Anonymous Responses Research Articles

Abstract 194: Public Perception Towards Out-of-Hospital Cardiac Arrest Victims: Potential Reasons Influencing the Decision to Perform Bystander Cardiopulmonary Resuscitation

Background: Bystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest (OHCA) improves survival and neurological outcomes. Unfortunately many OHCA victims do not receive bystander CPR during a witnessed arrest. It is known that gender disparities play a role with lower rates of bystander CPR in women suffering OHCA in public places. Our aim was to identify potential factors influencing the decision to perform bystander CPR. Methods: Participants at CPR training events were surveyed prior to training. Using different scenarios, subjects were asked about their comfort level performing CPR on female, geriatric, and pediatric victims. Anonymous responses were collected and transformed into categorical variables by a psychometrist. Results: Of the 677 participants, 585 (86.4%) responded the survey, with 87.5% between 18-29 years of age, 58.8% without prior CPR training and 93.3% without prior CPR experience. Reasons to hesitate starting bystander CPR in women included concern about exposing the victim (12.9%), being accused of sexual assault (6.1%), and possible pregnancy (6.5%). In participants with prior CPR training, 61.1% reported concerns about performing CPR on women, with 18.9% having concerns about performing chest compressions in relation to breast location. In participants without prior CPR training, 73.2% reported having concerns about performing CPR on women. Causing injury and exposing the patient were top concerns to perform CPR in women amongst participants who were uncomfortable (30.5% and 17.5% respectively) and comfortable (14.5% and 9.8% respectively) performing CPR in public. Causing injury was the top concern in performing CPR on geriatric (45.4%) and pediatric patients (41.7%), followed by fragility (18.1% and 10.2% respectively). Lack of skills to perform CPR on children was reported in 22% of CPR-trained participants. Conclusion: Public perception of OHCA victims influences willingness to perform bystander CPR. Factors such as age, gender, fear of injury, pregnancy status and sexual assault concerns can negatively impact this life saving intervention. Awareness of the importance of bystander CPR on any cardiac arrest victim must be improved.

Communication Skills Training for Surgical Inpatient Advanced Practice Providers in an Academic Health-Care System.

Background:Good communication skills enhance the patient experience, clinical outcomes, and patient satisfaction.Objective:A course was developed by an interdisciplinary team (surgeon, nurse practitioner, and nurse MBA) for advanced practice providers (APPs) working for the department of surgery—a mix of practice and hospital-employed professionals—to enhance communications skills in an inpatient setting.Methods:Current concepts on provider–patient communication were discussed. Participants also asked to view and critique a video “provider–patient communication gone wrong” scenario. Lastly, participants were provided with techniques for improving provider–patient communication. The participants assessed the course. Provider communication scores were tracked from quarter 1, Fiscal Year 2014 to quarter 4 Fiscal Year 2017.Results:Of 110 eligible APPs, 95 (86%) attended the course. The anonymous survey response rate was 90% (86/95). Participants expressed satisfaction with the course content confirmed by Likert score weighted averages of >4.6/5 in all 8 domains. Communication scores increased with time.Conclusion:An interdisciplinary course aimed at enhancing provider–patient communication skills was well-received by the APP participants. The course was part of ongoing system-wide efforts to improve patient experiences, satisfaction, and outcomes. Continuing education in communication continues to play a key role in improving clinical outcomes and patient satisfaction.

ОСОБЛИВОСТІ ЗДОРОВ’ЯЗБЕРІГАЮЧОЇ ПОВЕДІНКИ ТА САМООЦІНКИ ЗДОРОВ’Я СТУДЕНТСЬКОЇ МОЛОДІ

Мета: на прикладі студентів-медиків оцінити особливості здоров’язберігаючої поведінки та самооцінки їх здоров’я.Матеріали і методи. Проведено оцінку здоров’язберігаючої поведінки студентської молоді на основі аналізу 242 анкетних відповідей студентів V–VI курсів, які навчаються за спеціальністю «Медицина». Використано методики: статистично-математичний, аналіз анкетних даних, аналітико-логічний.Результати. Отримані дані вказують на наявність порушень у здоров’ї студентської молоді, незважаючи на високу самооцінку щодо стану свого здоров’я. Дані відхилення розвиваються в результаті низки таких факторів, як академічне навантаження, індивідуальні особливості ставлення до власного здоров’я, самолікування, поведінкові ризики (куріння, алкоголь), нераціональне харчування.Висновки. Проведене дослідження показало, що існує потреба у вдосконаленні існуючих медико-­соціальних заходів щодо збереження здоров’я студентської молоді – потенціалу нашого суспільства.

Assessing the Impact of a Professional Development Program for Physician Assistant Program Directors.

The growth of physician assistant (PA) programs nationally has stretched the available capacity of experienced PA program directors. To address this need, a professional developmental program was designed to provide new program directors with the knowledge, skills, and resources necessary to succeed in the role. This study sought to characterize the impact of program attendance over time. Data were collected from individuals representing 5 cohorts that participated in the annual Physician Assistant Education Association New Program Directors Retreat between 2011 and 2015. An electronic survey was developed and sent to all 5 cohorts (n = 139). Anonymous responses were collected and quantitative data were analyzed in the aggregate and also by year of participation. Qualitative data were analyzed, and a thematic analysis was conducted. Results were compared with baseline data collected during the program registration process and with published national data on program director characteristics. Seventy-five program participants completed the survey, for a response rate of 57%. Program director stability, educational achievement, and involvement in leadership and service activities were found to be positive outcomes for individuals who had participated in the professional development program. Survey respondents reported positive outcomes after attending a professional development program; these outcomes are consistent with research on similar programs published in the literature. Our findings suggest that new program directors who participated in this professional development program not only derived career-stabilizing benefits but also succeeded in creating supportive peer networks while gaining greater confidence in their new academic role.

Detailed Findings From the CLER National Report of Findings 2018.

Detailed Findings From the CLER National Report of Findings 2018.

Connecting Personal Experiences of Loss and Professional Practices in Advance Care Planning and End-of-Life Care: A Survey of Providers.

Although practitioners overwhelmingly agree on the importance of advance care planning (ACP) and preparing for the end of life (EOL), the process is fraught with barriers. The goal of this research was to explore potential connections between providers' own personal experiences and current professional practices in ACP and EOL care. A cross-sectional survey design, gathering voluntary, anonymous responses from participants between August and December 2016. The survey sought information from providers in 3 distinct areas: (1) personal experiences of loss, (2) personal ACP, and (3) professional practices related to ACP and EOL care. One hundred and ninety health-care professionals (primarily physicians, nurses, and social workers) participated in the survey across a greater, Metropolitan area in the Midwest. Questions for professional practices were subscales from the End-of-Life Professional Caregiver Survey: Patient- and Family-Centered Communication (PFCC) and Effective Care Delivery (ECD). Questions developed by the research team were evaluated by judges chosen for clinical and/or research expertise. Numerous connections were found between professionals' histories of loss, personal ACP, and professional practices. For example, both clinicians with personal experience caring for someone who is dying and clinicians who had completed their own ACP scored higher in both PFCC and ECD and were more likely to refer patients to hospice and palliative care. Results support educational interventions involving opportunities for reflection and completion and communication about ACP. Additionally, educational opportunities for students in health care should focus on incorporating both ACP and greater exposure to hospice and palliative care.

Systemic barriers in substance use disorder treatment: A prospective qualitative study of professionals in the field

BackgroundThe US is in the midst of one of the largest public health crises in recent history with over 63,000 drug poisoning deaths in 2016 and a projected annual economic cost of over $420 billion. With the rise of deaths and economic burden related to substance use, it is paramount that systemic barriers within the treatment industry be identified and resolved. MethodsData were collected from US substance use treatment professionals (N = 182) in the fall of 2016. Thematic analysis with axial coding was used on anonymized responses to an online open-ended survey. Additional ad hoc testing for variance (education, generation, regional location, and employment) was completed using Monte Carlo chi-square analyses. Results7 major themes emerged: 1) additional training, education, and use of evidence-based practices, 2) expansion of treatment services, 3) increased resources, 4) stigma reduction, 5) increased collaboration and leadership, 6) reductions in regulations, requirements, and incentives, and 7) expansion of recovery support services. Participant response yielded a significant relationship between employment type (p = 0.002) and regional location (p = 0.046). ConclusionsSystemic barriers in the treatment field are prevalent from the perspective of professionals engaged in the field. While previously identified barriers are still present, newly reported barriers include: 1) lack of treatment services (e.g., capacity), 2) lack of technological resources (e.g., technological support tools), 3) lack of recovery support services (e.g., recovery housing), 4) lack of collaboration and leadership (e.g., communication and partnership), and 5) increasing unethical practices in the field (e.g., incentive-based patient brokering).

Workplace incivility, psychological distress, and the protective effect of co-worker support

PurposePrevious in-depth focus groups found that postal workers employed by a crown corporation in Canada identified a lack of respect in the workplace. A lack of respect or discourteous behavior might be better understood as a phenomenon of workplace incivility. The purpose of this paper is to report a larger cross-sectional survey to determine: the magnitude of workplace incivility among Canadian postal workers; any association between incivility and indicators of worker well-being; and, the potential buffering benefits of social support from co-workers.Design/methodology/approachQuestionnaire packages were mailed to nearly 2,000 employees of Canada Post Corporation, asking for anonymous responses to questions about their job, demographics, satisfaction and commitment, treatment in the workplace, and well-being.FindingsMore than 82 percent of 950 respondents reported at least some workplace incivility. After controlling for demographic and work factors, incivility explained significant variation in worker burnout, anxiety, depression, and hostility (i.e. adjusted R2 values ranged from 5 to 46). In addition, the association between incivility and worker anxiety, depression, and hostility was reduced when workers reported greater social support from co-workers.Research limitations/implicationsIncivility is more than just a minor or infrequent source of psychological distress for people working in service. However, a positive outcome is that co-worker support helps reduce the adverse effects of rude and discourteous behavior.Originality/valueTo our knowledge, this was the first large-scale survey exploring workplace incivility in the public postal service. The data from a large sample of postal workers across Canada suggest that the treatment of employees is an ongoing problem at this organization. This research is relevant for understanding workplace interactions and health in the service sector in Canada, though the authors expect it is germane also to other occupations worldwide.

Barriers to participation in clinical trials: a physician survey.

Clinical trials are vital for evidence-based cancer care. Oncologist engagement in clinical trials has an effect on patient recruitment, which in turn can affect trial success. Identifying barriers to clinical trial participation might enable interventions that could help to increase physician participation. To assess factors affecting physician engagement in oncology trials, a national survey was conducted using the online SurveyMonkey tool (SurveyMonkey, San Mateo, CA, U.S.A.; http://www.surveymonkey.com). Physicians associated with the Canadian Cancer Clinical Trials Network and the Canadian Cancer Trials Group were asked about their specialty, years of experience, barriers to participation, and motivating interventions, which included an open-ended question inviting survey takers to suggest interventions. The survey collected 207 anonymous responses. Respondents were predominantly medical oncologists (46.4%), followed by radiation oncologists (24.6%). Almost 70% of the respondents had more than 10 years of experience. Significant time constraints included extra paperwork (77%), patient education (54%), and extended follow-up or clinic visits (53%). Timing of events within trials was also a barrier to participation (55%). Most respondents favoured clinical work credits (72%), academic credits (67%), a clinical trial alert system (75%), a regular meeting to review trial protocols (65%), and a screening log to aid in patient accrual (67%) as motivational strategies. Suggested interventions included increased support staff, streamlined regulatory burden, and provision of greater funding for trials and easier access to ancillary services. The present study confirms that Canadian oncologists are willing to participate in clinical research, but face multiple barriers to trial participation. Those barriers could be mitigated by the implementation of several interventions identified in the study.

Needle electromyography practice patterns in patients taking novel oral anticoagulants: A survey‐based study

This study sought to evaluate needle electromyography (EMG) practice patterns among electromyographers with patients taking novel oral anticoagulants (NOAC). A survey questionnaire was sent to members of the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) via email web link. Anonymous survey responses were collected through an online website. Fifty-eight AANEM members responded, 28 (48%) of whom worked at a teaching hospital and 30 (52%) of whom worked in a private setting. Fifty-four (93%) responders perform needle EMG on patients taking NOACs. Twenty-nine (50%) responders examine paraspinal muscles, and 20 (40%) responders examine facial muscles. Among 14 responders who perform single-fiber EMG (SFEMG), 8 examine patients taking NOACs. Although most of the electromyographers perform needle EMG on patients taking NOACs, they reported variable practice patterns in examination of the paraspinal and facial muscles and in performing SFEMG. A prospective risk-benefit study is required. Muscle Nerve 58: 307-309, 2018.

Use of integrated clinical trial protocols - Asurvey in early medicines development .

Purpose: To collect information on the use of integrated protocols in early clinical medicines development. Materials and methods: The questionnaire was mailed in fall 2014 to members of human pharmacology societies in Europe for anonymous responses via the online tool SurveyMonkey®. Results: 97 respondents reported on 164 integrated protocols overall. In general, integrated protocols comprised 2 or 3 trial elements. One third of integrated protocols involved patients. The most frequent trial elements were single dose, multiple dose, and food effect. Drug-drug interaction, age, gender, and relative/absolute bioavailability were less common elements. Ethnic bridging and mass balance were mentioned in single cases. Out of the entire spectrum of reported trial element combinations, single (ascending) dose plus multiple (ascending) dose was most frequent (90/164 protocols, 55%); 84% of integrated protocols used adaptive elements. 29%, 17%, and 8% of integrated protocols required 1, 2, or 3 substantial amendments, respectively. Based on 118 protocols, competent authority approval was granted to 100, deficiency letters were issued 15 times and approval was refused in 3 cases. Conclusion: The use of integrated protocols is common practice in early medicines development. Most often single ascending dose and multiple ascending dose were the trial elements combined in one integrated protocol. Perceived main advantages were gain in time and reduced costs. Perceived main disadvantage was increased complexity.

Practice Pattern of Fresh Gas Flow and Volatile Agent Choices among Anesthesiologists Working in Different Indian Hospitals: An Online Survey.

Background:Fresh gas flow (FGF) during volatile inhalational agent-based anesthesia is a concern for many reasons. Advancement in anesthesia workstation (WS) and monitoring of anesthesia gas concentrations has led to the feasibility of lower flow safely. However, the practice pattern is not yet well known. The information can help us in better protocol formation.Aim:The survey was aimed to know the prevailing practice pattern of FGF and volatile agent choices and compare them among anesthesiologists of different working setups and experiences.Materials and Methods:With approval, the present cross-sectional survey was conducted using SurveyMonkey® software from January 2018 to May 2018. Anesthesiologists working in different organizations across India were approached through E-mail and WhatsApp. Anonymous responses were collected, expressed in number and percentage scale, as well as compared using INSTAT software and appropriate tests; P < 0.05 was considered statistically significant.Results:A total of 251 (15.2%) responses were received and 249 were analyzed. Overall, 87% of respondents were using anesthesia WS and 71% were using nitrous oxide as balance gas. The FGF of <600 mL/min was highest with desflurane. Minimum alveolar concentration (MAC) monitoring was very poor in nonteaching (NT) hospitals as compared to teaching hospitals; P < 0.0001. The Boyle's machine was more common in use in NT hospitals as compared to medical colleges and corporate hospitals; P < 0.0001.Conclusion:Low-flow anesthesia (LFA) use is still suboptimal, and there are ample opportunities to increase and optimize the FGF used. The use of Boyle's machine is associated with higher flow use. MAC monitoring and LFA use are poor in NTs.

Professional identity of Hungarian psychiatrist. Experiences of a study

A main determinant of professional identity is the integrity of the discipline. The complexity of psychiatry in biological, psychological and sociological aspects is a typical instance of the necessity for integration. Based on the bio-psycho-social dimensions and on their opinion about acceptance of psychiatry, we explored the professional identities of physicians working in Hungarian contemporary psychiatry. Voluntary, anonymous responses were collected by using a 10-point evaluation scale on professional attitude, appreciation of psychiatry from lay society and other medical professions, and the importance of biology, psychology and sociology within psychiatry. The 228 respondents showed a highly significant effect of basic sciences: biology was the most relevant followed by psychology and sociology. Specialists in psychiatry (n = 171) showed a more marked preference for biology than the trainees, while specialists in psychotherapy (n = 74) considered the psychological component significantly more important than other respondents. The public acceptance of psychiatry was low as compared with other medical professions. The consistency between self-image and profession shows that the multidimensionality of psychiatry is not primarily an individual challenge. The impact on identity shows the key importance of education. Improving the prestige of psychiatry requires keeping our professional identity up-to-date, communicating with physicians with different preferences, and cooperating with other medical professions. Orv Hetil. 2018; 159(2): 58-63.

Gulf cooperation council female residents in orthopedics: Influences, barriers, and mental pressures: A cross-sectional study

Objectives: There is insufficient data about female orthopedic residents in the Gulf Cooperation Council (GCC) region. This study was performed to survey what influences females to take up orthopedics, and the barriers, mental pressures, and obstacles they face while a resident in training. Methods: This is a cross-sectional study, which was conducted using an online self-reported validated questionnaire. Our population consisted of 569 orthopedic trainees who met our inclusion criteria, and we received 254 anonymous responses (44.6%). Results: The response rate was 78.7% for females (37 out of 47 total females who were sent the questionnaire) and 41.6% for males (217 out of 522 total number of males). The gender distribution of those who responded was 14.6% (n=37) females and 85.4% (n=217) of males. Around half of the females (48.6%) in the study decided to join orthopedic programs during their undergraduate studies. The majority of female residents (75.7%) agreed that orthopedics is physically tiring and 89.2% of them agreed that there are gender intolerances. The need to increase the number of female residents was another notion shared by 86.5% of them. On the contrary, 62.2% of the male responders disagreed to the need of increasing the female orthopedic residents and 34% were with the opinion that female residents are not fit to cover on-call duties. Conclusion: Gender intolerances exist in the GCC orthopedic programs. This might discourage female physicians from pursuing orthopedic careers. All of the concerns raised by the residents are adjustable and attainable, such as offering maternity leaves, encouraging positive behavioral changes in male surgeons, and providing equal opportunities for applicants to orthopedic boards' acceptance.

Digital Socialization? An Exploratory Sequential Analysis of Anonymous Adolescent Internet-Social Interaction

This paper applies “extensive sequential analyses” as described by Oevermann in 1996 to a personal account posted on the MTV website A Thin Line (ATL), to the respective anonymous responses posted by account readers and to the website as the pragmatic framework of this interaction. This analysis shows that interactive websites are understood as social spaces where one can find a counterpart for intimate, socialization-relevant interaction. This means that a large amount of confidence is placed in the Internet and social media to provide new possibilities for the discussion of central personal life issues. Beyond the reconstruction of this transformation of social reality, this analysis enables the quality of this interaction that competes with traditional socialization contexts to be judged. P, a 17-year-old girl, is able to control the communication of her private problems in a new way through the use of digital interaction structures, filtering the interaction. The anonymous counterparts are assured by the character limits that they only have to participate superficially and without any major involvement. In the case of traditional instances of socialization, such an unattached and filtered interaction is already an expression of its failure. The Internet-based interaction analyzed here lacks key qualities of socialization interaction.

Research misconduct is common among Middle East scientists, new study shows

Research misconduct is a serious problem in the Middle East, a survey of academic scientists there shows. Nearly 60% of respondents reported committing at least one breach of research ethics, and almost 75% said they knew of similar problems among their colleagues. “Scientific misconduct represents a significant issue in several universities in the Middle East,” the paper says. Previous studies have found that misconduct is common in the U.S., Europe, and beyond. However, this is the first examination of the problem in the Middle East, the authors say. They analyzed anonymous responses from 278 investigators at universities in three countries: Egypt, Lebanon, and Bahrain (J. Acad. Ethics 2017, DOI: 10.1007/s10805-017-9295-9). The most common type of misconduct was circumventing research ethics regulations, followed by fabrication and falsification of data. Faculty were less likely to have committed misconduct than students and postdocs. Lack of ethics training was a significant predictor of misconduct.

The influence of Organizational Image on Academic Success for International Students

Image as a concept that develops through personal, environmental, cultural, and organizational factors throughout history. Organizational image is the overall evaluation of people’s views regarding an organization or system. The purpose of present study was to determine the relationship between international university students’ academic achievement and perceived organizational image. As this is a descriptive research for it measures the image perceptions of the participants at a single time, quantative research methods were used. The population of the research was 2208 international students at Uludag University in Bursa. Randomly selected 1718 students (%77.8) who provided anonymous responses were the sample of the study. To examine the relation between organizational image and academic achievement, correlation analysis was used. To control the effect of the organizational image on the academic achievement regression analysis was used. Students’ academic achievement was mostly affected by reputation and recognition, provided services and general view and physical infrastucture at moderate level. As the students' image perception towards the university increases, their acdemic success also increase. Perceived organizational image affected students’ academic achievement significantly and explained 16% of the variance of academic achievement. General view &amp;physical infrastructure provided services, reputation and recognition, and extra curricular activities from the sub-dimensions of organizational image perception have a meaningful effect on the academic success of students. Key findings are discussed and recommendations offered to address issues related to organizational image.

Practice patterns in the management of post-tonsillectomy hemorrhage: An American Society of Pediatric Otolaryngology survey

ObjectivesTo evaluate practice patterns amongst pediatric otolaryngologists in the management of post-tonsillectomy hemorrhage. MethodsA cross-sectional survey of the American Society of Pediatric Otolaryngology membership was administered electronically. The survey contained questions related to practice type, availability of resident and fellow call coverage, and management of different scenarios of post-tonsillectomy hemorrhage. Anonymous responses were collected and tabulated. ResultsThe response rate was 157/443 (35%). For patients presenting with a convincing history of post-tonsillectomy hemorrhage but no clot or bleeding on exam, the most common management was overnight observation (55%) or discharge home with close follow-up (29%). In patients presenting with tonsillar clot but no active bleeding, the most common management was operating room for control (50%), followed by observation (25%) and bedside topical treatment (13%). In the same scenario with a cooperative teenager, bedside topical treatment was most common (45%), followed by operating room for control (27%) and observation (16%). In patients presenting with active tonsillar bleeding, operating room for control was most common (83%) while few (6%) attempted bedside treatment. If the patient was a cooperative teenager, 38% attempted bedside treatment while 52% would still go to the operating room. ConclusionsThere is substantial variation in the management of post-tonsillectomy hemorrhage amongst the pediatric otolaryngologists. Further studies to determine outcomes associated with differing treatment strategies would be useful in establishing practice recommendations.

Analysis of tourism and hospitality sustainability education with co-competition creativity course planning

Recently, with the increasing awareness of the importance of environmental protection, a critical need for tourism and hospitality education on sustainability has been widely recognized. This study adapts a pedagogical co-competition strategy, creative problem solving (CPS) and Abbreviated Torrance Tests of Creative Thinking for accurately measures creativity to predict the influences of the learning environment. Questionnaires were collected, with 196 effective anonymous responses from tourism and hospitality students. The results show that co-competition course design may encourage students’ critical thinking regarding sustainability and increase student creativity, which should be promoted as a useful tool in sustainability education in the future.

Do Patients Understand the Role of Resident Physicians in the Operating Room? A Survey of Gynaecology Patients

ObjectiveStudies from disciplines outside gynaecology have found that most patients do not understand the clinical responsibilities allocated to physicians-in-training. No research on this topic has been published in gynaecology, despite litigation against gynaecological surgeons regarding the role of residents in surgery. The goal of this research was to explore what gynaecological surgery patients understand about the role of resident doctors. MethodsA questionnaire was distributed to female patients in gynaecological surgery pre-admission clinics in Edmonton, Alberta. Surveys included knowledge and opinion statements about residents' duties. Anonymous responses were entered into a secure database. Descriptive statistics were used to characterize the results. ResultsOf 108 participants, 83% understood that residents had a higher level of training than medical students, yet 40% were unsure whether residents were doctors. Almost one half (43%) of participants were uncertain whether residents required supervision, including while operating (20%). Most (92%) believed it was important to know their physician's level of training, yet only 63% reported knowing this information. Only 50% of participants would be comfortable with residents operating on them under supervision. A considerable number (56%) wanted to learn more about residents' roles. ConclusionPatients do not fully understand the role of residents, and many are uncomfortable with trainees operating on them under supervision. Considering the significant role of residents in patient care, educating patients is essential to improve their comfort and the overall consent process.