Free-text Questions Research Articles

The Impact of COVID-19 on the Division of Household Labor Among Women Physicians and Advanced Practice Providers.

COVID-19 increased the burden of childcare on parents, leaving women vulnerable to increased disparities in the division of domestic labor. Women healthcare workers may be at heightened risk of worsening gender parity in the workplace as a result. To examine the impact of the COVID-19 pandemic on gender parity in the division of household responsibilities among women healthcare workers. Cross-sectional survey assessing changes in the workplace and changes in the balance of domestic duties with partners via multiple open-ended and Likert-scale type questions. Data were analyzed descriptively, including thematic analysis of free-text responses. This survey study included 1459 women healthcare workers and 244 of their partners. Primary outcomes were levels of responsibility for domestic labor, including housework, childcare, and child education. Free-text questions focused on the impact of household responsibilities on the workplace. In total, 1459 healthcare workers identifying as women responded to this survey. Of them, 655 (45%) practice in an academic setting, and 1025 (70%) are physicians. Additionally, 244 self-identifying partners of women healthcare workers responded; the majority were men (204 [84%]), and over one-third (91 [38%]) work in healthcare. Among respondents overall, women reported doing most of the housework (52% of respondents [756/1459] versus 27% of partners [61/244]) and child education, compared with their partners (31% of respondents [451/1459] versus 23% of partners [55/244]). Thematic analysis of free-text questions revealed that women experienced worsened gender parity in the workplace because of increased household responsibilities. We observed significant gender-based disparities in the division of household labor among healthcare workers, with negative impacts on work performance, focus, and academic productivity. Our results support the notion that the COVID-19 pandemic worsened gender parity in the homes of healthcare workers, thus negatively affecting gender parity in the medical workplace.

Student and Physician Views of How the Dobbs Decision Affects Training and Practice Location Preferences: Cross-Sectional Questionnaire Study.

By allowing for abortion bans and restrictions to take effect in the majority of US states, the 2022 Dobbs v Jackson Women's Health Organization decision portends to have lasting impacts on patient care and the physician workforce. Notably, it is already beginning to impact practice location preferences of US health care workers, evidenced by declining application rates to residency programs in abortion-restrictive states since 2022. Yet, there remains a gap in the literature regarding why this trend exists. This study aims to describe what factors are driving the practice location preferences of medical students and physicians after the Dobbs decision. This study analyzes qualitative data from a web-based, cross-sectional study. In August 2022, a nonprobabilistic sample of physicians and medical students were surveyed on social media about the impact of overturning Roe v Wade on practice location preferences, which included the free-text question "Please share your thoughts about the overturning of Roe v Wade and how it will affect your decision about your (residency/job or fellowship) programs." A total of 3 independent team members completed an inductive thematic analysis of 524 free responses, resolving differences by discussion. Approximately 1 in 4 survey respondents also completed the free-response item (524/2063, 25.4%); a total of 219 were medical students, 129 were residents and fellows, and 176 were practicing physicians. Of them, approximately half (261/524, 50.5%) resided in states where abortion bans were in place or anticipated. Those who answered the free-response item were relatively more likely to hail from states with restrictive abortion bans (P<.001) compared to those who did not, with other demographic characteristics being largely similar between the groups. Inductive thematic analysis yielded 2 broad thematic categories: patient-related and workforce-related factors influencing practice decision preferences. The 3 most common themes overall were respondent concerns regarding their patient's access to care (249/524, 47.5%), their desire not to practice or train in a state with abortion restrictions regardless of current residence (249/524, 47.5%), and their personal belief that abortion bans are human rights and/or body autonomy violation (197/524, 37.6%). Some respondents stated that the Dobbs decision would not impact their choice of practice location (41/524, 7.8%), and some supported it (35/594, 6.7%). This study shows that abortion restrictions are having an impact on the practice location preferences of the physician workforce due to both patient care and personal factors. It is important that state policy makers and others who are considering abortion restrictions also consider how to address these concerns of physicians and medical students, to avoid worsening geographic maldistribution of physicians and worsening access to care from physicians for their citizens.

Walking a mile in their shoes —How local politicians reason about trade-off decisions

ABSTRACT In times of increased financial constraints and ageing population, politicians must make difficult trade-off decisions that challenge their legitimacy in the eyes of the public. This is not least the case at local level where policy issues tend to be more immediate and comprehensible to individuals than policy decisions at the national level. Analysing originally collected responses from over 800 Swedish local politicians through free-text questions, we examine the perspectives of those responsible for making difficult trade-off decisions, as well as their strategies for generating public acceptance. Our findings show that politicians are prepared to make difficult trade-offs, but also that they expect the public to do their part by engaging in constructive dialogue and accepting reasonable justifications. The study thereby provides a practice-based understanding of the considerations of local politicians that can inform contemporary debates on democratic representation and the role of citizens in political decision-making.

Racial/Ethnicity Disparities in COVID-19 Worry for Caregivers of Adults With Intellectual and Developmental Disabilities.

This study investigated the racial/ethnic differences in COVID-19-related worry amongst family caregivers of adults with intellectual and developmental disabilities (IDD) living in Texas using the COVID-Related Thoughts and Behavioral Symptoms-Adult Version (COV-TaBS-A) questionnaire. Two hundred and six caregivers completed the survey. Compared to White caregivers, Latino caregivers were more likely to be very concerned about having enough food and supplies (adj OR 3.41, 95% CI [1.50, 7.74]) when adjusting for being that sole caregiver and using provider services. In free text questions, caregivers described feeling overwhelmed by additional responsibilities, disruptions in home health services, and concerns about their loved ones' wellness. Study findings can be used to strategize support for caregivers of adults with IDD during pandemic/emergency situations.

Understanding the risk factors for student attrition across pre-registration nursing and midwifery programmes in a United Kingdom university: A sequential explanatory mixed methods study

BackgroundThe World Health Organization estimates a global shortage of 4.5 million nurses and 0.31 million midwives by 2030, which presents a significant problem for workforce planning. Despite aspirational United Kingdom (UK) government policy targets and ongoing efforts, the number of nursing and midwifery vacancies continues to increase. One contributing factor is student nurse and midwife attrition. AimTo identify risk factors that contribute to nursing and midwifery students interrupting or withdrawing from pre-registration programmes. DesignSequential explanatory mixed-methods design. SettingA University School of Nursing and Midwifery in the Southwest of England. Participants534 pre-registration nursing and midwifery student survey respondents and 8 focus group participants. MethodsStudents' perspectives of attrition risk factors were evaluated using a Likert scale with free text questions used to capture additional factors affecting interruption or withdrawal. Students were also invited to take part in focus group discussions. Survey data were coded and analysed utilising SPSS (Version 25) software. Survey free text narrative and focus group data were analysed using reflexive thematic analysis. ResultsSurvey results revealed 55 students had interrupted and returned and 281 students had considered leaving or interrupting their programme. Survey descriptive statistics data were grouped into top attrition risk factors. Free text narratives and focus group data identified four themes: multiple and overlapping challenges; the threats and opportunities of clinical placements; the availability of the right support at the right time; and, investing for a better future for myself and others. ConclusionNursing and Midwifery students reported challenges across their pre-registration programmes resulting in risk factors that might lead to students interrupting or withdrawing. Optimal cooperation between higher education institutions (HEI) and clinical stakeholders is of paramount importance to address these challenges as is government and Nursing and Midwifery Council (NMC) acknowledgement and consideration of the identified risks linked to attrition; specifically relating to national funding arrangements and the clinical practice hours required for registration within the UK. This may also resonate with professional programmes internationally, faced with similar staffing shortages.

An online survey of perspectives towards the impact of the covid-19 pandemic amongst caregivers of adolescents with ASD

BackgroundThe coronavirus disease (COVID-19) pandemic has had a negative impact on the health and mental health of adolescents and adolescents with autism spectrum disorders (ASD) and their caregivers, have been disproportionally affected. The purpose of this study was to investigate the impact of COVID-19 on Thai caregivers and adolescents with ASD.MethodsThis study used an online survey with closed and free text questions to investigate how the pandemic had impacted on social skills development and psychological variables, and perceived needs for support. The survey link was shared to parents via the Yuwaprasart Withayopathum Child and Adolescent Hospital and the social media platforms of known ASD stakeholder networks in Thailand. Binary logistic regression was used to investigate the relationships between sociodemographic characteristics, service use, and social skills problems experienced by adolescents during the pandemic. Content analysis was applied to analyse free-text data.ResultsA total of 376 caregivers of adolescents with ASD aged 10–19 years completed the survey, of which 364 were included in the analysis. In total, 38.7% of caregivers reported that during the pandemic the social skills of their adolescent family member had worsened. Most families reported that they were able to continue to access support from healthcare and educational services, albeit in different ways than pre-pandemic, during the acute stages of the pandemic which benefited the maintenance of ASD symptoms and social skills. Factors identified as reducing the odds of a worsening in social skills during the pandemic included; regular access to treatment for adolescents (odds ratio [OR] = 0.55, confidence interval 95% (CI) 0.32–0.98, p = 0.044), caregivers feeling that they had sufficient support from hospitals (OR = 0.46, 95% CI 0.26–0.81, p = 0.007) and older age of adolescents (OR = 0.53, CI 0.29–0.99, p = 0.047). The qualitative free text comments showed that the caregivers felt that greater information on managing adolescent behaviours, opportunities for adolescents to practice social skills, and the provision of greater emotional support and material assistance from healthcare professionals during the pandemic would have helped them to care for the adolescents with ASD.ConclusionRegular access to services, support from hospitals during the pandemic and older age in adolescence may have helped prevent the worsening of the social skills problems of adolescents with ASD.

"No doctor ever asked me…so I thought it wasn't a valid concern":endometriosis patients' perspectives of barriers and facilitators to sexual health communication in general practice.

Sexual health communication between general practitioners (GPs) and individuals with chronic diseases is well documented as an important component of sexual well-being. However, a notable gap exists in understanding factors that contribute to sexual health communication in the endometriosis context. Endometriosis-related research has focused on the assessment of sexual functioning and its role in influencing health-related quality of life, with a limited understanding of the management of sexual well-being in primary healthcare settings. To explore how individuals with endometriosis perceive their experiences of sexual health communication with GPs to understand the barriers and facilitators of this communication in general practice. This study formed part of a larger online quantitative survey measuring psychological and sexual well-being in individuals with endometriosis. In total 141 participants provided responses via open-ended unlimited free-text questions focused on their experiences of sexual health communication with GPs, including their perspectives on barriers and facilitators. Four overarching themes regarding barriers to sexual health communication were identified through thematic template analysis: (1) systemic factors; (2) practitioner factors; (3) patient factors; and (4) interpersonal factors. Facilitators mirrored strategies to address these barriers. Additionally, participants offered recommendations for developing resources to improve sexual health communication. Despite patients' interest, sexual health concerns in endometriosis are commonly overlooked in general practice due to various barriers, which individuals suggest could be addressed through comprehensive GP education and practical aids including communication tools. Although the sample is large for a qualitative study, the potential selection bias-stemming from participants' high levels of sexual dysfunction and motivation to discuss sexual health with a GP-may limit the diversity of perspectives. GP perspectives were not evaluated, precluding any assessment of the accuracy of individuals' perceptions of practitioner factors. Individuals with endometriosis encounter various systematic, practitioner, personal, and interpersonal factors that hinder or facilitate sexual health communication in general practice. Future research should prioritize strategies to improve sexual health communication for both GPs and patients.

Support for pharmacy professionals returning to (clinical) practice after a break: a cross-sectional survey

Abstract Introduction The continuing expansion of clinical roles for pharmacists, combined with National Health Service workforce shortages and the COVID-19 pandemic, have significantly increased pressure on pharmacy professionals.1 These pressures have heightened stress levels, causing many to consider leaving the field.2 Addressing workforce shortages and retension is crucial, with a particular focus on the reintegration of professionals returning to practice after a break. However, those returning after extended breaks often face challenges such as decreased skills and confidence. Nevertheless, research on the effectiveness of reintegration programmes to help pharmacy professionals return remains limited. Aim To explore participants’ reasons for leaving and returning and to assess the effectiveness of the Centre for Pharmacy Postgraduate Education (CPPE)’s Return to practice (RTP) and Return to the register (RTTR) programmes in helping individuals return to pharmacy practice in England. Methods CPPE emailed an anonymous link to an online survey, with two reminders, in December 2023 and January 2024, to individuals who participated in the RTP and/or RTTR programme(s) before March 2023 (n=701) and had given consent to be contacted for evaluation purposes. The survey employed closed, Likert-type and free-text questions. Quantitative data were analysed using the Statistical Package for Social Sciences (SPSS), with inferential statistics for subgroup comparisons and thematic analysis for qualitative comments (statistical significance p≤0.05).3 Using the university’s ethical approval tool, this study did not require approval due to not collecting personal, confidentical or sensitive information, with no vulnerable groups included, or risk of disclosure. Results The valid response rate was 15% (n=106). Most respondents were female (n=67, 79.8%), aged 35 and older (n=82, 97.6%), and pharmacists (n=77, 85.6%) or pharmacy technicians (n=8, 8.9%). The primary reasons for leaving included family responsibilities, career transition, and relocation, while the main motivations for returning were career reconnection, relocation, and other personal reasons. Participants reported a high degree of satisfaction with both programmes; those who perceived high content relevance reported significantly higher satisfaction (8.90±1.47 for RTP and 8.75±1.58 for RTTR on a 10-point scale). Overall, 70.8% (n=75) successfully returned to pharmacy practice and/or the GPhC register after completing the programme(s). Of those who returned, 68.1% (n=47) took less than 6 months. It was found that those who were more satisfied and more likely to recommend the programme(s), had been off the register for less than 10 years (n=41, 78.8%), and completed the programme(s) before 2020, prior to the shift to online delivery due to COVID-19 (n=41, 83.7% for RTP and n=16, 88.90% for RTTR), were more likely to have returned. Discussion/Conclusion The CPPE RTP and RTTR programmes supported participants effectively in returning to pharmacy practice. Increasing the number of pharmacy professionals returning to practice using reintegration course(s) positively impacts workforce shortages and addresses skill gaps after a break. One study limitation is the lack of information about those who did not use or are unaware of these support programmes. Further research could explore the support needs of all those wishing to return to practice or the GPhC register.

Veterinary medicine under COVID-19: a mixed-methods analysis of student and practitioner experiences in Austria.

This study aimed to provide a detailed analysis of the pandemic's impact on the veterinary profession and education in Austria. Two online surveys were conducted from November 2022 to January 2023, inviting all veterinarians and veterinary students in Austria to share their experiences on the impact of the pandemic on their veterinarian work and education in a free text question. A total of n = 289 veterinarians and n = 272 veterinary students provided an answer. In summary, 39.8% of veterinarians reported no impact by the pandemic, while others experienced changes in workload (19.7%), changes in client behavior (14.9%), implementation of safety measures (13.1%), and organizational changes (13.1%). Additional impacts included effects on mental health, private life, finances, as well as physical health. Changes were more frequently mentioned in veterinarians working with pets compared to those working with livestock. In the student panel, only a minority reported no significant impact (8.1%) but 44.9% reporting changes due to online and hybrid learning. Key issues included impaired learning conditions (34.9%), and social distancing (34.6%) leading to social isolation. Some students appreciated increased flexibility and reduced commuting (10.7%), while others experienced mental health challenges (10.7%). Further impacts were related to the implementation of safety measures (5.5%), organizational changes (4.8%) and impaired physical health due to infection (1.1%). Negative changes related to distance learning were mainly reported by students in the final study phase, whereas those in the first study phase reported more positive aspects related to online/hybrid learning. Overall, this study highlights the significant impact of the COVID-19 pandemic on veterinary education and professional practice in Austria, revealing diverse challenges for students and relatively lower but still notable effects on practicing veterinarians. Future research should monitor these impacts longitudinally and explore the integration of beneficial practices into standard veterinary education and care, such as effective digital learning platforms and appointment-based systems.

Impact of the COVID-19 Pandemic Onset on the Early Careers of Pediatric Oncology Health Professionals and Researchers: A Report From the Children's Oncology Group Young Investigators Committee, Young SIOP Network, and Young SIOPE.

The COVID-19 pandemic onset had a global debilitating impact on individuals and on burgeoning careers. In 2021, the Children's Oncology Group Young Investigators Committee, Young SIOP (International Society of Paediatric Oncology) Network, and Young SIOPE (European Society for Paediatric Oncology) co-sponsored a survey to explore the impacts of the first year of the pandemic on early-career pediatric oncology professionals with respect to working practices, productivity, professional and career development, personal wellbeing, and changing childcare needs. The survey comprised demographic, multiple-choice, and free-text questions, and was distributed via email and social media with English, French, and Spanish versions available. Descriptive statistics and chi-square tests were used to compare quantitative data by self-designated gender and country of origin. Qualitative data were described using content analysis. Professionals (N = 499, 26.3% male, 77.2% MDs) in 48 countries (77.6% high income) responded in English (79.4%), Spanish (12.4%), and French (8.2%). Respondents had difficulty obtaining and keeping jobs (26.9%), worsened overall academic productivity (50.7%, with higher rates among bench scientists, p<0.01), and decreased career opportunities (40.9%). Childcare challenges impacted 56.7% of respondents and was felt more negatively among women (p = 0.008) and in high-income settings (p<0.0001). Qualitative data (n = 300) highlighted these differences were often attributable to diminished professional/personal boundaries and impacted their personal wellbeing. The COVID-19 pandemic significantly impacted early-career academic and clinical professionals working in pediatric oncology, with unique challenges noted among those with childcare responsibilities. Career disruptions that resulted from the pandemic should be considered and mitigated by governing bodies and hiring institutions.

Development of an Exploratory Dementia Family Caregiver Pain Assessment Survey.

To develop an exploratory survey measuring family caregiver use of elements of pain assessment in people living with dementia (PLWD). A survey development process was conducted: Phase 1 (item development), Phase 2 (content validity), and Phase 3 (face validity). A set of survey questions was developed, and their wording modified after review by experts in survey question writing. Content experts rated the exploratory questions as having item content validity indices (I-CVI) from 0.25 to 1. Questions were further tested with a sample of family caregivers (N = 10) who supported face validity and content validity for questions with a low I-CVI. The final survey has eight quantitative and two free-text questions. This survey can be used for exploratory purposes to describe pain assessment by family caregivers of PLWD; however, further validation is needed for uses beyond exploratory work. [Research in Gerontological Nursing, 17(6), 308-316.].

Vision corrections used by presbyopic orienteers

SIGNIFICANCE Evaluating the visual challenges and refractive correction solutions of presbyopic orienteers identifies features of relevance to optometric management of the visual needs of active presbyopes. PURPOSE Orienteering is a unique sport requiring visual clarity at a range of viewing distances and has a high proportion of presbyopic participants. This study evaluates the vision corrections used by presbyopic orienteers, specifically aiming to characterize the prevalence of different vision correction options used and to explore the strengths and limitations of different vision correction solutions. METHODS Orienteers 40 years or older completed an online questionnaire consisting of multiple-choice questions covering personal demographics, orienteering participation, and visual corrections worn in everyday life and for orienteering. Free-text questions asked for further information about the corrections used and advice received from eye care practitioners were analyzed using content analysis. RESULTS There were 469 respondents (195 women, 274 men; median age category, 55 to 59 years). For the 187 people without distance refractive correction, the most frequent corrections for orienteering were “off the shelf” reading spectacles (n = 95) or use of a compass magnifier (n = 24), and for the 277 people with distance refractive correction, they were progressive addition spectacles (n = 96) and monovision contact lenses (n = 63). The main visual challenges faced by orienteers were seeing map detail, lens obstruction from fogging and rain, and difficulty orienteering in low light in the daytime. An ideal correction needed to provide visual clarity for both map and terrain. No visual correction type consistently addressed all challenges. Orienteers valued personalized discussion with eye care practitioners to address their needs. CONCLUSIONS Optimal visual corrections for presbyopic orienteers are individual, but higher reading additions to clarify map detail, contact lenses to avoid lens obstruction, additional light, and solutions that provide clear vision at all viewing distances while avoiding the reading add blurring the ground at the orienteer's feet should be considered. Personalized care is necessary to optimize visual correction solutions.

Development and Implementation of the “Exercise is Medicine” Elective at an Osteopathic Medical School

Abstract Introduction Lifestyle changes are a powerful way to combat many chronic illnesses. However, education on appropriate instruction of physical activity appears to be insufficient among medical students. This manuscript highlights development, incorporation, and feedback of the Exercise is Medicine elective at the West Virginia School of Osteopathic Medicine. Materials and Methods Twenty-four medical students attended ten weekly sessions, each of which lasted 2 h and covered a different topic. Participants were selected based on previous experience with exercise-based medicine and their personal beliefs on incorporating it into clinical encounters. Outcomes were gathered using surveys consisting of the Likert Scale, rating, yes/no/maybe, and free text questions. Results Confidence in prescribing lifestyle changes increased (p &lt; 0.0001) from pre- to post-elective. Feelings of incorporating course material into practice increased (p &lt; 0.05) after the elective. Feelings that physicians could impact their patients’ physical activity did not change. Conclusion Implementation of the Exercise is Medicine elective was well received among students and increased student knowledge and confidence in prescribing lifestyle changes to a variety of patient populations.

Language and terminology to describe transgender communities; Perspectives from people with lived experience

Background There is no consensus over the meaning of “transgender,” “trans and gender diverse,” and other terminology used to describe people with a gender different from the gender presumed or recorded for them at birth. We aimed to survey transgender (trans) individuals to understand lived experience perspectives on terminology. Methods An online cross-sectional survey of trans people currently living in Australia and aged ≥16 was conducted from June 2021 to April 2022. Demographic data and terminology preferences were ascertained through fixed-option and free-text questions. Results Of 1023 respondents with a median age of 30 years (IQR 24, 41), 37.1% were trans women, 34.9% were trans men, 27.6% were non-binary, and 0.4% had a culturally specific identity. There was no consensus regarding community-level terminology, with “trans/transgender and gender diverse” the most preferred term (21.9%), followed by “trans/transgender” (19.3%), and “gender diverse” (15.1%). The term “trans/transgender” was more preferred by trans women (27.9%), trans men (19.0%), respondents who had a history of or wanted gender-affirming hormone therapy (GAHT; 20.7%), and gender-affirming surgery (GAS; 20.9%), compared to non-binary respondents (8.2%), and respondents who did not want GAHT (4.9%) or GAS (13.9%). Three themes emerged from free-text responses regarding term preference: (1) Inclusivity, (2) Trans as a binary and medicalized experience, and (3) Societal understanding, accessibility, and destigmatization. Conclusion From Australian trans communities’ perspectives, the term “trans/transgender and gender diverse” was the most preferred community-level terminology to collectively describe people with a gender different from the gender presumed or recorded for them at birth. Further perspectives are needed from other cohorts internationally.

A survey of obstetrical anesthesia health equity practices at academic centers in the United States (US)

BackgroundLimited research has explored obstetrical anesthesiologists' perceptions of healthcare disparities associated with labor and delivery. The objective of this study was to evaluate the perception of obstetrical anesthesia related healthcare disparities, drivers of disparities, and potential solutions. MethodsAn online survey was emailed to division leads at Accreditation Council for Graduate Medical Education (ACGME) accredited obstetrical anesthesiology programs in the United States. The survey included a mixture of yes/no, select all that apply, and free-text questions. Descriptive statistics were used to characterize variable distribution. Free text responses were categorized into themes by selective coding. Results149 surveys were delivered, 74 surveys were conducted (50 %), and 57 were completed entirely (38 %). Fifty-seven percent of participants reported perceived presence of obstetrical/obstetrical anesthesia related healthcare disparities. Most participants reported that they consider a patient's cultural preferences during clinical management, collect race/ethnicity data, implement specific practices to address disparities, and analyze outcome data by social determinants of health. The majority of participants reported using additional relevant practice features, including translator services, quality improvement practices, provider rounds, standardized protocols, and cultural competency or diversity training. Thematic analysis of free text responses into drivers of disparities mapped to 6 themes: language barriers, racism or bias, socioeconomics or social determinants of health, access or quality of care, patient-provider interactions or cultural sensitivity, and individual patient factors. ConclusionMost academic obstetrical anesthesia center division leads reported perceived presence of obstetric anesthesia related health care disparities. Efforts should be made to devise targeted solutions to this multifaceted, pervasive problem.

3D printed teeth with adhesive bridge preparation guide

In this study a 3D printed tooth with adhesive bridge preparation guide was designed and tested for feasibility and evaluated by students. The tooth, printed by a stereolithographic printer, consisted of two differently colored layers with an integrated adhesive bridge preparation. This showed the extent and thickness of the preparation. 42 dental students in the fourth year of their studies were trained in a voluntary course. The printed teeth were evaluated with a questionnaire using German school grades from 1 (best) to 6 (worst). The production of the printed teeth for the adhesive bridge preparation was feasible and inexpensive. Overall, the students rated the teeth as good (Ø1.9 ± 0.2) in the questionnaire and evaluated the teaching method positively in the free text questions. This method supported the students to visualize the target preparation and develop a self-assessment through the ability to control their work directly on their own. The feasibility of this teaching concept was confirmed. It is suitable for teaching of new preparations forms such as adhesive bridges. The color-coded integrated preparation in the printed teeth and the printed tooth model enabled the students to learn the preparation of an adhesive bridge independently.

Interpretability and clinical utility of the strength and stressors in parenting questionnaire.

This study aimed to enhance the interpretability and clinical utility of the strength and stressors in parenting (SSF) questionnaire, a parent-reported questionnaire designed to assess strength, stress and associated risks of mental ill-health in parents of children with developmental disabilities. Responses to the SSF and a demographic questionnaire were collected from 576 parents of children with (n = 203) and without (n = 373) developmental disabilities. To enhance the interpretability of the SSF, a subset of 129 parents were invited to complete an additional questionnaire consisting of three free-text questions regarding recent help-seeking behavior, experiences of mental ill-health and experiences of parenthood. Parents' responses to the free-text questions were then categorized as indicative of higher or lower degrees of stress and compared to their SSF score distribution to derive empirical cut-offs for strength, stress and risk of mental ill-health as measured by the SSF. The credibility of these cut-offs was evaluated by comparing the cut-offs with SSF scores collected from the other 447 parents. Finally, SSF scores from parents of children without developmental disabilities (n = 373) were used to generate percentile values for the SSF to enable a standardized interpretation of SSF scores. To increase the utility of the SSF, we examined a recurring pattern of missing answers to items 23 and 33-38, noted in previous studies of the SSF and repeated in the present study. These items were excluded from further analysis since our examination revealed that they were not missing at random but rather constituted real differences in parental experiences, such as receiving a healthcare allowance, or caring for more than one child. The proposed empirical cut-offs performed well in discriminating between the two groups and yielded a specificity of 77-89% and a sensitivity of 68-76% for the strength, stress and risk of mental ill-health subscales of the SSF. This study also presents a conversion chart associating each SSF score with a corresponding percentile value. We propose modifications to the SSF, whereby items 23 and 33-38 are excluded, which will enable a more reliable assessment of parental experiences. This will, together with the empirical cut-offs and percentile values, enhance the interpretability and clinical utility of the SSF.

Signs, Sources, Coping Strategies, and Suggested Interventions for Burnout Among Preclerkship Students at a U.S. Medical School: A Qualitative Focus Group Study.

Research suggests that burnout can begin early in medical school, yet burnout among preclerkship students remains underexplored. This study aimed to characterize burnout signs, sources, coping strategies, and potential interventions among preclerkship students at one U.S. medical school. The authors conducted a qualitative study of preclerkship students at Mayo Clinic Alix School of Medicine (MCASOM) in June 2019. Participants completed 2 Maslach Burnout Inventory (MBI) items (measuring frequency of emotional exhaustion and depersonalization) and 2 free-text questions on burnout before participating in 1 of 3 semistructured focus groups. Focus group questions were derived from a literature review on medical student burnout with input from the MCASOM Student Life and Wellness Committee. Group discussions were recorded, transcribed, coded inductively, and analyzed iteratively (along with free-text comments) using a general inductive approach from a constructivist perspective. Eighteen of 111 eligible students (16%) participated, with 5/18 (28%) reporting weekly emotional exhaustion and/or depersonalization on MBI items. Analysis of focus group transcripts showed that most students had experienced burnout symptoms during their first or second year, corresponding with school-related stressors and manifesting in cognitive-emotional, physical, and verbal-behavioral ways. Students identified systemic, institutional, and individual burnout drivers and discussed how these drivers interacted (e.g., high standards of excellence at the system level interacted with anxiety and maladaptive thinking at the individual level, creating pressure to always do more). Students used various coping strategies (e.g., self-care, peer support, reframing, and compartmentalization) but emphasized limitations of these strategies and recommended interventions directed toward systemic and institutional burnout drivers. This study offers insights into burnout signs and sources among preclerkship medical students that can inform future large-scale studies. Results suggest that burnout emerges from dynamic interactions among systemic, institutional, and individual factors and may benefit from multipronged interventions.

Radiography students' knowledge, attitude and practice relating to infection prevention and control in the use of contrast media injectors in computed tomography.

Radiography students complete professional placements in various clinical settings and must adhere to distinct infection prevention and control (IPC) protocols. The aim of this study was to explore radiography students' training, knowledge, attitudes, and practice (KAP) relating to IPC in the use of contrast media injectors in computed tomography (CT). An online survey study was undertaken with radiography students enrolled at two Australian universities. Survey questions related to contrast media training and KAP regarding IPC in CT. Data was summarised using descriptive statistics, with comparisons between experience in public and private practice. One free-text response question focused on non-adherence to IPC best practice, analysed using content analysis. In total, 40 students completed the survey (9% response rate). Reports of IPC and contrast media equipment training was high, with disposition for further training. Regarding IPC knowledge, 65% of students responded correctly to all 'knowledge' items (individual scores range: 60-100%). Low consensus was observed regarding whether gloves replace the need for hand hygiene and if CT contrast tubing poses risk to healthcare workers (85% each). Mean scores ranged from 41% to 100% regarding identification of sterile syringe and tubing components. Responses to the open-ended question were categorised into four themes: 'High non-adherence risk working conditions', 'attitudes and practice', 'knowledge', and 'prioritise good IPC practice'. Radiography students demonstrate varied comprehension of IPC regarding contrast media equipment, and results suggest need for collaborative efforts between academic institutions and clinical training sites to integrate IPC protocols into curricula and on-site training.

Career advancement insights from certified pharmacy technicians: Enhanced opportunities for the pharmacy technician workforce

BackgroundSustainable career advancement opportunities for pharmacy technicians will be a critical part of patient-centered community pharmacy environments as the role of the pharmacist provider expands. Objective(1) To determine the impact of a Pharmacy Technician Certification Board (PTCB) pharmacy certification on career advancement and professional growth metrics; (2) To assess technicians’ role in advanced pharmacy services before and after certification; and (3) To identify changes in pharmacist services when a certified pharmacy technician (CPhT) was added to the provider team. MethodsA 73-question web-based survey was distributed to all PTCB CPhT in the United States, Washing DC, Puerto Rico, Guam, and the US Virgin Islands. The survey was distributed by PTCB in April 2021 with a 28-day collection period. The survey included multiple choice, rating scale, and free text questions centered on 5 domains: practice experience, career aspirations, compensation, pharmacy practice motivations, and impact of COVID-19 pandemic. ResultsA total of 23,007 CPhTs completed the survey. Respondents were primarily females (85.5%), age 30-39 (32.8%), and ≥10 years CPhT experience (42.8%). The majority of respondents cited improvement of patient health (77.4%), career advancement opportunities (53.5%), the ability to expand their role during emergencies (e.g., COVID-19) (52.6%), and future career advancement opportunities (51.7%) as benefits of CPhT certification. Increases in job responsibility after certification included changes occurring in roles related to clinical pharmacy services, patient education, preventive health services, provider communication, and staff training. Respondents agreed that PTCB-certification allowed for the expansion of pharmacists’ services where they practiced, including clinical services (18.5%), patient education (18.3%), and preventive health services (18.1%). ConclusionCPhT’s value certification for its benefits on career advancement, personal growth, and salary enhancement. Affirmation of skill and training through certification is also recognized to positively influence patient care and the pharmacy's ability to provide advanced patient care and services.