Journal articles on the topic 'Physicians (General practice) Training of Australia'
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Isaac, Sami, Andrew McLachlan, and Betty Chaar. "Australian pharmacists’ perspectives on physician-assisted suicide (PAS): thematic analysis of semistructured interviews." BMJ Open 9, no. 10 (October 2019): e028868. http://dx.doi.org/10.1136/bmjopen-2018-028868.
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ObjectivesThis study aimed to investigate Australian pharmacists’ views about their role in physician-assisted suicide (PAS), their ethical and legal concerns and overall thoughts about PAS in pharmacy.DesignSemistructured interviews of pharmacists incorporating a previously validated vignette and thematic analysis.SettingAustralia (face to face or phone call).Participants40 Australian Health Practitioner Regulation Agency registered pharmacists, majority women (65%) with varied experiences in community, hospital, industry, academia, government and other fields.ResultsEmergent themes from the interviews were:legal and logistical framework,ethical framework,training and guidanceandhealthcare budget. More than half the participants supported the role of pharmacists in the supply of medicines for PAS, while less than half were either against or unsure of the legislation of PAS in Australia. Shared concerns included transparency of prescribing practices and identification of authorised physicians involved in PAS, which were consistent with existing literature. Religious faith, emotion and professional autonomy were key indicators for the implementation of conscientious objection to the supply of medicines in PAS. Re-evaluation of current guidelines, pharmacist training and government reimbursement was also of significance from participants’ perspectives.ConclusionThis study revealed current concerns of practising pharmacists in Australia, including previously undocumented perspectives on the pharmacoeconomic impact of and barriers relating to PAS. The need for training of all healthcare professionals involved, the provision of clear guidelines, including regulation around storage, administration and disposal of medicines dispensed for PAS and the updating of current therapeutic guidelines around end-of-life care were all issues delineated by this study. These findings highlighted the need for current and future policies to account for all stakeholders involved in PAS, not solely prescribers.
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Kurti, Linda, Susan Rudland, Rebecca Wilkinson, Dawn DeWitt, and Catherine Zhang. "Physician's assistants: a workforce solution for Australia?" Australian Journal of Primary Health 17, no. 1 (2011): 23. http://dx.doi.org/10.1071/py10055.
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Significant medical workforce shortages, particularly in rural and remote locations, have prompted a range of responses in Australia at both state and Commonwealth levels. One such response was a pilot project to test the suitability of the Physician Assistant (PA) role in the Australian context. Five US-trained and accredited PAs were employed by Queensland Health and deployed in urban, rural and remote settings across Queensland. A concurrent mixed-method evaluation was conducted by Urbis, an independent research firm. The evaluation found that the PAs provided quality, safe clinical care under the supervision of local medical officers. The majority of nurses and doctors who worked with the PAs believed that the PAs made a positive contribution to the health care team by increasing capacity to meet patient needs; reducing on-call requirements for doctors; liaising with other clinical team members; streamlining procedures for efficient patient throughput; and providing continuity during periods of doctor changeover. The Pilot demonstrated that a delegated PA role can provide safe, quality health care by augmenting an established healthcare team. The PA role has the potential to benefit the community by increasing the capacity of the health care system, and to improve recruitment and retention by providing an additional professional pathway. The small size of the Pilot limits the ability to generalise regarding the future efficacy of the PA role in Australia. Further research is required to test training and deployment of PAs in a wider range of Australian clinical settings, including general practice and rural health clinics.
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Lahham, Aroub, Angela T. Burge, Christine F. McDonald, and Anne E. Holland. "How do healthcare professionals perceive physical activity prescription for community-dwelling people with COPD in Australia? A qualitative study." BMJ Open 10, no. 8 (August 2020): e035524. http://dx.doi.org/10.1136/bmjopen-2019-035524.
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ObjectivesClinical practice guidelines recommend that people with chronic obstructive pulmonary disease (COPD) should be encouraged to increase their physical activity levels. However, it is not clear how these guidelines are applied in clinical practice. This study aimed to understand the perspectives of respiratory healthcare professionals on the provision of physical activity advice to people with COPD. These perspectives may shed light on the translation of physical activity recommendations into clinical practice.DesignA qualitative study using thematic analysis.SettingHealthcare professionals who provided care for people with COPD at two major tertiary referral hospitals in Victoria, Australia.Participants30 respiratory healthcare professionals including 12 physicians, 10 physical therapists, 4 nurses and 4 exercise physiologists.InterventionsSemistructured voice-recorded interviews were conducted, transcribed verbatim and analysed by two independent researchers using an inductive thematic analysis approach.ResultsHealthcare professionals acknowledged the importance of physical activity for people with COPD. They were conscious of low physical activity levels among such patients; however, few specifically addressed this in consultations. Physicians described limitations including time constraints, treatment prioritisation and perceived lack of expertise; they often preferred that physical therapists provide more comprehensive assessment and advice regarding physical activity. Healthcare professionals perceived that there were few evidence-based strategies to enhance physical activity. Physical activity was poorly differentiated from the prescription of structured exercise training. Although healthcare professionals were aware of physical activity guidelines, few were able to recall specific recommendations for people with COPD.ConclusionPractical strategies to enhance physical activity prescription may be required to encourage physical activity promotion in COPD care.
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Veness, Benjamin G., Holly Tibble, Brin FS Grenyer, Jennifer M. Morris, Matthew J. Spittal, Louise Nash, David M. Studdert, and Marie M. Bismark. "Complaint risk among mental health practitioners compared with physical health practitioners: a retrospective cohort study of complaints to health regulators in Australia." BMJ Open 9, no. 12 (December 2019): e030525. http://dx.doi.org/10.1136/bmjopen-2019-030525.
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ObjectivesTo understand complaint risk among mental health practitioners compared with physical health practitioners.DesignRetrospective cohort study, using incidence rate ratios (IRRs) to analyse complaint risk and a multivariate regression model to identify predictors of complaints.SettingNational study using complaints data from health regulators in Australia.ParticipantsAll psychiatrists and psychologists (‘mental health practitioners’) and all physicians, optometrists, physiotherapists, osteopaths and chiropractors (‘physical health practitioners’) registered to practice in Australia between 2011 and 2016.Outcome measuresIncidence rates, source and nature of complaints to regulators.ResultsIn total, 7903 complaints were lodged with regulators over the 6-year period. Most complaints were lodged by patients and their families. Mental health practitioners had a complaint rate that was more than twice that of physical health practitioners (complaints per 1000 practice years: psychiatrists 119.1 vs physicians 48.0, p<0.001; psychologists 21.9 vs other allied health 7.5, p<0.001). Their risk of complaints was especially high in relation to reports, records, confidentiality, interpersonal behaviour, sexual boundary breaches and the mental health of the practitioner. Among mental health practitioners, male practitioners (psychiatrists IRR: 1.61, 95% CI 1.39 to 1.85; psychologists IRR: 1.85, 95% CI 1.65 to 2.07) and older practitioners (≥65 years compared with 36–45 years: psychiatrists IRR 2.37, 95% CI 1.95 to 2.89; psychologists IRR 1.78, 95% CI 1.47 to 2.14) were at increased risk of complaints.ConclusionsMental health practitioners were more likely to be the subject of complaints than physical health practitioners. Areas of increased risk are related to professional ethics, communication skills and the health of mental health practitioners themselves. Further research could usefully explore whether addressing these risk factors through training, professional development and practitioner health initiatives may reduce the risk of complaints about mental health practitioners.
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O'Sullivan, Belinda, Danielle Couch, and Ishani Naik. "Using Mobile Phone Apps to Deliver Rural General Practitioner Services: Critical Review Using the Walkthrough Method." JMIR Formative Research 6, no. 1 (January 25, 2022): e30387. http://dx.doi.org/10.2196/30387.
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Background The widespread use of mobile phones represents new frontiers for improving access to health care. This includes using mobile apps to deliver general practitioner (GP) services in rural areas. However, the wider adoption of apps for increasing access to rural GP services relies on understanding how they might intersect with the rural health system context. Objective This research aims to critically review mobile apps for delivering GP services in a rural health service context using the walkthrough method. Methods The sample comprised 3 GP service apps under the top 100 list in the medical category in the Apple App Store (also available via the Google Play Store) in Australia as of June 2020. The walkthrough method was applied to extract data and critique the explicit factors, such as the app interface elements, and implicit factors, such as the embedded cultural features related to use for people in rural settings. Data analysis was undertaken between 3 researchers over 6 months applying the walkthrough method and using critical reflection. Results There were 3 main themes: improving rural access, addressing rural health care needs, and providing quality of care. App-based GP services may improve rural GP service availability. However, this may be at a relatively superficial level that does not encompass the scope and intensity of the services needed in rural areas (including relevant chronic and emergency care) at a cost that rural patients can afford. The apps showed signs of limited tailoring to the cultural dimensions of rural health care as a barrier to rural use. Patients generally self-selected to use GP service apps with limited support, potentially leading to inappropriate uptake especially by disadvantaged groups with lower health literacy. Although the apps claimed to avail most GP services (70%-80% in some cases), it emerged after enrollment that emergency, complex, and serious conditions might be excluded, potentially imposing more complex caseloads on in-person rural GPs. Apps provided limited information about continuity and coordination of care and sharing information with rural GPs, potentially leading to fragmented and low-quality care. There was commonly no assurance of rural skills and experience of physicians staffing apps despite the wider scope of skills needed to be effective in rural general practice. Conclusions GP apps may increase the availability of GP services, but they may require clearer exclusions, appropriate use through decision-making tools, more rural-tailored interfaces, and capacity to align appointment times and costs with patients with complex needs to engage and be useful in a rural context. It is also important to consider how these app-based services could share information with local health care staff for safety and continuity of rural primary care. Finally, information about the physicians’ rural training and experience is critical for quality.
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Sawyer, Susan M., Bridget Farrant, Anganette Hall, Andrew Kennedy, Donald Payne, Kate Steinbeck, and Veronica Vogel. "Adolescent and young adult medicine in Australia and New Zealand: towards specialist accreditation." International Journal of Adolescent Medicine and Health 28, no. 3 (August 1, 2016): 253–61. http://dx.doi.org/10.1515/ijamh-2016-5006.
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Abstract In Australia and New Zealand, a critical mass of academic and clinical leadership in Adolescent Medicine has helped advance models of clinical services, drive investments in teaching and training, and strengthen research capacity over the past 30 years. There is growing recognition of the importance of influencing the training of adult physicians as well as paediatricians. The Royal Australasian College of Physicians (RACP) is responsible for overseeing all aspects of specialist physician training across the two countries. Following advocacy from adolescent physicians, the RACP is advancing a three-tier strategy to build greater specialist capacity and sustain leadership in adolescent and young adult medicine (AYAM). The first tier of the strategy supports universal training in adolescent and young adult health and medicine for all basic trainees in paediatric and adult medicine through an online training resource. The second and third tiers support advanced training in AYAM for specialist practice, based on an advanced training curriculum that has been approved by the RACP. The second tier is dual training; advanced trainees can undertake 2 years training in AYAM and 2 years training in another area of specialist practice. The third tier consists of 3 years of advanced training in AYAM. The RACP is currently seeking formal recognition from the Australian Government to have AYAM accredited, a process that will be subsequently undertaken in New Zealand. The RACP is expectant that the accreditation of specialist AYAM physicians will promote sustained academic and clinical leadership in AYAM to the benefit of future generations of young Australasians.
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Israilova, Darygul Kubanychbekovna, Guldeste Askarbekovna Askarbekova, Abdilatip Abdyrakhmanovich Shamshiev, and Yrysbek Abdyzhaparovich Aldashukurov. "TRAINING OF SPECIALISTS FOR GENERAL (FAMILY) PRACTICE PHYSICIANS." Bulletin of Osh State University, no. 3 (2022): 38–43. http://dx.doi.org/10.52754/16947452_2022_3_38.
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Hickner, John M. "Training for rural practice in Australia 1990." Medical Journal of Australia 154, no. 2 (January 1991): 111–18. http://dx.doi.org/10.5694/j.1326-5377.1991.tb120996.x.
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Hays, R. B., D. A. Wallace, and T. K. Sen Gupta. "Training for rural family practice in australia." Teaching and Learning in Medicine 9, no. 2 (January 1997): 80–83. http://dx.doi.org/10.1080/10401339709539819.
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TRUMBLE, Steve. "Changes to training for General Practice in Australia." Asia Pacific Family Medicine 2, no. 3 (September 2003): 171–74. http://dx.doi.org/10.1046/j.1444-1683.2003.00085.x.
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Kimsma, Gerrit K., and B. J. van Duin. "Teaching Euthanasia: The Integration of the Practice of Euthanasia Into the Grief, Death, and Dying Curricula of Postgraduate Family Medicine Training." Cambridge Quarterly of Healthcare Ethics 5, no. 1 (1996): 107–12. http://dx.doi.org/10.1017/s0963180100006770.
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The open practice of euthanasia in The Netherlands stood alone in the world until the government of the Northern Territories in Australia accepted the possibility of physician-assisted suicide. Even though the active ending of lives in The Netherlands is still a crime by law, the current practice allows it and acquits physicians if certain conditions have been met. Of the many facets of euthanasia, the teaching of this practice represents a further logical step. In this contribution, we intend to describe the comprehensive teaching program of euthanasia of the Free University of Amsterdam's Postgraduate Family Medicine Program. Here students receive university-based training for 1 day a week in a cohort of 12 and on the job training for 4 days with individual family physicians for 2 consecutive years. We especially intend to portray the integration of euthanasia into the wider teaching of the process of counseling and aid of the dying.
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Davies, Peter G. "Problems with training for general practice in South Australia." Medical Journal of Australia 155, no. 7 (October 1991): 457–62. http://dx.doi.org/10.5694/j.1326-5377.1991.tb93842.x.
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Idel, Irena, Suet-Wan Choy, Catherine Marnoch, and Lawrence P. McMahon. "A review of the structure and training pathways for obstetric medicine physicians in Australia and New Zealand." Obstetric Medicine 10, no. 4 (October 11, 2017): 161–64. http://dx.doi.org/10.1177/1753495x17733208.
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In recent decades, women with significant medical conditions have increasingly chosen to become pregnant. This has broadened and intensified the interface between obstetrics and internal medicine, a collaboration which has always needed cooperation but which increasingly demands open discussion and planning to ensure optimal outcomes for mother and fetus. The aims of this article are to describe the state of obstetric medicine practice in Australia and New Zealand, including its history and development, the training and education curriculum, organisation of its service delivery, and potential opportunities for research and collaboration.
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Sivakumar, Jonathan, and Gary Crosthwaite. "Role of private practice in general surgical training in Australia." ANZ Journal of Surgery 90, no. 11 (November 2020): 2164–65. http://dx.doi.org/10.1111/ans.16243.
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Warwick, Sophia, Laura Kantor, Erin Ahart, Katie Twist, Terrance Mabry, and Ky Stoltzfus. "Physician Advocacy: Identifying Motivations for Work Beyond Clinical Practice." Kansas Journal of Medicine 15, no. 3 (December 19, 2022): 433–36. http://dx.doi.org/10.17161/kjm.vol15.18255.
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Introduction. Advocacy is a perceived social and professional obligation of physicians, yet many feel their training and practice environment don’t support increased engagement in advocacy. The aim of this qualitative project was to delineate the role advocacy plays in physicians’ careers and the factors driving physician engagement in advocacy. Methods. We identified physicians engaged in health advocacy in Kansas through personal contacts and referrals through snowball sampling. They received an email invitation to participate in a short in-person or phone interview which was recorded using Apple Voice Memos and Google Dictation. Two team members independently identified themes from interview transcripts, while a third member served as a moderator if themes identified were dyssynchronous. Results. Of the 19 physicians invited to participate, 13 were interviewed. The most common reasons for engaging in advocacy included the desire to change policy, obligation to go beyond regular clinic duties, giving patients a voice, and avoiding burnout. Physicians reported passion for patients and past experiences with disparities as the most common inspiration. Most physicians did not have formal advocacy training in school or residency, but identify professional societies and peers as informal guides. Common support for advocacy were professional organizations, community partners, and employers. Time was the most common barrier to conducting advocacy work. Conclusions. Physicians have a broad number of reasons for the importance of doing advocacy work, but identify key professional barriers to further engagement. Providing accessible opportunities through professional organizations and community partnerships may increase advocacy participation.
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Pereira, M. Graça, Alfonso Alonso Fachado, and Thomas Edward Smith. "Practice of Biopsychosocial Medicine in Portugal: Perspectives of Professionals Involved." Spanish journal of psychology 12, no. 1 (May 2009): 217–25. http://dx.doi.org/10.1017/s1138741600001621.
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Although, recently, the biopsychosocial approach has been emphasized in the practice of family medicine, how psychologists and physicians interact in collaborative family health care practice is still emerging in Portugal. This article describes a qualitative study that focused on the understanding of psychologists and family physicians' perceptions of their role and the collaborative approach in health care.A questionnaire gathered information regarding collaboration, referral, training and the practice of biopsychosocial medicine. A content analysis on respondents' discourse was performed. Results show that both physicians and psychologists agree on the importance of the biopsychosocial model and interdisciplinary collaboration. However, they also mentioned several difficulties that have to do with the lack of psychologists working full time in health care centers, lack of communication and different expectancies regarding each other roles in health care delivery.Both physicians and psychologists acknowledge the lack of academic training and consider the need for multidisciplinary teams in their training and practice to improve collaboration and integrative care. Implications for future research and for the practice of biopsychosocial medicine are addressed.
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Feigin, Ralph D., Jan E. Drutz, E. O'Brian Smith, and Carol Ritter Collins. "Practice Variations by Population: Training Significance." Pediatrics 98, no. 2 (August 1, 1996): 186–90. http://dx.doi.org/10.1542/peds.98.2.186.
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Objective. This study sought to examine variations in the frequency of procedures performed and patterns of care of sick infants and older children by general pediatricians in different sized communities. The results of the study will be considered in developing relevant educational experiences for postgraduate trainees. Methodology. Questionnaires were sent to 1412 Texas pediatricians requesting frequency information for 29 procedures and whether they provided various levels of care to sick infants and older children. Responses were tabulated by the size of the community in which each pediatrician practiced. Results. Fifty-four percent of the questionnaires were returned. The proportion of pediatricians performing each procedure was significantly different for all but 8 of the 29 procedures between communities of less than 100 000 and more than 100 000 population. For all procedures with significant differences, the proportion of physicians performing the procedures was significantly greater for pediatricians practicing in communities of less than 100 000 population. No significant difference was found between the proportion of pediatricians providing newborn level II and III care; however, more than 65% of both groups provided level II care. Physicians in communities of less than 100 000 population were more likely to provide intermediate and intensive care beyond the newborn period. Conclusion. The general practice rotation in the community setting will not provide adequate training experiences for many of the procedures currently being performed by general pediatricians.
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Lian, Siqing, Qi Chen, Mi Yao, Chunhua Chi, and Michael D. Fetters. "Training Pathways to Working as a General Practitioner in China." Family Medicine 51, no. 3 (March 1, 2019): 262–70. http://dx.doi.org/10.22454/fammed.2019.329090.
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Background and Objectives: To achieve the goal of 300,000 general practitioners by 2020—an increase of 215,200 in a decade—China is utilizing multiple training pathways. To comprehensively illustrate general practitioner training strategies in China, this article introduces and describes these pathways. Methods: We used descriptive policy analysis. This involved taking an inventory of existing literature and source documents and developing a model to illustrate pathways for training general practice physicians. Results: The rural doctor pathway represents rural clinicians who had only basic training and practiced multiple years prior to training reforms. The 3+2 pathway to assistant general practitioners requires 3 years of junior college and 2 years of clinical training. The transfer pathway for current physicians requires 1-2 years of training. The 5+3 pathway comprises 5 years of bachelor of science degree training in clinical medicine and 3 years of standardized residency training. Despite the development of advanced degree programs, their use remains limited. Conclusions: These pathways illustrate significant heterogeneity in training of general practitioners. Training ranges from a 2-year technical degree to a doctorate with research. Emphasis on the 5+3 track shows promise for China’s goals of improved quality and new goal of 500,000 additional general practitioners by 2030.
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Raymond, Mark R., Janet Mee, Steven A. Haist, Aaron Young, Gerard F. Dillon, Peter J. Katsufrakis, Suzanne M. McEllhenney, and David Johnson. "Expectations for Physician Licensure: A National Survey of Practice." Journal of Medical Regulation 100, no. 1 (March 1, 2014): 15–23. http://dx.doi.org/10.30770/2572-1852-100.1.15.
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ABSTRACT To investigate the practice characteristics of newly licensed physicians for the purpose of identifying the knowledge and skills expected of those holding the general, unrestricted license to practice medicine, a questionnaire was mailed in May 2012 to 8,001 U.S. physicians who had been granted an unrestricted license to practice medicine between 2007 and 2011. The questionnaire requested information on stage of training, moonlighting, and practice setting; it also listed 58 clinical procedures and asked respondents to indicate whether they had ordered, performed, or interpreted the results of each procedure since obtaining their unrestricted license. A strategy was implemented to identify the relevance of each clinical activity for undifferentiated medical practice. The response rate was 37%. More than two-thirds of newly licensed physicians still practiced within a training environment; nearly one-half of those in training reported moonlighting, mostly in inpatient settings or emergency departments. Physicians who had completed training and entered independent practice spent most of their time in outpatient settings. Residents/fellows engaged in a broader range of clinical activities than physicians in independent practice. Several clinical procedures were identified that were specialty-specific and did not appear to be skills expected for general medical practice. The results may help residency programs and licensing authorities identify the knowledge and skills required of newly licensed physicians as they transition from supervised to unsupervised practice. The results are relevant to the topic of moonlighting by identifying the skills and procedures required of physicians who engage in this activity. While the study identified procedures that have limited utility for licensure decisions because they are not consistent with general medical practice, the inclusion of such procedures in residency may add value by promoting beneficial variation in training experiences.
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Kerem, Nogah C., and Daniel Hardoff. "Adolescent health care education and training: insights from Israel." International Journal of Adolescent Medicine and Health 28, no. 3 (August 1, 2016): 303–7. http://dx.doi.org/10.1515/ijamh-2016-5014.
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Abstract There is a growing need for health care professionals to extend their knowledge in adolescent health care. Formal training curricula in adolescent medicine have been established in the United States, Canada, and Australia, yet many other countries have developed shorter training programs to enable interested physicians to further pursue knowledge and practical experience in delivering improved quality health care for adolescents. The Israeli experience in building an infrastructure that allows students and physicians to learn about adolescent medicine and to train in the field is described. It includes a series of lectures and seminars for medical students during medical school and at the clinical rotations in pediatric wards; the development of hospital-based and community-based multidisciplinary adolescent health services where residents can practice adolescent health care; a 3-year diploma course in adolescent medicine for specialists in pediatrics and family medicine; mini courses in adolescent medicine for pediatricians and family practitioners working in community settings; and a simulated patient-based program regarding communication with adolescents, aimed for all professional levels – medical students, residents, and specialists. This infrastructure has been developed to create a leading group of physicians, who are able to operate adolescent clinics and to teach adolescent medicine. Recently, a formal fellowship program in adolescent medicine has been approved by the Scientific Council of the Israel Medical Association. The Israeli experience described here could be applied in countries, where formal training programs in adolescent health care are not yet established.
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Dine, C. Jessica, Lisa M. Bellini, Gretchen Diemer, Allison Ferris, Ashish Rana, Gina Simoncini, William Surkis, et al. "Assessing Correlations of Physicians' Practice Intensity and Certainty During Residency Training." Journal of Graduate Medical Education 7, no. 4 (December 1, 2015): 603–9. http://dx.doi.org/10.4300/jgme-d-15-00092.1.
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ABSTRACT Background Variation in physicians' practice patterns contributes to unnecessary health care spending, yet the influences of modifiable determinants on practice patterns are not known. Identifying these mutable factors could reduce unnecessary testing and decrease variation in clinical practice. Objective To assess the importance of the residency program relative to physician personality traits in explaining variations in practice intensity (PI), the likelihood of ordering tests and treatments, and in the certainty of their intention to order. Methods We surveyed 690 interns and residents from 7 internal medicine residency programs, ranging from small community-based programs to large university residency programs. The surveys consisted of clinical vignettes designed to gauge respondents' preferences for aggressive clinical care, and questions assessing respondents' personality traits. The primary outcome was the participant-level mean response to 23 vignettes as a measure of PI. The secondary outcome was a certainty score (CS) constructed as the proportion of vignettes for which a respondent selected “definitely” versus “probably.” Results A total of 325 interns and residents responded to the survey (47% response rate). Measures of personality traits, subjective norms, demographics, and residency program indicators collectively explained 27.3% of PI variation. Residency program identity was the largest contributor. No personality traits were significantly independently associated with higher PI. The same collection of factors explained 17.1% of CS variation. Here, personality traits were responsible for 63.6% of the explained variation. Conclusions Residency program affiliations explained more of the variation in PI than demographic characteristics, personality traits, or subjective norms.
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Twilling, Lisa L., Mark E. Sockell, and Lucia S. Sommers. "Collaborative practice in primary care: Integrated training for psychologists and physicians." Professional Psychology: Research and Practice 31, no. 6 (2000): 685–91. http://dx.doi.org/10.1037/0735-7028.31.6.685.
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Nawka, Marie Teresa, Jens Fiehler, Johanna Spallek, Jan-Hendrik Buhk, and Andreas Maximilian Frölich. "Current status of training environments in neuro-interventional practice: are animal models still contemporary?" Journal of NeuroInterventional Surgery 11, no. 3 (July 26, 2018): 283–89. http://dx.doi.org/10.1136/neurintsurg-2018-014036.
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PurposeSeveral different training environments for practicing neurointerventional procedures have been realized in silico, in vitro, and in vivo. We seek to replace animal-based training with suitable alternatives. In an effort to determine present training model distribution and preferences, we interviewed interventional neuroradiologists from 25 different countries about their experience in distinct training environments.MethodsA voluntary online survey comprising 24 questions concerning the different training facilities was designed and electronically conducted with the members of the European Society for Minimally Invasive Neurological Therapy.ResultsSeventy-one physicians with an average experience of 11.8 (±8.7) years completed the survey. The majority of participants had experience with animal-based training (eg, stroke intervention: 36; 50.7%). Overall, animal-based training was rated as the most suitable environment to practice coil embolization (20 (±6)), flow diverter placement (13 (±7)), and stroke intervention (13.5 (±9)). In-vitro training before using a new device in patients was supported by most participants (35; 49.3%). Additionally, preference for certain training models was related to the years of experience.ConclusionThis survey discloses the preferred training modalities in European neurointerventional centers with the majority of physicians supporting the general concept of in-vitro training, concomitantly lacking a standardized curriculum for educating neurointerventional physicians. Most suitable training modalities appeared to be dependent on procedure and experience. As animal-based training is still common, alternate artificial environments meeting these demands must be further developed.
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Islam, Mohammad Rafiqul, Sarmistha Biswas, Mohammad Robed Amin, and Md Ridwanur Rahman. "Knowledge Attitude and Practice of Dengue Syndrome Management on the Basis of National Guideline by the Physicians of Dhaka City." Journal of Medicine 22, no. 1 (January 14, 2021): 18–21. http://dx.doi.org/10.3329/jom.v22i1.51386.
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Objectives: Dengue is the fastest emerging arboviral infection. It was expected that the National Control Program will promote the use of the revised and updated version of the guideline for uniform clinical management of Dengue/DHF in the country with a view to reduce case fatality due to dengue. We tried to assess the knowledge attitude and practice of different tier of physicians on the basis of this guideline.
Method: Total 317 physicians from academic hospital, 57 physicians from non-academic hospital and 21 private practitioners took part in the survey.
Results: knowledge and attitude regarding management protocol of Dengue syndrome were significantly (p<0.05) associated with different academic tier but practice was not significantly (p<0.05) associated with different academics. The mean of accurate knowledge regarding management protocol of Dengue syndrome was significantly (p<0.05) associated with training status but attitude and practice were not significantly (p<0.05) associated with training status.
Conclusion: This study reveals that physicians possibly didn’t went through the dengue guideline properly as their knowledge, attitude and practice were poor in each tier of professional practice. But dengue training improved knowledge regarding management of patients.
J MEDICINE JAN 2021; 22 (1) : 18-21
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Wood, Amy M., M. Douglas Jones, James H. Wood, Zhaoxing Pan, and Thomas A. Parker. "Neonatal Resuscitation Skills Among Pediatricians and Family Physicians: Is Residency Training Preparing for Postresidency Practice?" Journal of Graduate Medical Education 3, no. 4 (December 1, 2011): 475–80. http://dx.doi.org/10.4300/jgme-d-10-00234.1.
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Abstract Background Pediatricians and family physicians are responsible for providing newborn resuscitation, yet Accreditation Council for Graduate Medical Education requirements for training in this area during residency differ markedly for the two specialties. Our objectives were to determine (1) the extent to which neonatal resuscitation training differs for pediatric and family medicine residents; (2) the extent to which general pediatricians and family physicians engage in newborn resuscitation in their practice; and (3) whether use of resuscitation skills differs between urban/suburban and rural providers. Methods We surveyed a national cohort of pediatricians and family physicians who obtained board certification between 2001 and 2005. Data were analyzed based on type of physician and setting of current practice. Results Survey response rate was 22% (382 of 1736). Compared with family medicine physicians, pediatricians received more neonatal resuscitation training during residency. Most members of both groups had attended no deliveries in the year prior to the survey (75% [111 of 148] versus 74% [114 of 154]). In their current practice, the groups were equally likely to have provided a newborn bag and mask ventilation, chest compressions, and resuscitation medications. Pediatricians were more likely than family physicians to have attempted to either intubate a newborn (20% [28 of 148] versus 10% [16 of 153]; P = .0495) or insert umbilical catheters (15% [22 of 148] versus 5% [8 of 153]; P = .005). Regardless of specialty, rural physicians were much more likely to report that they attended deliveries (61% [41 of 67] versus 15% [36 of 234]; P < .001). Among rural pediatricians attending deliveries, 44% (7 of 16) reported feeling inadequately prepared for at least one delivery in the past year. Conclusions Few primary care pediatricians and family physicians provide newborn resuscitation after residency. For those who do attend deliveries, current training may provide insufficient preparation. Flexible, individualized residency curricula could target intensive resuscitation training to individuals who plan to practice in rural areas and/or attend deliveries after graduation.
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Turki, M., T. Babbah, R. Ouali, S. Ellouze, W. Abid, R. Charfi, N. Halouani, and J. Alouou. "Psychiatric referrals in general practice." European Psychiatry 64, S1 (April 2021): S402—S403. http://dx.doi.org/10.1192/j.eurpsy.2021.1079.
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IntroductionOver half of patients with mental disorders are seen by primary care physicians. However, as for patients with somatic problems, referral to psychiatrists seems to be sometimes necessary.ObjectivesThe present study aimed to identify reasons and difficulties perceived by general practitioners (GP) in mental health referrals.MethodsA cross-sectional web-based survey was conducted between August 22 and September 23, 2020, so that 47 responses of GP were included.ResultsThe mean age of respondents was 37.3 years. Their seniority as doctors was 8 years on average. Among them, only 17% attended a post-university psychiatric training. The participants reported that they refer on average 32.5% of patients with mental disorders to psychiatrist: 85.1% to psychiatric hospital, 40.4% to liberal psychiatrists and 21.3% to clinical psychologists. Regarding the reasons for referral to mental healthcare structures, 70.2% of doctors justified their doing so by their insufficient training in mental healthcare; 66% by a need for hospitalization, 57.4% by the presence of delusions, while in 27.7 % of cases, the transfer was carried out at the request of the patient or his family. The difficulties mentioned by GP were patient refusal to consult a psychiatrist (70.2%) and difficulties related to the management delay (44.7%).ConclusionsPatient and health system factors, as well as physicians experience seem to have important influences on mental health referral. Open communication and ease of consultation with psychiatrists can make the care of patients with mental health problems even more rewarding to the primary care physician.
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Green-McKenzie, Judith, and Edward A. Emmett. "Characteristics and Outcomes of an Innovative Train-in-Place Residency Program." Journal of Graduate Medical Education 9, no. 5 (October 1, 2017): 634–39. http://dx.doi.org/10.4300/jgme-d-16-00689.1.
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ABSTRACT Background Physicians who make a midcareer specialty change may find their options for formal training are limited. Here, we describe a train-in-place program, with measureable outcomes, created to train midcareer physicians who desire formal training in occupational medicine. Objective We evaluated educational outcomes from a novel residency program for midcareer physicians seeking formal training and board certification in occupational medicine. Methods Physicians train in place at selected clinical training sites where they practice, and participate in 18 visits to the primary training site over a 2-year period. Program components include competency-based training structured around rotations, mentored projects, and periodic auditing visits to train-in-site locations by program faculty. Main outcome measures are achievement of Accreditation Council for Graduate Medical Education Occupational Medicine Milestones, American College of Occupational and Environmental Medicine competencies, performance on the American College of Preventive Medicine examinations, diversity in selection, placement of graduates, and the number of graduates who remain in the field. Results Since inception of this program in 1997, there have been 109 graduates who comprise 7.2% of new American Board of Preventive Medicine diplomates over the past decade. Graduates scored competitively on the certifying examination, achieved all milestones, expressed satisfaction with training, and are geographically dispersed, representing every US region. Most practice outside the 25 largest standard metropolitan statistical areas. More than 95% have remained in the field. Conclusions Training in place is an effective approach to provide midcareer physicians seeking comprehensive skills and board certification in occupational medicine formal training, and may be adaptable to other specialties.
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Jasani, MD, Gregory, James MacNeal, DO, MPH, and Jon Mark Hirshon, MD, PhD. "Emergency department active shooter training: A survey of current practices in 2020." American Journal of Disaster Medicine 16, no. 4 (December 1, 2021): 263–69. http://dx.doi.org/10.5055/ajdm.2021.0410.
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Background: Shooting events in hospitals are increasing in frequency, with the emergency department (ED) being the most common site of such events. EDs must be prepared for shooting events, but current practices surrounding active shooter preparation are unknown.Objective: To determine what active shooter training emergency medicine physicians are receiving.Methods: A survey was developed to assess current practices around active shooter preparation in EDs. The survey was distributed to members of the American College of Emergency Physicians’ Emergency Medicine Practice Research Network. All members of the Emergency Medicine Practice Research Network are currently practicing emergency medicine physicians.Results: There were 194 respondents. The most common form of training received was online (76/194), followed by lecture (50/194). Only 39 respondents had participated in an active shooter drill. Sixty-five respondents (33 percent) reported having never received any formal active shooter training.Conclusion: There is a wide array of active shooter training that emergency medicine physicians are receiving, with nearly one-third receiving no training at all.
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Lefevre, Frank V., Teresa M. Waters, and Peter P. Budetti. "A Survey of Physician Training Programs in Risk Management and Communication Skills for Malpractice Prevention." Journal of Law, Medicine & Ethics 28, no. 3 (2000): 258–66. http://dx.doi.org/10.1111/j.1748-720x.2000.tb00669.x.
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Malpractice lawsuits serve as a great source of pain, consternation and loss for physicians and patients alike, usually leaving all parties involved in the process with a sense of betrayal. A significant number of physicians will be sued at least once in their career, especially if they practice in some of the more vulnerable specialties. In addition, there is some evidence that the threat of malpractice lawsuits changes the practice style of many physicians, leading to the practice of “defensive medicine” and raises the total cost of health care. Clearly, the prevention of medical malpractice is an issue that deserves considerable attention from physicians and from those who train them.Empirical evidence suggests that medical negligence may play a relatively minor role in malpractice lawsuits. As demonstrated by Localio, et al., one in thirty-five cases of negligence or incompetence actually results in a lawsuit.
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Tinley, Paul. "Occupational Stress Among Australian Podiatric Physicians in General and Geriatric Practice." Journal of the American Podiatric Medical Association 105, no. 2 (March 1, 2015): 130–34. http://dx.doi.org/10.7547/0003-0538-105.2.130.
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Background High levels of occupational stress have been reported in podiatric physicians practicing in Australia. One possible stressor is the predominance of the treatment of aged patients with chronic disease in podiatric medical practice. Methods Forty podiatric physicians attending a regional podiatric medical conference were invited to participate in the research using a convenience sampling method. Podiatric physicians were asked to complete a survey examining occupational stress in general and specifically in relation to practice with older adults (defined as those older than 65 years). Results The survey of sources of occupational stress among podiatrists identified patient demands and expectations as the most significant stressor in general and geriatric practice for the podiatric physician. The perceived limited clinical gains and chronic nature of the conditions in older patients was also ranked highly as a stressor. Conclusions Working with the elderly is a substantial part of podiatric medical practice and, as such, needs to be seen with a more positive attitude by many practitioners. The development of geriatric practice as a speciality within the profession may help raise the value of working with the elderly. This has implications for preparing podiatric physicians for practice with the geriatric population along with the need for strategies to avoid or minimize these work stressors.
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Takahashi, S. Glover, M. Alameddine, D. Martin, S. Verma, and S. Edwards. "70. Supporting IMG integration into residency trainings." Clinical & Investigative Medicine 30, no. 4 (August 1, 2007): 67. http://dx.doi.org/10.25011/cim.v30i4.2831.
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This paper is describes the design, development, implementation and evaluation of a preparatory training program for international medical trainees. The program was offered for one week full time shortly before they begin their residency training programs. First the paper reports on the survey and focus groups that guided the learning objectives and the course content. Next the paper describes the curriculum development phase and reports on the topical themes, session goals and objectives and learning materials. Three main themes emerged when developing the program: understanding the educational, health and practice systems in Canada; development of communication skills; and supporting personal success in residency training including self assessment, reflection and personal wellness. Sample lesson plans and handouts from each of the theme areas are illustrated. The comprehensive evaluation of the sessions and the overall program is then also described. The paper then summarizes the identified key issues and challenges in the design and implementation of a preparatory training program for international medical trainees before they begin their residency training programs.
Allan GM, Manca D, Szafran O, Korownyk C. Workforce issues in general surgery. Am Surg. 2007 Feb; 73(2):100-8.
Dauphinee, WD. The circle game: understanding physician migration patterns within Canada. Acad Med. 2006 (Dec); 81(12 Suppl):S49-54.
Spike NA. International medical graduates: the Australian perspective. Academic Medicine. 2006 (Sept); 81(9):842-6.
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Patterson, Davis G., C. Holly A. Andrilla, and Lisa A. Garberson. "Preparing Physicians for Rural Practice: Availability of Rural Training in Rural-Centric Residency Programs." Journal of Graduate Medical Education 11, no. 5 (October 1, 2019): 550–57. http://dx.doi.org/10.4300/jgme-d-18-01079.1.
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ABSTRACT Background Exposing residents to rural training encourages future rural practice, but unified accreditation of allopathic and osteopathic graduate medical education under one system by 2020 has uncertain implications for rural residency programs. Objective We describe training locations and rural-specific content of rural-centric residency programs (requiring at least 8 weeks of rurally located training) before this transition. Methods In 2015, we surveyed residency programs that were rurally located or had rural tracks in 7 specialties and classified training locations as rural or urban using Rural-Urban Commuting Area (RUCA) codes. Results Of 1849 residencies in anesthesiology, emergency medicine, general surgery, internal medicine, obstetrics and gynecology, pediatrics, and psychiatry, 119 (6%) were rurally located or offered a rural track. Ninety-seven programs (82%) responded to the survey. Thirty-six programs required at least 8 weeks of rural training for some or all residents, and 69% of these rural-centric residencies were urban-based and 53% were osteopathic. Locations were rural for 26% of hospital rotations and 28% of continuity clinics. Many rural-centric programs (35%) reported only urban ZIP codes for required rural block rotations; 54% reported only urban ZIP codes for required rural clinic sessions, and 31% listed only urban ZIP codes in reporting rural full-time training locations. Programs varied widely in coverage of rural-specific training in 6 core competencies. Conclusions In multiple specialties important for rural health care systems, little rurally located residency training and rural-specific content was available. Substantial proportions of training locations reported to be rural were actually urban according to a common rural definition.
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Wong, Mitchell D., Lourdes Guerrero, Tamer Sallam, Joy S. Frank, Alan M. Fogelman, and Linda L. Demer. "Outcomes of a Novel Training Program for Physician-Scientists: Integrating Graduate Degree Training With Specialty Fellowship." Journal of Graduate Medical Education 8, no. 1 (February 1, 2016): 85–90. http://dx.doi.org/10.4300/jgme-d-15-00135.1.
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ABSTRACT Background Although physician-scientists generally contribute to the scientific enterprise by providing a breadth of knowledge complementary to that of other scientists, it is a challenge to recruit, train, and retain physicians in a research career pathway. Objective To assess the outcomes of a novel program that combines graduate coursework and research training with subspecialty fellowship. Methods A retrospective analysis was conducted of career outcomes for 123 physicians who graduated from the program during its first 20 years (1993–2013). Using curricula vitae, direct contact, and online confirmation, data were compiled on physicians' subsequent activities and careers as of 2013. Study outcomes included employment in academic and nonacademic research, academic clinical or private practice positions, and research grant funding. Results More than 80% of graduates were actively conducting research in academic, institutional, or industrial careers. The majority of graduates (71%) had academic appointments; a few (20%) were in private practice. Fifty percent had received career development awards, and 19% had received investigator-initiated National Institutes of Health (NIH) R01 or equivalent grants. Individuals who obtained a PhD during subspecialty training were significantly more likely to have major grant funding (NIH R series or equivalent) than those who obtained a Master of Science in Clinical Research. Trainees who obtained a PhD in a health services or health policy field were significantly more likely to have research appointments than those in basic science. Conclusions Incorporation of graduate degree research, at the level of specialty or subspecialty clinical training, is a promising approach to training and retaining physician-scientists.
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Yasien, Esraa, and Qais kadhem. "Knowledge, attitude and practice of family physicians toward osteoporosis in Babylon governorate." Iraqi National journal of Medicine 4, no. 2 (July 1, 2022): 195–203. http://dx.doi.org/10.37319/iqnjm.4.2.4.
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Introduction: Osteoporosis is a metabolic bone illness that occurs in males and females and is widely disturbed around the world. Research shows that females are more affected after menopause than males due to decreased estrogen secretion. The aim of this research is to evaluate the knowledge, attitude, and practice of family physicians concerning osteoporosis. Method: A cross-sectional study started from May to July 2020 in Babylon region. Almost all family physicians work in rural and urban areas in Babylon governorate have been included in the current study. A self-administered questionnaire was collected after taking verbal consent from all participants, with no exclusion criteria. The first part focused on demographic and specialized practice information data, while the second part contained a Knowledge, Attitude, and Practices (KAP) survey. Results: Out of 97 family physicians, 59% scored moderate, 34% poor, and 6% good in awareness response. Regarding attitude response, 76% were good, 22% moderate, and 2% poor. In practice response, 53% were moderate, 33% good, and 13% poor. There was a significant association between place of work and attitude, source of experience and practice, practice and osteoporosis-training course, practice and use of guidelines, and the years of work and practice. Conclusion: Most family physicians in Babylon province had moderate awareness, good attitude, and moderate practice towards osteoporosis. Family doctors working in hospitals had poor attitude towards osteoporosis. Therefore, all family doctors can benefit from training courses, especially family doctors who work in a hospital. Further, the current osteoporosis guidelines must be revised for any mistakes. Keywords: Knowledge, Attitude, Practice, Family Physicians, Osteoporosis, Babylon City.
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Lin, Tso-Chou, Luo-Ping Ger, Joseph V. Pergolizzi, Robert B. Raffa, Ju-O. Wang, and Shung-Tai Ho. "Knowledge, Attitude and Practice Survey of Prescribing Opioids for Chronic Noncancer Pain in Taiwan—Comparison of Pain and Non-Pain Physicians." Pain Medicine 20, no. 12 (August 13, 2016): 2397–410. http://dx.doi.org/10.1093/pm/pnw189.
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Abstract Background Prescribing opioids for chronic noncancer pain (CNCP) has been strictly regulated in Taiwan. This study was undertaken to survey pain and non-pain related physicians’ knowledge, attitudes, and practices regarding prescribing opioids for CNCP. Methods A questionnaire survey was conducted in this comparison study. All 66 physicians who were treating officially registered CNCP outpatients were visited and completed anonymous questionnaires. The other physicians (anesthesiologists, oncologists, and non-pain physicians) were surveyed by a mailed questionnaire. Results A total of 266 (75%) questionnaires were received from 355 board-certified physicians. More CNCP physicians (81.8%) and anesthesiologists (69.7%) had received prior CNCP-related training courses than had oncologists (21.2%) and non-pain physicians (10.3%). Varied proportions of physicians by type were unfamiliar with the Taiwan opioid regulations (16.7–86.8%) and would accordingly skip or reduce dosage of opioid prescriptions (27.3–73.5%). In addition, non-pain physicians had a significantly lower knowledge level, more negative attitudes, and greater hesitation about prescribing opioids compared to the pain-related physicians (P < 0.001). CNCP physicians who had received CNCP-related training courses had a higher knowledge score than did those not receiving training (P = 0.002). Overall, the leading barriers for prescribing opioids were inadequate knowledge of pain management (76%), physician reluctance (73%), and family reluctance (78%). Conclusion There are substantial knowledge gaps, negative attitudes, and hesitation toward prescribing long-term opioids for CNCP patients by physicians in Taiwan, suggesting that efforts are needed to improve postgraduate education regarding adequate opioid management for CNCP.
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Umar, Badar Uddin, Nazmun Nahar Alam, Tanbira Alam, Mahmudul Mannan, and S. M. Niazur Rahman. "Impact of Training Modules on Physicians’ Perspective of COVID-19: An Online Survey." Journal of Medicine 22, no. 2 (December 1, 2021): 107–13. http://dx.doi.org/10.3329/jom.v22i2.56699.
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Background: The outbreak of COVID-19 has remained a massive challenge for healthcare workers specially physicians. Effective professional training has a crucial role in preparing doctors for responding to pandemics. Objective: To assess the effectiveness of existing training modules on enhancing knowledge, ensuring safe practice, and improving behavior on COVID-19 among physicians. Methods: This is a descriptive, cross-sectional, online survey; where a virtual questionnaire was used to collect data through online professional platforms. A pre-tested survey tool was employed to assess the impact of professional training on infection prevention and control. Results: Total 161 physicians participated in this survey from 15 different countries. Most of the respondents (72%) received training from various sources like the workplace (60%) and international agencies (21%), through the in-person or online format. Knowledge assessment revealed advanced (43%) and competent (40%) understanding by the participants. Improving knowledge progression was displayed by the cohort who received professional training (p<0.00). Physicians’ positive behavior and good practices were observed with the training modules. Conclusion: It became evident from this study, that professional training is effective in enhancing knowledge, improving behavior, and ensuring safe practices. Hence, designing such training modules for the physicians is warranted to tackle ongoing and future pandemics. J MEDICINE 2021; 22: 107-113
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Withers, A., J. Downs, A. Wilson, and G. Hall. "P137 Diagnosis of nocturnal hypoventilation in children with neuromuscular disorders by polysomnography – a survey of clinical practice in Australia and New Zealand." SLEEP Advances 3, Supplement_1 (October 1, 2022): A73—A74. http://dx.doi.org/10.1093/sleepadvances/zpac029.205.
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Abstract Background Diagnosis of nocturnal hypoventilation requires measurement of pCO2 during sleep, which can occur via exhaled gas (capnography) or transcutaneous methods. Different national and international definitions of hypoventilation exist, which may contribute to significant variation in clinical practice. Methods An electronic survey was completed by pediatric sleep physicians in Australia and New Zealand to determine how pCO2 was measured during polysomnography, what pCO2 data was available to reporting physicians/included in the report and which definitions of hypoventilation physicians use. Results More than two thirds (70%) of physicians indicated that in their centre pCO2 was collected via transcutaneous measurement only and 30% by both transcutaneous and end-tidal measurement. Twelve definitions of hypoventilation were used, including published definitions from the American Academy of Sleep Medicine manual and the pediatric Australasian Sleep Association/Australasian Sleep Technologists Association recommendations. The most commonly used definition was an increase in pCO2 >50mmHg for >25% total sleep time. The percentage of total sleep time with pCO2 >50mmHg was routinely included in the report and/or easily available in the raw data for 70% of physicians. Discussion There was significant variation and lack of standardisation within Australia and New Zealand when measuring and reporting pCO2 during polysomnography as well as definitions of hypoventilation used by pediatric sleep physicians. The Australasian Sleep Association/Australasian Sleep Technologists Association recommendations were not frequently used, possibly due to relevant information not being available to reporting physicians, recommendations being irrelevant and/or outdated and excessive cognitive load associated with remembering multiple definitions.
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Kopanczyk, Rafal, Micah T. Long, Sree V. Satyapriya, Amar M. Bhatt, and Michael Lyaker. "Developing Cardiothoracic Surgical Critical Care Intensivists: A Case for Distinct Training." Medicina 58, no. 12 (December 17, 2022): 1865. http://dx.doi.org/10.3390/medicina58121865.
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Cardiothoracic surgical critical care medicine is practiced by a diverse group of physicians including surgeons, anesthesiologists, pulmonologists, and cardiologists. With a wide array of specialties involved, the training of cardiothoracic surgical intensivists lacks standardization, creating significant variation in practice. Additionally, it results in siloed physicians who are less likely to collaborate and advocate for the cardiothoracic surgical critical care subspeciality. Moreover, the current model creates credentialing dilemmas, as experienced by some cardiothoracic surgeons. Through the lens of critical care anesthesiologists, this article addresses the shortcomings of the contemporary cardiothoracic surgical intensivist training standards. First, we describe the present state of practice, summarize past initiatives concerning specific training, outline why standardized education is needed, provide goals of such training standardization, and offer a list of desirable competencies that a trainee should develop to become a successful cardiothoracic surgical intensivist.
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Akhtar, Noshad, Syed Shahzad Hasan, and Zaheer-Ud-Din Babar. "Evaluation of general practice pharmacists’ role by key stakeholders in England and Australia." Journal of Pharmaceutical Health Services Research 13, no. 1 (March 1, 2022): 31–40. http://dx.doi.org/10.1093/jphsr/rmac002.
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Abstract Objectives This study aims to measure expectations and perceptions about the general practice pharmacists’ (GPPs) roles in England and Australia. Methods The study is based on the interviews conducted with key stakeholders from England and Australia, including general practitioners, nurses, GPPs, organizational lead and academics. There were a total of 14 participants, 7 each from England and Australia. The participants were involved in a semi-structured, audio-recorded interview, which was later transcribed verbatim, coded and underwent a thematic analysis to extract the general themes, raised by participants’ views and experiences about GPPs’ role. Key findings From the transcribed data, the main themes extracted were initial expectations and reservations by key stakeholders, barriers and facilitators, working collaboration, GPPs’ skillset, views on key performance indicators (KPIs), patients’ feedback and the stakeholders’ views on the future of GPPs in England and Australia. The participants from both England and Australia did acknowledge the growing role of GPPs. Few concerns were raised by some participants about aspects like role description, training pathways, prescribing protocols and funding. Despite these concerns, all participants strongly believed that by taking steps to overcome main barriers like funding in Australia and training pathways in England, GPPs could be an ideal professional to bridge the gaps in the general practice framework. Conclusions GPPs could be an ideal professional to bridge the gaps in the general practice framework, but steps need to be taken to overcome barriers. Based on the comparative data, recommendations were made on funding structure, role description, prescribing qualification, training pathways and KPIs. These recommendations can be used as guidance for both England and Australia while implementing relative policies in these countries.
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Widyahening, Indah S., Rodri Tanoto, Fedri Rinawan, Elsa P. Setiawati, and Zorayda E. Leopando. "Does the establishment of universal health coverage drive the foundation of postgraduate education for primary care physicians?" Medical Journal of Indonesia 26, no. 2 (August 18, 2017): 141–51. http://dx.doi.org/10.13181/mji.v26i2.1857.
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Background: Studying the formation of postgraduate training in primary care within countries which has attained Universal Health Coverage (UHC) is important to support the development of similar training in low-and middle-income countries aiming to achieve UHC by 2030. This review aims to describe the state of postgraduate training for primary care physicians in UHC-attaining countries.Methods: A literature review of published literature and official documents from the websites of regional and global health/primary care organizations or societies such as World Health Organization (WHO), World Organization of Family Doctors (WONCA), European Forum for Primary Care, European Union of General Practitioners (GP)/Family Physicians (FP), European Academy of Teachers in GP/Family Medicine (FM), as well as the websites of GP/FP organizations in each of the respective countries. The list of UHC attained countries were identified through WHO and International Labor Organization databases.Results: A total number of 72 UHC-attained countries were identified. Postgraduate education for primary care physicians exists in 62 countries (86%). Explicit statements that establish primary care postgraduate training were corresponded with the policy on UHC is found in 11 countries (18%). The naming of the program varies, general practice and family medicine were the commonest. In 33 countries (53%), physicians are required to undertake training to practice in primary level. The program duration ranged from 2–6 years with 3 years for the majority.Conclusion: Although UHC is not the principal driving force for the establishment of postgraduate training for primary care physicians in many countries, most UHC-attaining countries make substantial endeavor to ensure its formation as a part of their health care reform to improve national health.
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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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Meadley, Liz, Jane Conway, and Margaret McMillan. "Education and training needs of nurses in general practice." Australian Journal of Primary Health 10, no. 1 (2004): 21. http://dx.doi.org/10.1071/py04004.
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Practice nurses have been identified as key personnel in management of patients either in the prevention of hospitalisation or follow-up post-discharge from acute settings. There is an increase in numbers of practice nurses (PNs) in Australia, but the role of nurses who work in general practice is poorly understood. There is considerable variation in the activities of PNs, which can include functions as diverse as receptionist duties, performing a range of clinical skills at the direction of the medical practitioner, and conducting independent patient assessment and education. This paper reports on an investigation of PNs? perceptions of their ongoing professional development needs, and identifies issues in providing education and training to nurses who work with general practitioners (GPs).
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GeneI, Myron, and Adrian Dobs. "Article Commentary: Translating Clinical Research into Practice: Practice-Based Research Networks—A Promising Solution." Journal of Investigative Medicine 51, no. 2 (March 2003): 64–71. http://dx.doi.org/10.1177/108155890305100207.
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Greater effort is needed to translate research discoveries into clinical practice and to ensure that proven treatments are routinely implemented by physicians. Practice-based research networks are an undervalued resource in the endeavor to bring research results to bear in patient care. These networks are groups of practicing health care providers who have organized to address research questions of primary importance to their patients. Existing practice-based research networks have addressed a wide range of issues, including improvement of preventive service delivery, reliability of diagnostic measures, practice variation, disease prevention, and systems of care coordination. Several deficiencies in the current system prevent practice-based research networks from reaching their full potential as mechanisms of translating clinical research into practice. For practice-based research networks to flourish, they need increased funding for practice-based research networks; information systems to facilitate research by practicing physicians; training programs for health care providers; and communication networks between providers, clinical researchers, professional societies, and academic health centers.
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Crowley, Jennifer, Lauren Ball, and Gerrit J. Hiddink. "Nutrition care by primary-care physicians: advancing our understanding using the COM-B framework." Public Health Nutrition 23, no. 1 (November 18, 2019): 41–52. http://dx.doi.org/10.1017/s1368980019003148.
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AbstractObjective:To investigate the nutrition education provided by primary-care physicians (PCP).Design:An integrative review was used to examine literature on nutrition care provided by PCP from 2012 to 2018. A literature search was conducted in MEDLINE, PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Scopus using key search terms.Setting:USA, Netherlands, Germany, Denmark, UK, Lebanon, Australia and New Zealand.Participants:Primary-care physicians.Results:Sixteen qualitative and quantitative studies were analysed thematically using meta-synthesis informed by the COM-B model of behaviour (capability, motivation and opportunity), to understand the influences on PCP behaviours to provide nutrition care. PCP perceive that they lack nutrition capability. While PCP motivation to provide nutrition care differs based on patient characteristics and those of their own, opportunity is influenced by medical educators, mentors and policy generated by professional and governmental organisations.Conclusions:The development of PCP capability, motivation and opportunity to provide nutrition care should begin in undergraduate medical training, and continue into PCP training, to create synergy between these behaviours for PCP to become confident providing nutrition care as an integral component of disease prevention and management in contemporary medical practice.
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Thach, Sarah B., Bryan Hodge, Misty Cox, Anna Beth Parlier-Ahmad, and Shelley L. Galvin. "Cultivating Country Doctors: Preparing Learners for Rural Life and Community Leadership." Family Medicine 50, no. 9 (October 2, 2018): 685–90. http://dx.doi.org/10.22454/fammed.2018.972692.
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Background and Objectives: Rural health disparities are growing, and medical schools and residency programs need new approaches to encourage learners to enter and stay in rural practice. Top correlates of rural practice are rural upbringing and rurally located training, yet preparation for rural practice plays a role. The authors sought to explore how selected programs develop learners’ competencies associated with rural placement and retention: rural life, community engagement, and community leadership. Methods: Qualitative, semistructured phone interviews (n=20) were conducted with faculty of medical schools or family medicine residencies across the United States, Canada, Australia, and South Africa in which success in training rural practitioners was identified in the literature or by leaders of the National Rural Health Association’s Rural Medical Educators Group. Participants included 18 physician program directors, one nonphysician program administrator, and one PhD researcher who had studied rural preparation. Interview transcripts were read twice using an inductive process: first to identify themes, and then to identify specific strategies and quotes to exemplify each theme. Results: Participants’ recommendations for rural preparation were: (1) Be intentional about strategies to prepare learners for rural practice; (2) Identify and cultivate rural interest; (3) Develop confidence and competence to meet rural community needs; (4) Teach skills in negotiating dual relationships, leading, and improving community health; and (5) Fully engage rural host communities throughout the training process. Conclusions: Medical schools and residencies may increase the likelihood of producing rural physicians by implementing these experts’ strategies. Educators may select strategies that mesh with the structure and location of their training program.
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Grimm, JW, and NR Chumbler. "Surgical referrals as evidence of a de facto podiatric medical specialization." Journal of the American Podiatric Medical Association 85, no. 9 (September 1, 1995): 481–87. http://dx.doi.org/10.7547/87507315-85-9-481.
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The authors present evidence on the patterns and correlates of surgical referrals to podiatric physicians that suggests a surgical specialty now exists in podiatric medicine. The primary factors on which surgical specialization appears to be based are residency training, hospital medical staff membership, and increased hospital podiatric practice activity. Surgically specialized podiatric physicians tend to be younger, but such specialization is not related to either the gender or race of podiatric physicians.
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Andrade, Joana Verdelho, Ana Manuela Rocha, Maria Inês Santos, Joana Campos, Elisabete Santos, and Alzira Ferrão. "Autoavaliação de médicos sobre sua formação em Medicina do Adolescente." Scientia Medica 28, no. 3 (July 19, 2018): 29642. http://dx.doi.org/10.15448/1980-6108.2018.3.29642.
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AIMS: To characterize the way in which general and family physicians and pediatricians consider approaching adolescents, identify their qualifications in Adolescent Medicine, ascertain which topics of this specialty these physicians would like to see addressed in future training, and to compare the perceptions of physicians of both specialties with respect to their experience in adolescent health practice.METHODS: Cross-sectional study based on a survey sent by e-mail to 241 physicians in the area of influence of a level II hospital, including specific training interns or experts in Pediatrics and General and Family Medicine from health centers of the municipality of Viseu, Portugal. Chi-square tests or Fisher's exact test were used to test associations between variables, assuming statistical significance when p <0.05.RESULTS: A total of 113 physicians completed the survey, of them 74% female, with a median of 12 years of practice (interquartile range 5-30, minimum 2 years, maximum 38 years). The pediatrics group had more training in Adolescent Medicine (57%) than the general and family medicine group (25%) (p=0.007). More physicians with specific training in Adolescent Medicine considered themselves prepared for the adolescent interview (51%, vs. 28% of those who did not have specific training, p=0.03). Family and general practitioners guided adolescents more about substance use, contraception, and sexually transmitted diseases, while pediatrics doctors identified more adolescents with depression. Most physicians rated themselves as having insufficient knowledge in Adolescent Medicine, with insufficient training being the most frequently referred barrier. Fifty-seven percent of pediatrics doctors, 78% of general practitioners and 84% of those with no specific training in Adolescent Medicine, considering the two specialties, would like to deepen their knowledge in this area.CONCLUSIONS: This study allowed identifying which areas of knowledge on Adolescent Medicine are deficient in the training of pediatricians and general practitioners. Most physicians, especially those with no training in Adolescent Medicine, showed interest in filling this gap.
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Xu, Rixiang, Tingyu Mu, Wang Jian, Caiming Xu, and Jing Shi. "Knowledge, Attitude, and Prescription Practice on Antimicrobials Use Among Physicians: A Cross-Sectional Study in Eastern China." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 58 (January 2021): 004695802110599. http://dx.doi.org/10.1177/00469580211059984.
Full textAbstract:
Over-prescription of antimicrobials for patients is a major driver of bacterial resistance. The aim of the present study was to assess the knowledge, attitude, and prescription practices regarding antimicrobials among physicians in the Zhejiang province in China, and identify the determining factors. A total of 600 physicians in public county hospitals and township health institutions were surveyed cross-sectionally using a structured electronic questionnaire. The questionnaire was completed by 580 physicians and the response rate was 96.67%. The mean score of 11 terms related to antimicrobial knowledge was 6.81, and an average of 32.1% of patients with upper respiratory tract infections (URTIs) were prescribed antimicrobials. Multivariate analysis indicated that young general practitioners with less training are more likely to contribute to more frequent antimicrobial prescriptions ( P < .05). In contrast, older physicians with more training are more willing to provide patients with the correct knowledge regarding antimicrobials and less likely to prescribe antimicrobials for URTIs. Correlation analysis showed that the level of physician's knowledge, attitude, and prescription practice is related ( P < .05). In conclusion, proper prescription of antimicrobials depends on adequate knowledge and regular training programs for physicians.
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Nelson, Angie, Tania Signal, and Rachel Wilson. "Equine Assisted Therapy and Learning." Society & Animals 24, no. 4 (August 18, 2016): 337–57. http://dx.doi.org/10.1163/15685306-12341418.
Full textAbstract:
This study examines the practices of Equine Assisted Therapy and Learning in Australia. Among Equine Assisted Therapy (eat) and Equine Assisted Learning (eal) centers there is a large degree of variation in practice worldwide. The current study outlines a range of practices in two states in Australia whereeatandealhave arisen and evolved from models developed elsewhere. The philosophical foundations, training and certification processes followed along with the types and training of horses involved are compared across facilities. The findings of the study illustrated the large variation ineatandealin current practice in Australia. The results suggested that if the practices ofeatandealare to move out of the “fringe” of mental health and learning professional practice and into the mainstream, their theoretical underpinnings, certification and licensure procedures, and methodology of practice must become more clearly defined.
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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.
Full textAbstract:
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.