Medicine and Health Sciences Commons^™

Individuals' Use Of Care While Uninsured: Effects Of Time Since Episode Inception And Episode Length, Carole Gresenz, J. Rogowski, Jose Escarce

Carole Roan Gresenz

No abstract provided.

Rules Of Engagement: Residents' Perceptions Of The In-Training Evaluation Process, Christopher Watling, Cynthia Kenyon, Elaine Zibrowski, Valerie Schulz, Mark Goldszmidt, Indu Singh, Heather Maddocks, Lorelei Lingard

Lorelei Lingard

BACKGROUND: In-training evaluation reports (ITERs) often fall short of their goals of promoting resident learning and development. Efforts to address this problem through faculty development and assessment-instrument modification have been disappointing. The authors explored residents' experiences and perceptions of the ITER process to gain insight into why the process succeeds or fails.

METHOD: Using a grounded theory approach, semistructured interviews were conducted with 20 residents. Constant comparative analysis for emergent themes was conducted.

RESULTS: All residents identified aspects of "engagement" in the ITER process as the dominant influence on the success of ITERs. Both external (evaluator-driven, such as evaluator credibility) …

Interprofessional Communication And Medical Error: A Reframing Of Research Questions And Approaches, Lara Varpio, Pippa Hall, Lorelei Lingard, Catherine Schryer

Lorelei Lingard

Progress toward understanding the links between interprofessional communication and issues of medical error has been slow. Recent research proposes that this delay may result from overlooking the complexities involved in interprofessional care. Medical education initiatives in this domain tend to simplify the complexities of team membership fluidity, rotation, and use of communication tools. A new theoretically informed research approach is required to take into account these complexities. To generate such an approach, we review two theories from the social sciences: Activity Theory and Knotworking. Using these perspectives, we propose that research into interprofessional communication and medical error can develop better …

Point-Of-Care Assessment Of Medical Trainee Competence For Independent Clinical Work, Tara Kennedy, Glenn Regehr, G. Baker, Lorelei Lingard

Lorelei Lingard

BACKGROUND: Clinical supervisors make frequent assessments of medical trainees' competence so they can provide appropriate opportunities for trainees to experience clinical independence. This study explored context-specific assessments of trainees' competence for independent clinical work.

METHOD: In Phase One, 88 teaching team members from internal and emergency medicine were observed during clinical activities (216 hours), and 65 participants completed brief interviews. In Phase Two, 36 in-depth interviews were conducted using video vignettes. Data collection and analysis employed grounded theory methodology.

RESULTS: Supervisors' assessments of trainee trustworthiness for independent clinical work involved consideration of four dimensions: knowledge/skill, discernment of limitations, truthfulness, and …

Grounded Theory, Mixed Methods, And Action Research, Lorelei Lingard, Mathieu Albert, Wendy Levinson

Lorelei Lingard

No abstract provided.

Critically Appraising Qualitative Research, Ayelet Kuper, Lorelei Lingard, Wendy Levinson

Lorelei Lingard

No abstract provided.

Mental Health Services Research & Policy Collection: Arl Collection Initiative, Phyllis Ruscella, Ardis Hanson, John Abresch, Claudia Dold

Ardis Hanson

An ARL-level mental health services research and policy collection will support, not only the international and national goals of improving mental health; it also positions USF (USF) within the renowned health services research community, becoming peers with other major university health services research centers. The further development of the mental health services research and policy collections, with the foci on disaster mental health and vulnerable populations and the improved access to related mental health services research grey literature, directly supports USF’s stated goals. It expands the university’s capacity for world-renowned interdisciplinary research. It supports globally competitive undergraduate, graduate, and professional …

Know When To Rock The Boat: How Faculty Rationalize Students' Behaviors, Shiphra Ginsburg, Lorelei Lingard, Glenn Regehr, Kathryn Underwood

Lorelei Lingard

BACKGROUND: When faculty evaluate medical students' professionalism, they make judgments based on the observation of behaviors. However, we lack an understanding of why they feel certain behaviors are appropriate (or not).

OBJECTIVE: To explore faculty's reasoning around potential student behaviors in professionally challenging situations.

DESIGN: Guided interviews with faculty who were asked to respond to 5 videotaped scenarios depicting students in professionally challenging situations.

SUBJECTS: Purposive sample of 30 attending Internists and surgeons.

APPROACH: Transcripts were analyzed using modified grounded theory to search for emerging themes and to attempt to validate a previous framework based on student responses.

RESULTS: Faculty's …

Biomedical Scientists' Perception Of The Social Sciences In Health Research, Mathieu Albert, Suzanne Laberge, Brian Hodges, Glenn Regehr, Lorelei Lingard

Lorelei Lingard

The growing interest in interdisciplinary research within the Canadian health sciences sector has been manifested by initiatives aimed at increasing the involvement of the social sciences in this sector. Drawing on Bourdieu's concept of field and Knorr-Cetina's concept of epistemic culture, this study explores the extent to which it is possible for the social sciences to integrate into, and thrive in, a field in which the experimental paradigm occupies a hegemonic position. Thirty-one semi-structured interviews were conducted to explore biomedical scientists' receptiveness toward the social sciences in general and to qualitative research in particular. We found that these respondents exhibited …

Catalyzing And Sustaining Communities Of Collaboration Around Interprofessional Care: An Evaluation Of Four Educational Programs, Eileen Egan-Lee, Elisa Hollenberg, Dale Dematteo, Stasey Tobin, Ivy Oandasan, Mary-Agnes Beduz, Debbie Kwan, Karen Leslie, Jacques Lee, Maria Tassone, Jane Merkley, Lorelei Lingard, Lynne Sinclair, Mandy Lowe, Danny Nashman, Cate Creede, Doreen Day, Ivan Silver, Scott Reeves

Lorelei Lingard

No abstract provided.

Health Hazard Manual For Firefighters, Nellie J. Brown

Nellie J. Brown, MS., C.I.H.

[Excerpt] Firefighters, as well as victims, can be exposed to a variety of toxic substances during a fire. Some of these toxicants are particularly insidious because they are produced by thermal decomposition before smoke makes a fire evident.

Designing A Successful Pbrn In Public Health: Key Concepts, Glen P. Mays, Sharla A. Smith

Glen Mays

Successful public health practice-based research networks (PBRNs) will require organizational, financial, and intellectual resources that allow practitioners and researchers to mount relevant studies in real-world public health settings. This brief outlines characteristics likely to be important to the success of public health PBRNs, based on the experience of PBRNs in other practice settings

Finding Order In Complexity: A Typology Of Local Public Health Delivery Systems, Glen Mays

Glen Mays

Public health decision-makers and researchers currently lack an evidence-based framework for describing, classifying, and comparing public health delivery systems based on their organizational components, operational characteristics, and division of responsibility. Related typologies developed in the health services sector have proven extremely valuable for policy and administrative decision-making as well as for ongoing research. Performance assessment, quality improvement, and accreditation activities are now blossoming in public health—adding urgency to the need for classification and comparison frameworks. This brief describes a newly-developed empirical typology for local public health systems and highlights its policy and managerial applications.

The Rhetoric Of Patient Voice: Reported Talk With Patients In Referral And Consultation Letters, Marlee Spafford, Catherine Schryer, Lorelei Lingard

Lorelei Lingard

Referral and consultation letters are written to enable the exchange of patient information and facilitate the trajectory of patients through the healthcare system. Yet, these letters, written about yet apart from patients, also sustain and constrain professional relationships and influence attitudes towards patients. We analysed 35 optometry referral letters and 35 corresponding ophthalmology consultation letters for reported 'patient voice' coded as 'experience' or 'agenda' and we interviewed 15 letter writers (eight optometry students, six optometrists, and one community ophthalmologist). There were 80 instances of reported 'patient voice' in 35 letters. The majority (68%) of the instances occurred in referral letters, …

Sampling-Based Approach To Determining Outcomes Of Patients Lost To Follow-Up In Antiretroviral Therapy Scale-Up Programs In Africa, Elvin H. Geng

Elvin H Geng

No abstract provided.

Reducing Adolescents' Perceived Barriers To Treatment And Increasing Help-Seeking Intentions: Effects Of Classroom Presentations By General Practitioners., Coralie J. Wilson

Coralie J Wilson

The Building Bridges to General Practice (BBGP) program is an outreach initiative (written by the first author). It aims to reduce young peoples’ perceived knowledge- and belief-based barriers to engaging in treatment and to increase their behavioral intentions to consult a general medical practitioner (GP) for physical and psychological problems. By increasing intentions, the BBGP program aims to increase actual consultations with a GP for both types of problem. The current paper is the first of a series that report results from a larger multi-cite research project, developed and led by the first author, which examines the impact of BBGP …

Reducing Adolescents' Perceived Barriers To Treatment And Increasing Help-Seeking Intentions: Effects Of Classroom Presentations By General Practitioners., Coralie J. Wilson

Frank Deane

The Building Bridges to General Practice (BBGP) program is an outreach initiative (written by the first author). It aims to reduce young peoples’ perceived knowledge- and belief-based barriers to engaging in treatment and to increase their behavioral intentions to consult a general medical practitioner (GP) for physical and psychological problems. By increasing intentions, the BBGP program aims to increase actual consultations with a GP for both types of problem. The current paper is the first of a series that report results from a larger multi-cite research project, developed and led by the first author, which examines the impact of BBGP …

Cancer Disparities Among American Indians And Alaska Natives, Lisa M. Lines

Lisa M. Lines

The burden of cancer on AIAN patients is a complicated one. The low incidence rates among AIANs may be more a reflection of the low screening rates than a true lack of incident cancers in this population, and while death rates are related to incidence, 5-year survival rates are more related to stage at detection and receipt of treatment. The cancer burden is more severe for AIAN patients in part because of barriers to access, including financial, cultural, and geographic factors. Although some efforts have been made to address these disparities, a critical lack of studies and data hampers efforts …

Escalating Levels Of Access To In-Hospital Care And Stroke Mortality., Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Stroke Outcome In Those Over 80: A Multicenter Cohort Study Across Canada., Gustavo Saposnik

Gustavo Saposnik

No abstract provided.