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Usability to Improve Healthcare
Published in Marcelo M. Soares, Francisco Rebelo, Tareq Z. Ahram, Handbook of Usability and User Experience, 2022
Christopher P. Nemeth, Jeremy C. Pamplin, Sena Veazey, Christopher Colombo
In accordance with an approved IRB protocol, we recruited and enrolled participants at San Antonio Military Medical Center (US Army Institute Surgical Research and Brooke Army Medical Center) (BAMC) and Madigan Army Medical Center (MAMC). We recruited active duty military clinicians with no formal surgical or anesthesia training such as family medicine, emergency medicine and internal medicine physicians, physician assistants or medics representing the types of clinicians likely to encounter PFC during military deployments. Our goal was to recruit at least 20 subjects per site (40 in all). Assuming a 20% dropout rate, 24 subjects would comprise the sample at each site (48 in all). We also used a survey to collect demographic information through a survey on the day before the simulation experiment. After providing consent, each subject was assigned a unique identifier and was assigned to a testing calendar.
Hong Kong
Published in Braithwaite Jeffrey, Mannion Russell, Matsuyama Yukihiro, Paul G. Shekelle, Whittaker Stuart, Al-Adawi Samir, Healthcare Systems:, 2018
Eliza Lai-Yi Wong, Hong Fung, Patsy Yuen-Kwan Chau, Eng-Kiong Yeoh
There have been a number of systematic reviews of PCC measurements, intervention, and outcomes. For the PCC measurements, the IAPO reviewed the literature and identified existing patient-centered healthcare domains and measurement indicators at the health system level, and in hospital or primary care settings (International Alliance of Patients’ Organizations, 2012). The term patient-centered first appeared in family medicine; however, the tools for measuring patients’ perception of PCC in family medicine were limited to four key dimensions: disease and illness experience, whole person, common ground, and patient–doctor relationships (Hudon et al., 2011). In terms of intervention and outcomes, the literature published between 1998 and 2013 summarized the positive impacts of person-centered approaches on patients’ peer support, information understanding, healthcare experience, and shared decision‑making. Most studies showed that patient-centered care had a positive impact on patient satisfaction, as well as increasing perceptions of quality of care (McMillan et al., 2013). Among a target population, such as those suffering from dementia, intensive activity-based person-centered intervention resulted in a significant reduction in agitation over the short‑term (Kim and Park, 2017). Meaningful analysis of cost-effectiveness, including research over the long‑term, was very limited.
Individual Variability in Clinical Decision Making and Diagnosis
Published in Pat Croskerry, Karen S. Cosby, Mark L. Graber, Hardeep Singh, Diagnosis, 2017
Further, insofar as academic achievement is associated with intellectual ability, there may be some additional differentiation through medical training. A study involving 883 graduates over a 10-year period found that academic achievement (measured by grade point average [GPA] and scores on steps 1 and 2 of the United States Medical Licensing Examination) was correlated with career choice [47]. Lower levels of academic achievement were significantly associated with the general residencies (family medicine, general practice, obstetrics-gynecology, general pediatrics, and general psychiatry), whereas the higher levels were associated with the specialized residencies (diagnostic radiology, surgery, anesthesiology, medicine pediatrics, ophthalmology, pathology, emergency medicine, and other surgical subspecialties) [47]. While there are probably many other factors at play here, it does at least raise the question of whether or not diagnoses are more challenging and therefore require greater intellectual effort in specialized medicine. Given that vulnerability to cognitive bias has been shown to be related to intellectual ability, and dispositions to engage in analytic processing (System 2) have been found to be negatively related to biases [48], it is interesting that diagnostic failure is reported to be highest in the general disciplines where diagnostic problems are the least differentiated (family practice, internal medicine, and emergency medicine) [49], and these same specialties are among those with the highest self-reported biases toward patients: emergency medicine at 62%, family medicine at 47%, and internal medicine at 40% (Figure 9.1) [50].
Attitudes and behaviors of family physicians regarding occupational diseases
Published in Archives of Environmental & Occupational Health, 2018
Ali Naci Yildiz, Tahir Metin Piskin, Mehmet Erdem Alaguney, Ozlem Kar Kurt, Ahmet Ozlu, Mustafa Kemal Basarali
Only three out of ten participants (29.6%) stated that they had training on ODs, while nearly half of them stated they did not have any training on ODs and one third of them stated they did not remember whether they had received such training. It is a striking finding that only one third of the trainees receive pre-graduate university education. In this regard, the US Accreditation Council for Graduate Medical Education has stated that information and clinical experience in occupational health care should be included in family medicine residency training.30 In a study evaluating family medicine programs in the US, it has been stated that the first three training titles are occupational history, physical examination, treatment of common occupational injuries and illnesses and fitness for return to work.31 In a study conducted in Singapore, 36% of family physicians said that they had received training on ODs after medical school education. But, approximately 80% of these stated that this training was not sufficient.32 In the survey study conducted with the participation of 6 countries in Europe, it was emphasized that the important factor about deficiencies in notification was inadequate education; and the quality of notification of ODs will be increased by education of the physicians who will use guidelines based on evidence.33
Evaluating burnout during the COVID-19 pandemic among physicians in a large health system in New York
Published in Archives of Environmental & Occupational Health, 2022
Vansha Singh, John Q. Young, Prashant Malhotra, Molly McCann-Pineo, Rehana Rasul, Samantha S. Corley, Andrew C. Yacht, Karen Friedman, Stephen Barone, Rebecca M. Schwartz
Demographic information, including physician age, gender, race, Hispanic ethnicity, and marital status were also collected. To understand the personal and social impact of the COVID-19 pandemic on healthcare workers, we utilized The Epidemic-Pandemic Impacts Inventory (EPII) for Healthcare Workers (brief module, Cronbach α = 0.773).47 Participants were asked whether they have had any of 16 potential negative occupationally-related experiences since the beginning of the COVID-19 pandemic. Each reported exposure (i.e., “Yes” response) was summated to create a total EPII score (range = 0–16). Responses of “No” and “NA” were collapsed to indicate no exposure, as recommended by the EPII authors. Sample EPII items include: “Inadequate/unhygienic personal protective equipment”, “Deaths of patients despite heroic efforts by the treatment team”, and “Forced separation from your children or spouse/partner for a week or more due to work or self-quarantine”. Inpatient medicine familiarity was also included as a covariate. Lack of prior experience in inpatient medicine was deemed a potential predictor of burnout, so to differentiate physicians with and without prior experience, we utilized a survey question that assessed “inpatient medicine familiarity”. Physicians were designated as having familiarity if they reported having a specialty in medicine (i.e., critical care, cardiology, critical care, gastroenterology, geriatric medicine, hematology/oncology, infectious disease, pulmonary medicine), in family medicine or in emergency medicine. Those considered not familiar with inpatient medicine included anesthesiology, dentistry, dermatology, ophthalmology, orthopedics, otolaryngology, pathology, pediatrics, psychiatry, sports medicine, surgery, urology, Provision of direct COVID-19 care (yes vs. no), irrespective of redeployment status, was also collected.