primary and secondary diseases of AIDS and new treatments and their side effects. Sterile technique and universal precautions have now taken on new importance.

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Huang, Vivian Wai-Mei, Hsiu-Ju Chang, Karen Ivy Kroeker, Karen Jean Goodman, Kathleen M. Hegadoren, Levinus Albert Dieleman, and Richard Neil Fedorak. "Management of Inflammatory Bowel Disease during Pregnancy and Breastfeeding Varies Widely: A Need for Further Education." Canadian Journal of Gastroenterology and Hepatology 2016 (2016): 1–13. http://dx.doi.org/10.1155/2016/6193275.

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Background.Inflammatory bowel disease (IBD) affects patients in their young reproductive years. Women with IBD require maintenance therapies during pregnancy and breastfeeding. However, physician management of IBD during pregnancy and breastfeeding has not been well characterized.Objective.To characterize physician perceptions and management of IBD during pregnancy and breastfeeding.Methods.A cross-sectional survey of Canadian physicians who are involved in the care of women with IBD was conducted. The survey included multiple-choice and Likert scale questions about perceptions and practice patterns regarding the management of IBD during pregnancy and breastfeeding.Results.183 practicing physicians completed the questionnaire: 97/183 (53.0%) gastroenterologists; 75/183 (41.0%) general practitioners; and 11/183 (6.0%) other physicians. Almost half (87/183, 47.5%) of the physicians felt comfortable managing pregnant IBD patients. For specified IBD medications, proportions of physicians who indicated they would continue them during pregnancy were as follows: sulfasalazine, 47.4%; oral mesalamine, 67.0%; topical mesalamine, 70.3%; oral prednisone, 68.0%; topical prednisone, 78.0%; oral budesonide, 61.6%; topical budesonide, 75.0%; ciprofloxacin, 15.3%; metronidazole, 31.4%; azathioprine, 57.1%; methotrexate, 2.8%; infliximab, 55.6%; adalimumab, 78.1%. Similar proportions of physicians would continue these medications during breastfeeding. A higher proportion of gastroenterologists than nongastroenterologists indicated appropriate use of these IBD medications during pregnancy and breastfeeding.Conclusions.Physician management of IBD during pregnancy and breastfeeding varies widely. Relative to other physicians, responses of gastroenterologists more frequently reflected best practices pertaining to medications for control of IBD during pregnancy and breastfeeding. There is a need for further education regarding the management of IBD during pregnancy and breastfeeding.

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Provenzano, David Anthony, Samuel Ambrose Florentino, Jason S. Kilgore, Jose De Andres, B. Todd Sitzman, Scott Brancolini, Tim J. Lamer, et al. "Radiation safety and knowledge: an international survey of 708 interventional pain physicians." Regional Anesthesia & Pain Medicine 46, no. 6 (March 9, 2021): 469–76. http://dx.doi.org/10.1136/rapm-2020-102002.

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IntroductionInterventional pain procedures have increased in complexity, often requiring longer radiation exposure times and subsequently higher doses. The practicing physician requires an in-depth knowledge and evidence-based knowledge of radiation safety to limit the health risks to themselves, patients and healthcare staff. The objective of this study was to examine current radiation safety practices and knowledge among interventional pain physicians and compare them to evidence-based recommendations.Materials and methodsA 49-question survey was developed based on an extensive review of national and international guidelines on radiation safety. The survey was web-based and distributed through the following professional organizations: Association of Pain Program Directors, American Academy of Pain Medicine, American Society of Regional Anesthesia and Pain Medicine, European Society of Regional Anesthesia and Pain Therapy, International Neuromodulation Society, and North American Neuromodulation Society. Responses to radiation safety practices and knowledge questions were evaluated and compared with evidence-based recommendations. An exploratory data analysis examined associations with radiation safety training/education, geographical location, practice type, self-perceived understanding, and fellowship experience.ResultsOf 708 responding physicians, 93% reported concern over the health effects of radiation, while only 63% had ever received radiation safety training/education. Overall, ≥80% physician compliance with evidence-based radiation safety practice recommendations was demonstrated for only 2/15 survey questions. Physician knowledge of radiation safety principles was low, with 0/10 survey questions having correct response rates ≥80%.ConclusionWe have identified deficiencies in the implementation of evidence-based practices and knowledge gaps in radiation safety. Further education and training are warranted for both fellowship training and postgraduate medical practice. The substantial gaps identified should be addressed to better protect physicians, staff and patients from unnecessary exposure to ionizing radiation during interventional pain procedures.

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Hansel, N. K., D. Koester, C. F. Webber, and R. Bastani. "Emergency room practice among family physicians." Academic Medicine 60, no. 11 (November 1985): 865–9. http://dx.doi.org/10.1097/00001888-198511000-00007.

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Kilo, Charles M. "Educating physicians for systems-based practice." Journal of Continuing Education in the Health Professions 28 (2008): 15–18. http://dx.doi.org/10.1002/chp.202.

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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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Taylor, T. L. "A practice profile of native American physicians." Academic Medicine 64, no. 7 (July 1989): 393–6. http://dx.doi.org/10.1097/00001888-198907000-00012.

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Nash, D. B., L. E. Markson, S. Howell, and E. A. Hildreth. "Evaluating the competence of physicians in practice." Academic Medicine 68, no. 2 (February 1993): S19–22. http://dx.doi.org/10.1097/00001888-199302000-00024.

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Sidorov, J. "Retraining specialist physicians for primary care practice." Academic Medicine 72, no. 4 (April 1997): 248–9. http://dx.doi.org/10.1097/00001888-199704000-00006.

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Mylopoulos, Maria, Lynne Lohfeld, Geoffrey R. Norman, Gurpreet Dhaliwal, and Kevin W. Eva. "Renowned Physicians’ Perceptions of Expert Diagnostic Practice." Academic Medicine 87, no. 10 (October 2012): 1413–17. http://dx.doi.org/10.1097/acm.0b013e31826735fc.

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Cowart, Kevin, Vidhi Patel, Jessica Bianco, Amanda Martinez, and Jason Castro. "Pharmacist-Physician Collaborative Practice to Improve Diabetes Care at Tampa General Medical Group." Clinical Diabetes 40, no. 2 (April 1, 2022): 240–44. http://dx.doi.org/10.2337/cd21-0080.

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Quality Improvement Success Stories are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of Clinical Diabetes. The following article describes a pharmacist-physician collaborative effort to reduce A1C and blood pressure and thereby lower risks for complications for people with diabetes being treated at a network of family care clinics in the Tampa, FL, area.

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Penderell, Adrienne, and Kevin Brazil. "The spirit of palliative practice: A qualitative inquiry into the spiritual journey of palliative care physicians." Palliative and Supportive Care 8, no. 4 (September 28, 2010): 415–20. http://dx.doi.org/10.1017/s1478951510000271.

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AbstractObjective:Much is known about the important role of spirituality in the delivery of multidimensional care for patients at the end of life. Establishing a strong physician–patient relationship in a palliative context requires physicians to have the self-awareness essential to establishing shared meaning and relationships with their patients. However, little is known about this phenomenon and therefore, this study seeks a greater understanding of physician spirituality and how caring for the terminally ill influences this inner aspect.Method:A qualitative descriptive study was used involving face-to-face interviews with six practicing palliative care physicians.Results:Conceptualized as a separate entity from religion, spirituality was described by participants as a notion relating to meaning, personal discovery, self-reflection, support, connectedness, and guidance. Spirituality and the delivery of care for the terminally ill appeared to be interrelated in a dynamic relationship where a physician's spiritual growth occurred as a result of patient interaction and that spiritual growth, in turn, was essential for providing compassionate care for the palliative patient. Spirituality also served as an influential force for physicians to engage in self-care practices.Significance of results:With spirituality as a pervasive force not only in the lives of palliative care patients, but also in those of healthcare providers, it may prove to be beneficial to use this information to guide future practice in training and education for palliative physicians in both the spiritual care of patients and in practitioner self care.

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Graff, Stephanie L., Julia Close, Suzanne Cole, Laurie Matt-Amaral, Rasha Beg, and Merry-Jennifer Markham. "Impact of Closed Facebook Group Participation on Female Hematology/Oncology Physicians." Journal of Oncology Practice 14, no. 12 (December 2018): e758-e769. http://dx.doi.org/10.1200/jop.18.00448.

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Purpose: Meaningful connections are an important aspect of career satisfaction. The Hematology Oncology Women Physician Group (HOWPG) is a private Facebook (FB) group of 936 women who practice within the hematology/oncology (H/O) field. We hypothesized that HOWPG adds value to education, emotional wellness, and practice of oncology for its membership. A survey was conducted within HOWPG to define group impact on members. Materials and Methods: A voluntary, anonymous 12-question online survey was distributed to members of HOWPG by sharing the survey link within the FB group. Participants were surveyed regarding demographics, general FB versus exclusive HOWPG use, and opinions regarding HOWPG value and impact. Results: A total of 169 members completed the survey; 9% were fellows, 65% had been in practice less than 10 years, and 26% had been in practice 10 years or more; 97% were age younger than 50 years; 85% practiced adult H/O, and the remainder divided their practice among pediatric H/O, radiation oncology, surgical specialty, and palliative care; 90% used FB at least daily, with 82% accessing HOWPG at least daily. The most common uses for the site included education (65% to 89%), advice on complex cases (65%), emotional support (65%), and networking (55%). On a scale of 1 to 10, learning from clinical cases (9.0) and emotional support (8.4) were rated the most beneficial aspects. Respondents felt HOWPG, when compared with FB in general, was more likely to improve career satisfaction and reduce professional burnout. Conclusion: HOWPG provides an opportunity for education and clinical and emotional support. Social media can be an effective venue to educate physicians, augment patient care via advice, foster networking, reduce burnout, and improve career satisfaction among female physicians in the field of H/O.

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Mortazavi, Seyede Salehe, Mohsen Shati, Seyed Kazem Malakouti, Hamid Reza Khankeh, Shiva Mehravaran, and Fazlollah Ahmadi. "Physicians’ role in the development of inappropriate polypharmacy among older adults in Iran: a qualitative study." BMJ Open 9, no. 5 (May 2019): e024128. http://dx.doi.org/10.1136/bmjopen-2018-024128.

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ObjectivesThe use of unnecessary or excessive medications (inappropriate polypharmacy) is a major health challenge among older adults which is driven by several factors. This study aims to provide in-depth descriptions of the physician’s role in the development of inappropriate polypharmacy among older adults in Iran.DesignQualitative content analysis of interviews, field notes and other relevant documents available (eg, medical records). Data collection and analyses were done concurrently to guide the sampling process.SettingThree purposively selected referral hospitals in Tehran, Iran.ParticipantsA total of 7 physicians, 10 older adults, 3 caregivers and 3 pharmacists with a median age of 54 (IQR 23) years were recruited through convenience sampling.ResultsEmerged categories included misdiagnosis, inappropriate prescribing, insufficient patient education, poor communication, unprofessional behaviour and limited perspectives which highlight the role of physicians in the development of inappropriate polypharmacy among older adults in Iran under the main concept of poor medical practice.ConclusionThis study provides valuable insight on the role of physicians in the development of inappropriate polypharmacy among the elderly in the healthcare setting in Iran by exploring the viewpoints of physicians, patients, caregivers and pharmacists. Physicians can be an influential factor in tackling this challenge through proper diagnosis, prescription, patient education and follow-up. In Iran, physicians’ practice styles are affected by potentially adverse factors such as the novelty of geriatric medicine, lack of a referral system, patient unfamiliarity with the system and lack of a monitoring system for multiple prescriptions. Furthermore, clinics tend to be overcrowded and visit fees can be low; in this setting, lack of physician assistants leads to limited time allocation to each patient and physician dissatisfaction with their income.

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Karnick, Paula M. "Humanbecoming Theory in Practice." Nursing Science Quarterly 25, no. 2 (March 25, 2012): 147–48. http://dx.doi.org/10.1177/0894318412437957.

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The age-old battle of what to include in nursing education continues. Now this battle extends itself into nurse practitioner education with a slightly different twist. Abandoning nursing theory-guided education for the medical model leaves nurse practitioner education flat. In this author’s academic experience, nursing theory was included in the curriculum. The exemplar presented is testament to the distinction and significance of including nursing theory-guided education. The unique difference between nurse practitioners and physicians is the use of theory in practice.

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Hotte, Sebastien J., Antonio Finelli, Shawn Malone, Bobby Shayegan, Alan I. So, Christina M. Canil, Huong Hew, Laura Park-Wyllie, Fred Saad, and Kim N. Chi. "Real world patterns of treatment sequencing in Canada for metastatic castrate-resistant prostate cancer." Journal of Clinical Oncology 36, no. 6_suppl (February 20, 2018): 320. http://dx.doi.org/10.1200/jco.2018.36.6_suppl.320.

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320 Background: The Canadian GU Research Consortium (GURC) was recently established to bring advanced prostate cancer centres together to collaborate on research, education, and adoption of best practices. As an initial step to inform the work of the GURC, an electronic questionnaire was designed to assess management of advanced prostate cancer care in Canada and how prostate cancer treatments are sequenced in a real-world setting. Methods: A 59-item online questionnaire was developed by a multidisciplinary scientific committee to measure physician practices, patterns of care, treatment sequencing, and management of mCRPC. After pre-testing, the online questionnaire was sent to 93 urologists, uro-oncologists, medical oncologists, radiation oncologists, and general practitioner oncologists who are actively involved in the treatment of prostate cancer. Results: A total of 49 (53%) respondents completed the questionnaire between April 17, 2017 to May 17, 2017. Based on physician reports, the most frequently used treatment for first-line mCRPC was AR-targeted therapy (94%, n = 46 physicians) such as abiraterone acetate plus prednisone and enzalutamide. Among those 46 physicians, AR-targeted therapy was usually followed by docetaxel second-line therapy (57%, 31 physicians). The most common line 1 to line 3 treatment sequence for mCRPC was: AR-targeted therapy--Docetaxel--AR-targeted therapy (35%, 17 physicians), followed by AR-targeted therapy--Docetaxel--Radium 223 (14%, n = 7), Provincial differences were observed in the line 1 to line 3 treatment sequences, which aligned to variation in provincial policies for access to the treatments. In patients previously treated with docetaxel in the hormone sensitive setting, the most frequently used treatment for first-line mCRPC was AR-targeted therapy (76%, 37 physicians). Conclusions: AR targeted therapy followed by docetaxel is the predominant pattern of practice for management of mCRPC, with variability beyond these lines of therapy. Prospective ongoing work through the GURC in research, education and best practices will aim to understand these practice patterns.

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J., Tobih, Oyewole A., Tobih D., Olajide A., and Esan T. "The Practice of Patient Education by Attending Physicians in Southwest Nigeria." African Journal of Biology and Medical Research 6, no. 1 (January 3, 2023): 9–23. http://dx.doi.org/10.52589/ajbmr-kalbt5ij.

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Background: The value of patient education involves an improved understanding of their medical conditions, diagnosis, disease, or disability. However, the challenge of educating patients is multi-faceted, considering the complexity of many diseases, limited health literacy and a limited number of available doctors to tend to the long awaiting patient queue. Objective: This study aimed to assess the practice of patients’ education of their illnesses by the treating physician in different practice settings, specialties, contact, duration of admission, the eventuality of death and post-mortem. Method: The study was a cross-sectional descriptive design conducted among 449 medical doctors. A self-administered semi-structured pretested questionnaire was administered to all cadres of physicians in four health centres selected randomly in the southwest, Nigeria. The data collected were analysed using SPSS version 25 and results were presented in descriptive statistics and inferential statistics with the level of significance set at p = < 0.05. Result: The majority (57.0%) of the respondents were within the age range of 25-40. The highest respondent cadres were registrars and medical officers 224 (49.9%). Of the total participants, 140 reported seeing over 40 patients per week. It was observed that 95.9% did explain to the patients the impressions of their symptoms at first contact. However, the percentage of respondents reduced markedly when giving the next appointment, 58.8%. Also, 86.6% always explain the need for hospital admission, 76.4% explained options of surgery while only 28.3% discussed mistakes/complications from the procedures. Conclusion: There were a lot of gaps in the patient’s understanding of their illnesses as imparted by the attending physicians. The gap increases after the first contact both in knowledge and understanding on the part of the patient which may be one of the major factors responsible for poor compliance and cooperation on the part of the patient which ultimately hinders the optimum delivery of effective and efficient health care. This in effect affects the overall health status of the community and society.

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Park, Hye Soon, Shin Hwi Lee, Jae Yong Shim, Jeong Jin Cho, Ho Cheol Shin, and Jung Yul Park. "The physicians' recognition and attitude about patient education in practice." Journal of Korean Medical Science 11, no. 5 (1996): 422. http://dx.doi.org/10.3346/jkms.1996.11.5.422.

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Cantor, J. C. "Preparedness for practice. Young physicians' views of their professional education." JAMA: The Journal of the American Medical Association 270, no. 9 (September 1, 1993): 1035–40. http://dx.doi.org/10.1001/jama.270.9.1035.

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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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Levy, Andrew E., Neel T. Shah, Christopher Moriates, and Vineet M. Arora. "Fostering Value in Clinical Practice Among Future Physicians." Academic Medicine 89, no. 11 (November 2014): 1440. http://dx.doi.org/10.1097/acm.0000000000000496.

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Hansel, N. K., S. A. Nixon, G. T. Oser, and G. O. Zenner. "Choice of practice location by Texas family physicians." Academic Medicine 63, no. 3 (March 1988): 191–3. http://dx.doi.org/10.1097/00001888-198803000-00007.

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Wenghofer, Elizabeth, Peter Boal, Nathanial Floyd, Joan Lee, Robert Woodard, and William Norcross. "Improving Charting Skills of Physicians in Monitored Practice." Journal of Continuing Education in the Health Professions 38, no. 4 (2018): 244–49. http://dx.doi.org/10.1097/ceh.0000000000000221.

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Lurie, N. "Preparing physicians for practice in managed care environments." Academic Medicine 71, no. 10 (October 1996): 1044–9. http://dx.doi.org/10.1097/00001888-199610000-00009.

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Weissman, S. "Who should prepare physicians for managed care practice?" Academic Medicine 73, no. 2 (February 1998): 115–6. http://dx.doi.org/10.1097/00001888-199802000-00001.

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Grace, Elizabeth S., Elizabeth J. Korinek, Lindsay B. Weitzel, and Dennis K. Wentz. "Physicians reentering clinical practice: Characteristics and clinical abilities*." Journal of Continuing Education in the Health Professions 30, no. 3 (2010): 180–86. http://dx.doi.org/10.1002/chp.20079.

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Grace, Elizabeth S., Elizabeth J. Korinek, Lindsay B. Weitzel, and Dennis K. Wentz. "Physicians Reentering Clinical Practice: Characteristics and Clinical Abilities." Journal of Continuing Education in the Health Professions 31, no. 1 (2011): 49–55. http://dx.doi.org/10.1002/chp.20106.

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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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Abdel-Razig, Sawsan, Halah Ibrahim, Hatem Alameri, Hossam Hamdy, Khaled Abu Haleeqa, Khalil I. Qayed, Laila O. Obaid, et al. "Creating a Framework for Medical Professionalism: An Initial Consensus Statement From an Arab Nation." Journal of Graduate Medical Education 8, no. 2 (May 1, 2016): 165–72. http://dx.doi.org/10.4300/jgme-d-15-00310.1.

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ABSTRACT Medical professionalism has received increased worldwide attention, yet there is limited information on the applicability and utility of established Western professionalism frameworks in non-Western nations.Background We developed a locally derived consensus definition of medical professionalism for the United Arab Emirates (UAE), which reflects the cultural and social constructs of the UAE and the Middle East.Objective We used a purposive sample of 14 physicians working in the UAE as clinical and education leaders. This expert panel used qualitative methods, including the world café, nominal group technique, the Delphi method, and an interpretive thematic analysis to develop the consensus statement.Methods The expert panel defined 9 attributes of medical professionalism. There was considerable overlap with accepted Western definitions, along with important differences in 3 aspects: (1) the primacy of social justice and societal rights; (2) the role of the physician's personal faith and spirituality in guiding professional practices; and (3) societal expectations for professional attributes of physicians that extend beyond the practice of medicine.Results Professionalism is a social construct influenced by cultural and religious contexts. It is imperative that definitions of professionalism used in the education of physicians in training and in the assessment of practicing physicians be formulated locally and encompass specific competencies relevant to the local, social, and cultural context for medical practice. Our goal was to develop a secular consensus statement that encompasses culture and values relevant to professionalism for the UAE and the Arab region.Conclusions

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Barry, Jonathan. "Educating physicians in seventeenth-century England." Science in Context 32, no. 2 (June 2019): 137–54. http://dx.doi.org/10.1017/s0269889719000188.

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ArgumentThe tension between theoretical and practical knowledge was particularly problematic for trainee physicians. Unlike civic apprenticeships in surgery and pharmacy, in early modern England there was no standard procedure for obtaining education in the practical aspects of the physician’s role, a very uncertain process of certification, and little regulation to ensure a suitable reward for their educational investment. For all the emphasis on academic learning and international travel, the majority of provincial physicians returned to practice in their home area, because establishing a practice owed more to networks of kinship, patronage and credit than to formal qualifications. Only when (and where) practitioners had to rely solely on their professional qualification to establish their status as young practitioners that the community could trust would proposals to reform medical education, such as those put forward to address a crisis of medicine in Restoration London, which are examined here, be converted into national regulation of medical education in the early nineteenth century, although these proposals prefigured many informal developments in medical training in the eighteenth century.

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Hseiki, Rasha A., Mona H. Osman, Rana T. El-Jarrah, Ghassan N. Hamadeh, and Najla A. Lakkis. "Knowledge, attitude and practice of Lebanese primary care physicians in nutrition counseling: a self-reported survey." Primary Health Care Research & Development 18, no. 06 (June 13, 2017): 629–34. http://dx.doi.org/10.1017/s1463423617000330.

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AimThis study aims to assess the knowledge, attitude and practice of primary care physicians (PCPs) in Lebanon regarding nutrition counseling and to investigate possible related barriers.BackgroundNutrition counseling is an important aspect of patient care, especially with the increase in nutrition-related disorders.MethodsThis is a descriptive study among a convenience sample of PCPs in Lebanon at two annual conferences in 2014 using an anonymous questionnaire.FindingsResponse rate was 54.6%. Overall, physicians considered that they have good to very good nutritional knowledge. Although they rated their formal nutritional education poorly, they had a positive attitude towards nutritional counseling and reported practicing general nutritional counseling with their patients. Barriers to nutritional counseling were: time, perceived poor patient adherence to diet, gap in physician’s nutritional knowledge and lack of insurance coverage for dietitian fees. Changes should be made to medical education curricula to include nutrition courses related to prevalent health problems.

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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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Barlam, Tamar F., Jake R. Morgan, Lee M. Wetzler, Cindy L. Christiansen, and Mari-Lynn Drainoni. "Antibiotics for Respiratory Tract Infections: A Comparison of Prescribing in an Outpatient Setting." Infection Control & Hospital Epidemiology 36, no. 2 (December 29, 2014): 153–59. http://dx.doi.org/10.1017/ice.2014.21.

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ObjectiveTo examine inappropriate antibiotic prescribing for acute respiratory tract infections (RTIs) in ambulatory care to help target antimicrobial stewardship interventions.Design and SettingRetrospective analysis of RTI visits within general internal medicine (GIM) and family medicine (FM) ambulatory practices at an inner-city academic medical center from 2008 to 2010.MethodsPatient, physician, and practice characteristics were analyzed using multivariable logistic regression to determine factors predictive of inappropriate prescribing; physicians in the highest and lowest antibiotic-prescribing quartiles were compared using χ2 analysis.ResultsVisits with FM providers, female gender, and self-reported race/ethnicity as white or Hispanic were significantly associated with inappropriate antibiotic prescribing. Physicians in the lowest quartile prescribed antibiotics for 5%–28% (mean, 21%) of RTI visits; physicians in the highest quartile prescribed antibiotics for 54%–85% (mean, 65%) of RTI visits. High prescribers had fewer African-American patients and more patients who were younger and privately insured. High prescribers had more patients with chronic lung disease. A GIM practice pod with a low prescriber was 3.0 times more likely to have a second low prescriber than other practice pods, whereas pods with a high prescriber were 1.3 times more likely to have a second high prescriber.ConclusionsMedical specialty was the only physician factor predictive of inappropriate prescribing when patient gender, race, and comorbidities were taken into account. Possible disparities in care need further study. Stewardship education in medical school, enlisting low prescribers as physician leaders, and targeting interventions to the highest prescribers might be more effective approaches to antimicrobial stewardship.Infect Control Hosp Epidemiol 2014;00(0): 1–7

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Wendling, Andrea L., Andrew Short, Fredrick Hetzel, Julie P. Phillips, and William Short. "Trends in Subspecialization: A Comparative Analysis of Rural and Urban Clinical Education." Family Medicine 52, no. 5 (May 5, 2020): 332–38. http://dx.doi.org/10.22454/fammed.2020.182557.

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Background and Objectives: Medical students who train in rural communities are often exposed to physicians practicing a broad scope of care, regardless of discipline. We examined how rural education is associated with practice specialization rates for students who match in primary care or general core specialties. Methods: We linked practice and specialty data (2016 AMA Masterfile dataset), demographics (American Medical College Application Service data), and internal college data for 1974-2011 Michigan State University College of Human Medicine graduates who received clinical education on either the Upper Peninsula (rural) or Grand Rapids (urban) campuses. Current practice was verified using internet searches. We compared specialty and practice data by rural or urban campus, controlling for multiple variables. Results: More rurally-trained graduates entered primary care (PC) residencies (128/208, 61.5%) than urban-trained graduates (457/891, 51.3%; P<.01), with rurally-trained graduates being twice as likely to enter family medicine (FM) residencies. Most FM residents remained PC physicians (205/219, 93.6%). Internal medicine residents were least likely to remain in primary care (91/189, 48.1%). Of the general core disciplines, general surgeons were least likely to remain in general surgical practice (45/134, 33.6%). Within each PC or general core discipline, the proportion of graduates who specialized did not differ by type of campus. Conclusions: Rurally-trained graduates are more likely to practice primary care, chiefly due to increased likelihood of choosing a FM residency. Graduates entering PC or general core residencies subspecialize at similar rates regardless of rural or urban education. FM residency match rate may be the best predictor of long-lasting impact on the primary care workforce.

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Mintz, Laura Janine, and James K. Stoller. "A Systematic Review of Physician Leadership and Emotional Intelligence." Journal of Graduate Medical Education 6, no. 1 (March 1, 2014): 21–31. http://dx.doi.org/10.4300/jgme-d-13-00012.1.

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Abstract Objective This review evaluates the current understanding of emotional intelligence (EI) and physician leadership, exploring key themes and areas for future research. Literature Search We searched the literature using PubMed, Google Scholar, and Business Source Complete for articles published between 1990 and 2012. Search terms included physician and leadership, emotional intelligence, organizational behavior, and organizational development. All abstracts were reviewed. Full articles were evaluated if they addressed the connection between EI and physician leadership. Articles were included if they focused on physicians or physicians-in-training and discussed interventions or recommendations. Appraisal and Synthesis We assessed articles for conceptual rigor, study design, and measurement quality. A thematic analysis categorized the main themes and findings of the articles. Results The search produced 3713 abstracts, of which 437 full articles were read and 144 were included in this review. Three themes were identified: (1) EI is broadly endorsed as a leadership development strategy across providers and settings; (2) models of EI and leadership development practices vary widely; and (3) EI is considered relevant throughout medical education and practice. Limitations of the literature were that most reports were expert opinion or observational and studies used several different tools for measuring EI. Conclusions EI is widely endorsed as a component of curricula for developing physician leaders. Research comparing practice models and measurement tools will critically advance understanding about how to develop and nurture EI to enhance leadership skills in physicians throughout their careers.

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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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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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Martinez, Serge A. "Currents in Contemporary Ethics: Reforming Medical Ethics Education." Journal of Law, Medicine & Ethics 30, no. 3 (2002): 452–54. http://dx.doi.org/10.1111/j.1748-720x.2002.tb00415.x.

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Biomedical advances of the past 20 years have stimulated a renewed interest in medical ethics. Transplantation of multiple human organs, implantation of artificial devices, advances in genetics, and stem cell research are a few of the medical procedures and discoveries that have awakened in both professionals and the public an awareness that medical discoveries often raise important ethical and societal issues. Today, members of the medical profession face issues that did not seem so pressing to their predecessors, and physician conduct in response to many of these issues involves decision-making based on ethical principles. Issues of informed consent, gifts from pharmaceutical companies, and patient rights to privacy were not of great concern to most physicians a generation ago. However, these and other topics that involve a physician's ethical conduct have become increasingly pertinent to the practice of medicine.A renewed emphasis on ethics has been voiced by leaders in the field of medicine.

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Barry, Jonathan. "Educating physicians in seventeenth-century England - ADDENDUM." Science in Context 32, no. 3 (August 27, 2019): 353. http://dx.doi.org/10.1017/s026988971900022x.

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ArgumentThe tension between theoretical and practical knowledge was particularly problematic for trainee physicians. Unlike civic apprenticeships in surgery and pharmacy, in early modern England there was no standard procedure for obtaining education in the practical aspects of the physician’s role, a very uncertain process of certification, and little regulation to ensure a suitable reward for their educational investment. For all the emphasis on academic learning and international travel, the majority of provincial physicians returned to practice in their home area, because establishing a practice owed more to networks of kinship, patronage and credit than to formal qualifications. Only when (and where) practitioners had to rely solely on their professional qualification to establish their status as young practitioners that the community could trust would proposals to reform medical education, such as those put forward to address a crisis of medicine in Restoration London, which are examined here, be converted into national regulation of medical education in the early nineteenth century, although these proposals prefigured many informal developments in medical training in the eighteenth century.

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Brown-Johnson, Cati, Rachel Schwartz, Amrapali Maitra, Marie C. Haverfield, Aaron Tierney, Jonathan G. Shaw, Dani L. Zionts, et al. "What is clinician presence? A qualitative interview study comparing physician and non-physician insights about practices of human connection." BMJ Open 9, no. 11 (November 2019): e030831. http://dx.doi.org/10.1136/bmjopen-2019-030831.

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ObjectiveWe sought to investigate the concept and practices of ‘clinician presence’, exploring how physicians and professionals create connection, engage in interpersonal interaction, and build trust with individuals across different circumstances and contexts.DesignIn 2017–2018, we conducted qualitative semistructured interviews with 10 physicians and 30 non-medical professionals from the fields of protective services, business, management, education, art/design/entertainment, social services, and legal/personal services.SettingPhysicians were recruited from primary care clinics in an academic medical centre, a Veterans Affairs clinic, and a federally qualified health centre.ParticipantsParticipants were 55% men and 45% women; 40% were non-white.ResultsQualitative analyses yielded a definition of presence as a purposeful practice of awareness, focus, and attention with the intent to understand and connect with individuals/patients. For both medical and non-medical professionals, creating presence requires managing and considering time and environmental factors; for physicians in particular, this includes managing and integrating technology. Listening was described as central to creating the state of being present. Within a clinic, presence might manifest as a physician listening without interrupting, focusing intentionally on the patient, taking brief re-centering breaks throughout a clinic day, and informing patients when attention must be redirected to administrative or technological demands.ConclusionsClinician presence involves learning to step back, pause, and be prepared to receive a patient’s story. Building on strategies from physicians and non-medical professionals, clinician presence is best enacted through purposeful intention to connect, conscious navigation of time, and proactive management of technology and the environment to focus attention on the patient. Everyday practice or ritual supporting these strategies could support physician self-care as well as physician-patient connection.

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Koehler, Tracy J., Jaclyn Goodfellow, Alan T. Davis, John E. vanSchagen, and Lori Schuh. "Physician Retention in the Same State as Residency Training: Data From 1 Michigan GME Institution." Journal of Graduate Medical Education 8, no. 4 (October 1, 2016): 518–22. http://dx.doi.org/10.4300/jgme-d-15-00431.1.

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ABSTRACT Background In a time of threats to the funding for graduate medical education (GME) and projected physician shortages, drawing attention to the value of physician training programs may be useful. One approach is to study the number and percentage of physicians who enter practice in the state in which they trained. Objective We sought to examine the percentage of graduates from a single Michigan-based GME institution over a 15-year period, who practiced medicine in Michigan during their career. Methods We performed a retrospective review of historical data for all graduates currently in practice, derived from 18 GME training programs from 2000 through 2014. Practice location data were collected and confirmed using multiple sources for accuracy. Results Data were available for 1168 graduates. The average age at the time of graduation was 32.6 ± 4.4 years (mean and standard deviation [SD]), and 60.2% were men (703 of 1168). There were 546 graduates (46.7%) who practiced in Michigan after graduation. Almost 80% of the graduates (279 of 358) who completed medical school and GME in Michigan also practiced in Michigan. Of those, 87.8% (245 of 279) also completed a bachelor's degree in Michigan. Conclusions The findings show that graduates from our GME programs were highly likely to practice in Michigan if they completed their pre-GME education in Michigan.

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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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Suryanto, S. "(P2-28) Collaboration Between Nurses and Physicians in the Emergency Department: An Indonesian Study." Prehospital and Disaster Medicine 26, S1 (May 2011): s144—s149. http://dx.doi.org/10.1017/s1049023x11004729.

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BackgroundPositive collaboration between nurses and physicians is essential in all areas of care especially in emergency practice. This is because it has a significant relationship with the quality, safety, accountability, and responsibility of care. Three areas are positively related to collaborative interaction between nurses and physicians: provider outcomes, patient outcomes, and organizational outcomes.AimTo examine nurses' and physicians' attitudes towards nurse-physician collaboration in the Emergency Department of Dr Saiful Anwar General Hospital, Malang, Indonesia.MethodsThe study was a comparative descriptive quantitative study using a modified Jefferson Scale of Attitude towards Physician-Nurse Collaboration. Data were collected from 47 nurses and 24 physicians who participated in the study. Descriptive statistics, parametric and non-parametric inferential statistics were used to determine group scores and to examine differences between groups, as well as to determine the relationship between demographic characteristics and participants attitudes.ResultsEmergency nurses had significantly more positive attitudes toward collaboration than emergency physicians (p < 0.001). Emergency nurses had significantly higher scores in three of four underlying factors of the instrument: “physician dominance”, “nurse autonomy”, and “caring as opposed to curing”. The effects of gender, age, education, and experience in other hospitals on nurses' and physicians' attitude towards collaboration were not statistically significant. However, experience in the Emergency Department of Dr Saiful Anwar General Hospital was significantly related to participants' attitudes towards collaboration (p = 0.023).ConclusionsThe findings of this study indicate that both organizational and individual strategies should be developed to enhance the nurse-physician collaborative relationship. Inter-professional education may enhance health care professionals' attitudes towards collaboration. A larger and more representative sample is needed for future research, especially examining relationships such as between collaboration of these health professionals and patient outcomes and work place satisfaction.

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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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Beagan, Brenda, Erin Fredericks, and Mary Bryson. "Family physician perceptions of working with LGBTQ patients: physician training needs." Canadian Medical Education Journal 6, no. 1 (April 20, 2015): e14-e22. http://dx.doi.org/10.36834/cmej.36647.

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Background: Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Understanding physician perceptions of this area of practice may aid in developing improved education.Method: In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software.Results: Three major themes emerged: 1) Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2) Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3) Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Conclusions: Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

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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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Journal articles on the topic 'Physicians (General practice) Education'

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