Medicine and Health Sciences Commons^™

Interprofessional Information Work: Innovations In The Use Of The Chart On Internal Medicine Teams, Lorelei Lingard, Lesley Conn, Ann Russell, Scott Reeves, Karen-Lee Miller, Chris Kenaszchuk, Merrick Zwarenstein

Lorelei Lingard

An abundance of evidence suggests that communication in interprofessional healthcare teams is a complex endeavour. Even relatively simple communication processes involving information work - the gathering, storage, retrieval and discussion of patient information - may be fraught with pitfalls, and yet teams manage to conduct their daily information work, often with a high degree of effectiveness. In this article, we explore one commonplace dimension of information work - the use of patient charts to foster collaborative decision-making and care enactment - towards building an elaborated understanding of how teams innovate in the face of daily complexities in their information work …

Co-Management In Healthcare: Negotiating Professional Boundaries, Catherine Schryer, Olga Gladkova, Marlee Spafford, Lorelei Lingard

Lorelei Lingard

This article investigates discursive practices associated with the co-management of patients between healthcare providers. Specifically, we focus on two genres (38 referral letters and 37 consultant reports) written by optometrists and ophthalmologists — two groups who are experiencing interprofessional tension over their scopes of practice. In our analysis we foreground four kinds of modality associated with verbs — epistemic, deontic, phatic and subjective. We found that these healthcare providers shared in the epistemic resources used to hedge their sense of clinical certainty, and that ophthalmologists used deontic resources to control future action. However, we also noted that both professions used …

Qualitative Research In The Rime Community: Critical Reflections And Future Directions, Lorelei Lingard

Lorelei Lingard

No abstract provided.

Implementation Of The Intervention-Based Family Assessment Procedure: A Case Study, Jeanne Jenkins, Audrey Ellenwood

Jeanne E. Jenkins

Chronic illness is a worldwide phenomenon impacting the emotional stability and daily functioning of families across cultures. Families with a chronically ill member are in need of interventions and therapy, yet, time constraints and care-taking demands make it difficult for families to seek traditional family therapy services. The objectives of this article are to (1) overview the Intervention-Based Family Assessment Procedure (IBFA) and (2) present a case vignette demonstrating the implementation of the procedure. The IBFA is an effective diagnostic tool and intervention strategy to help family therapists alter the dysfunctional and rigid structural dynamics of families with a chronically …

Questioning Competence: A Discourse Analysis Of Attending Physicians' Use Of Questions To Assess Trainee Competence, Tara Kennedy, Lorelei Lingard

Lorelei Lingard

BACKGROUND: Attending physicians (APs) must constantly assess trainees' competence to act independently, to promote learning while ensuring quality of care. This study aimed to explore, through discourse analysis of case presentations, the process of competence assessment for case-specific clinical independence.

METHOD: Twenty-six case presentations in emergency medicine were observed and audiorecorded. A discourse analysis was conducted, focusing on APs' use of questioning strategies.

RESULTS: Questioning strategies involved clarifying questions (to ensure APs' understanding of the case), probing questions (to probe trainees' understanding of a case or their underlying knowledge), and challenging questions (to challenge presuppositions). Case-related probing questions and challenging …

Seeing And Listening: A Visual And Social Analysis Of Optometric Record-Keeping Practices, Lara Varpio, Marlee Spafford, Catherine Schryer, Lorelei Lingard

Lorelei Lingard

This article investigates the contribution visual rhetoric and rhetorical genre studies (RGS) can make to health care education and communication genres. Through a visual rhetorical analysis of a patient record used in an optometry teaching clinic, this article illustrates that a genre's visual representations provide significant insights into the social action of that genre. These insights are deepened by an insider analysis of the patient record that highlights how content analyses of visual designs need to be elaborated by contextual considerations. A combined visual rhetoric and RGS analysis shows that clinical novices learn to interpret the record's visual cues to …

Assessment Of Indirect Cost-Of-Illness In A Subsistence Farming Society By Using Different Valuation Methods, Tin Su

Tin Tin Su

Indirect costs or productive labour time lost are the largest share of household economic burden of illness. However, the estimate of household indirect cost can vary depending on the valuation methods used. We therefore estimated household indirect cost in a subsistence farming society in Burkina Faso based on daily production value. These results were validated by using willingness-to-pay method and current wage rate. Among the three methods, the value of a day lost for adults assessed by willingness-to-pay method was considerably higher than other methods. There were no significant differences in indirect costs estimated by daily production value and wage …

Feminism And Profit In American Hospitals: The Corporate Construction Of Women's Health Centers, Jan Thomas

Jan Thomas

No abstract provided.

Healthcare Markets, The Safety Net, And Utilization Of Care Among The Uninsured, Carole Roan Gresenz, Jeannette Rogowski, Jose J. Escarce

Carole Roan Gresenz

No abstract provided.

Brief Report: Impact Of Classroom Presentations About Health And Help Seeking On Rural Australian Adolescents’ Intentions To Consult Health Care Professionals., Coralie J. Wilson

Frank Deane

Building Bridges-GP-Team (Building Bridges-Team; Wilson et al., 2004c) is a variation of the Building Bridges to General Practice: GPs in Schools program (Building Bridges-GP; Wilson et al., 2004a), which promotes consultation with health care professionals who are local and available for rural and regional adolescent’ consultation. The first major component of Building Bridges-GP-Team involves structured health professional training that provides knowledge in three basic areas: (1) adolescents’ help seeking barriers and ways to address barriers in primary health care; (2) developmental issues relevant to adolescent’ help seeking; and (3) classroom management, presentation strategies, and elementary teaching skills. Training is based …

Brief Report: Impact Of Classroom Presentations About Health And Help Seeking On Rural Australian Adolescents’ Intentions To Consult Health Care Professionals., Coralie J. Wilson

Coralie J Wilson

Building Bridges-GP-Team (Building Bridges-Team; Wilson et al., 2004c) is a variation of the Building Bridges to General Practice: GPs in Schools program (Building Bridges-GP; Wilson et al., 2004a), which promotes consultation with health care professionals who are local and available for rural and regional adolescent’ consultation. The first major component of Building Bridges-GP-Team involves structured health professional training that provides knowledge in three basic areas: (1) adolescents’ help seeking barriers and ways to address barriers in primary health care; (2) developmental issues relevant to adolescent’ help seeking; and (3) classroom management, presentation strategies, and elementary teaching skills. Training is based …

Depressive Symptoms And Help-Seeking Intentions In Young People., Coralie J. Wilson

Coralie J Wilson

Whether the help-negation effect as demonstrated for suicidal thoughts was also evident for depressive symptoms was investigated in three studies of young people from diverse urban areas. The studies comprised a large sample of younger high school students (years 7-10), a sample of older high school students (years 8-12), and first year university students. A self-report questionnaire that measured help-seeking intentions, prior help-seeking experiences, and depression was administered. Results revealed the strongest inverse association between level of depressive symptoms was with intentions to seek help from parents across all three samples. There was a consistent trend for students to report …

When And How Do Young People Seek Professional Help For Mental Health Problems?, Coralie J. Wilson

Coralie J Wilson

Despite the high prevalence of mental health problems and disorders that develop in adolescence and early adulthood, young people tend to not seek professional help. Young men and young people from Indigenous and ethnic minority groups tend to be those most reluctant to seek help. Young people are more inclined to seek help for mental health problems if they: have some knowledge about mental health issues and sources of help; feel emotionally competent to express their feelings; and have established and trusted relationships with potential help providers. Young people are less likely to seek help if they: are experiencing suicidal …

Weekends: A Dangerous Time For Having A Stroke?, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Hospital Volume And Stroke Outcome: Does It Matter?, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Technological Iatrogenesis: New Risks Force Heightened Management Awareness, Patrick Albert Palmieri

Patrick Albert Palmieri

Iatrogenesis is a term typically reserved to express the state of ill health or the adverse outcome resulting from a medical intervention, or lack thereof. Three types of iatrogenesis are described in the literature: clinical, social and cultural. This paper introduces a fourth type, technological iatrogenesis, or emerging errors stimulated by the infusion of technological innovations into complex healthcare systems. While health information technologies (HIT) have helped to make healthcare safer, this has also produced contemporary varieties of iatrogenic errors and events. The potential pitfalls of technological innovations and risk management solutions to address these concerns are discussed. Specifically, failure …