Communication Gap Research Articles

Survey on nurse-physician communication gaps focusing on diagnostic concerns and reasons for silence

Diagnosis improvement requires physician-nurse collaboration. This study explored nurses’ concerns regarding physicians’ diagnoses and how they were communicated to physicians. This cross-sectional study, employing a web-based questionnaire, included nurses registered on Japan’s largest online media site from June 26, 2023, to July 31, 2023. The survey inquired whether participants felt concerned about a physician’s diagnosis within a month, if they communicated their concerns once they arose, and, if not, their reasons. The reasons for not being investigated were also examined. The nurses’ frequency of feeling concerned about a physician’s diagnosis and the barriers to communicating these concerns to the physician were evaluated. Overall, 430 nurses answered the survey (female, 349 [81.2%]; median age, 45 [35–51] years; median years of experience, 19 [12–25]). Of the nurses, 61.2% experienced concerns about a physician’s diagnosis within the past month; 52.5% felt concerned but did not communicate this to the physician. The most common reasons for not communicating included concern about the physician’s pride, being ignored when communicating, and the nurse not believing that a diagnosis should be made. Our results highlight the need to foster psychologically safe workplaces for nurses and create educational programs encouraging nurse involvement in diagnosis.

Bridging the Communication Gap: Utilizing Large Language Models to Detect Emotional Distress and Depression in Adolescent Communication for Parental Support

In the digital age, the communication gap between parents and adolescents has increased, presenting challenges to understanding the emotional well-being of their children. With the increasing prevalence of social networks, adolescents tend to express their feelings and struggles online rather than engage in face-to-face interaction. Existing monitoring tools allow parents to read messages and observe social media activity, but often fail to interpret the emotional content. Recent studies have explored the feasibility of using natural language processing and machine learning to predict depression based on social media activity. By analyzing the linguistic patterns, sentiments, and emotional content of online communication, researchers have demonstrated the potential to identify individuals suffering from depression at an early stage. This article proposes a novel solution that uses large language models (LLMs) to monitor and analyze adolescent communication on digital platforms, including smartphones and social media. The system aims to detect emotional distress, signs of depression, and other mental health indicators, providing timely alerts to parents. This technology enables parents to understand their teens’ emotions, offer the necessary support, and prevent the escalation of anxiety and depression.

Using digital communication tools to improve interprofessional collaboration and satisfaction in a student-run free clinic.

Interprofessional collaboration can improve the quality of care in complex health conditions often seen in underserved populations. Communication is key to effective collaboration, and digital communication tools can enhance information sharing, collaboration, and satisfaction between professionals, especially when teams are distanced. In a semirural student-run free clinic that provides care to uninsured and underinsured patients with multifaceted health issues, there is a gap in communication and collaboration across interprofessional teams because of the frequent rotation of various staff, part-time hours, and electronic health record (EHR) function and interoperability limitations. The aim of this nurse practitioner-led quality improvement project was to determine whether implementing digital communication tools could enhance communication and improve provider collaboration and satisfaction during clinical decision-making among the several interprofessional teams at the student-run free clinic. Digital communication tools were implemented in a two-part intervention: (1) virtual case conferences to discuss patient care plans and (2) an EHR-linked tool to document the care plans. Survey evaluation across six virtual case conferences found above-average ratings for collaboration, satisfaction, and usability of the EHR-linked tool. There was a 15.78% improvement in global collaboration from the first to third conference, with a sustained improvement of 11.49%. Satisfaction improved by 4.62% from the first to the fourth conference. Digital communication tools can facilitate efficient communication and collaboration among staff while providing a more streamlined approach to patient care. These technologies can be useful in similar settings, especially when teams are distanced.

Causes of occupational stress and burnout amongst administrative staff in public universities: case of Pakistan

PurposeThe primary aim of this study is to delve into the causes of occupational stress and burnout amongst administrative staff members in Pakistani universities. It does so by employing a qualitative research strategy, offering a comprehensive understanding of the issue.Design/methodology/approachThis study uses a qualitative research strategy to examine the causes of occupational stress and burnout amongst administrative staff members in Pakistani universities. Around 20 semi-structured interviews were conducted via Teams with administrative employees in renowned universities in Rawalpindi, Islamabad and the Lahore region of Pakistan. Saldana's (2014) structured inductive data analysis method was used to analyse the collected data.FindingsThe study sheds light on the harsh realities faced by university administrative staff in Pakistani universities. These include top management ineffectiveness, role ambiguity, role conflict, favouritism, inequality, a communication gap with higher authorities, disparity of rewards and recognition, no career paths and opportunities, feeble leadership, corruption, inappropriate use of power, mishandling of qualified staff and non-acceptance of shifting roles from administration to academia. These are not just academic concepts but real-life challenges that demand immediate attention.Originality/valueThe study's findings have significant implications for Pakistan's Ministry of Education. Based on these findings, the recommendations proposed can serve as a roadmap for enhancing interpersonal development, implementing career development programmes, succession planning and supporting university administrative staff. These initiatives can lay the groundwork for achieving the UN Sustainable Development Goal-4 targets, making this research a valuable resource for policymakers.

PresAIse, a prescriptive AI solution for enterprise

Prescriptive artificial intelligence (AI) represents a transformative shift in decision-making by offering causal insights and actionable recommendations. Despite its huge potential, enterprise adoption of prescriptive AI faces several challenges. One such challenge is caused by the lack of experimental data for many enterprises, making it hard to attribute differences in outcomes to interventions alone. The second pertains to the explainability of AI recommendations, which is crucial for enterprise decision-making settings. The third challenge is contributed by the silos between technologists and business users, hindering effective collaboration. This paper outlines an initiative from IBM Research, PresAIse, aiming to address some of these challenges by offering a suite of prescriptive AI solutions. Leveraging insights from various research papers, the solutions include scalable causal inference methods, interpretable decision-making approaches, and the integration of large language models (LLMs) to bridge the communication gap via a conversation agent. A proof-of-concept demonstrates the solutions’ potential by enabling non-ML experts to interact with prescriptive AI models via a natural language interface, democratizing advanced analytics for strategic decision-making.

Experiences and preferences of people with stroke and caregivers, around supports provided at the transition from hospital to home: a qualitative descriptive study

BackgroundTransitioning home from the structured hospital setting poses challenges for people with stroke (PWS) and their caregivers (CGs), as they navigate through complex uncertainties. There are gaps in our understanding of appropriate support interventions for managing the transition home. In this qualitative study, we explored the perspectives of PWS and their CGs regarding their support experiences and preferences during this period.MethodsBetween November 2022 and March 2023, and within six months of hospital discharge, audio-recorded, semi-structured interviews were conducted with PWS and CGs. All interviews were transcribed, imported into NVivo software, and analysed using reflexive thematic analysis.ResultsSixteen interviews were conducted, nine with PWS and seven with CGs. Four themes relevant to their collective experiences and preferences were identified: (i) Need for tailored information-sharing, at the right time, and in the right setting; (ii) The importance of emotional support; (iii) Left in limbo, (iv) Inequity of access. Experiences depict issues such as insufficient information-sharing, communication gaps, and fragmented and inequitable care; while a multi-faceted approach is desired to ease anxiety and uncertainty, minimise delays, and optimise recovery and participation during transition.ConclusionsOur findings highlight that regardless of the discharge route, and even with formal support systems in place, PWS and families encounter challenges during the transition period. The experiences of support at this transition and the preferences of PWS and CGs during this important period highlights the need for better care co-ordination, early and ongoing emotional support, and equitable access to tailored services and support. Experiences are likely to be improved by implementing a partnership approach with improved collaboration, including joint goal-setting, between PWS, CGs, healthcare professionals and support organisations.

Lessons From Leading During a Pandemic: An Exploratory Study of Public Health Leadership Insights on Training, Preparation, and Experiences From the Field During COVID-19.

The public health workforce encountered challenges during the COVID-19 pandemic that exposed areas for improvement in preparation for future public health threats. Key among these is well-trained public health leaders equipped with an array of crisis leadership skills. To examine the training background, assess the perceived preparedness, and garner recommendations for training of the future public health workforce from public health leaders who navigated the COVID-19 pandemic. This exploratory research gleaned information by utilizing an online questionnaire and interviews to provide lessons learned regarding improvements needed for public health leader preparedness. Three California public health departments representing urban, suburban, and rural populations. Thirty public health leaders who were directly involved in public health work for ≥3years in a leadership/management role and involved in COVID-19-related work for at least 6months participated. Questionnaire findings revealed gaps in crisis leadership, communication, and collaboration training. Interview results supported and expanded upon the quantitative findings, including the value of various competencies and recommendations to improve the preparedness of future public health leaders. The findings suggested that although many of the skills needed are competencies for accredited public health training programs, effective leadership during public health emergencies may require additional training beyond what is generally provided. Recommendations include integrating study findings into public health training programs to address competency gaps, leveraging results to enhance leadership skills, and promoting collaboration between public health departments and academic institutions to develop evidence-informed crisis leadership training. These findings inform strategies to ensure the preparedness of the public health workforce for future crises.

Exploring the efficacy of ecolabels as a marketing strategy: Insights from the emerging bioplastic packaging market

AbstractThe packaging industry's significant role in plastic production and environmental pollution underscores the need for more sustainable alternatives. Bioplastics emerge as a promising solution, yet consumer understanding of this innovative material often lags, particularly in emerging markets. This study thus aims to explore effective marketing strategies for communicating bioplastic packaging to shape consumer adoption and disposal practices in such markets. Through a case study approach, we examine the role of ecolabels as a marketing tool across key sectors of the bioplastic packaging supply chain. Drawing upon the signalling theory, we identify key characteristics of effective signals, including costly signalling, visibility, clarity, fitness, consistency and credibility, which should be integrated into a broader context of ecolabels design in order to encourage consumer adoption and responsible disposal. Our study also identifies instances where noises from the environment may have little impact and where communication gaps hinder feedback loops between consumers and producers.

The significance of personalized medicine in healthcare services of the 21st century: a brief literature review

In modern healthcare services, patient safety is a primary goal. With technological advancements, the complexity of healthcare services increases, which in turn creates increased pressure on health professionals during decision-making processes and can lead to errors worldwide. Communication gaps, human factors, patient-originated issues, technical failures, and inadequate policies have been identified as the main causes of medical errors. While research shows that errors stem from human nature and are inevitable, it is emphasized that it is possible to develop methods that enhance patient safety. Utilizing digital technologies to improve the quality and efficiency of healthcare services is a crucial strategy. Innovations such as wearable technologies, mobile devices, digital media-delivered education and consulting services, telehealth applications, 3D printers, clinical decision support systems, and implantable biosensors encompass advancements in the digital health field. This research aims to analyze the complex and dynamic structure of healthcare services in the 21st century, especially considering the opportunities presented by the integration of artificial intelligence and genomic data, within the scope of the relevant literature.

Transforming Hypertension Diagnosis and Management in The Era of Artificial Intelligence: A 2023 National Heart, Lung, and Blood Institute (NHLBI) Workshop Report.

Hypertension is among the most important risk factors for cardiovascular disease, chronic kidney disease, and dementia. The artificial intelligence (AI) field is advancing quickly, and there has been little discussion on how AI could be leveraged for improving the diagnosis and management of hypertension. AI technologies, including machine learning tools, could alter the way we diagnose and manage hypertension, with potential impacts for improving individual and population health. The development of successful AI tools in public health and health care systems requires diverse types of expertise with collaborative relationships between clinicians, engineers, and data scientists. Unbiased data sources, management, and analyses remain a foundational challenge. From a diagnostic standpoint, machine learning tools may improve the measurement of blood pressure and be useful in the prediction of incident hypertension. To advance the management of hypertension, machine learning tools may be useful to find personalized treatments for patients using analytics to predict response to antihypertension medications and the risk for hypertension-related complications. However, there are real-world implementation challenges to using AI tools in hypertension. Herein, we summarize key findings from a diverse group of stakeholders who participated in a workshop held by the National Heart, Lung, and Blood Institute in March 2023. Workshop participants presented information on communication gaps between clinical medicine, data science, and engineering in health care; novel approaches to estimating BP, hypertension risk, and BP control; and real-world implementation challenges and issues.

Stochastic cluster head selection model for energy balancing in IoT enabled heterogeneous WSN

Energy dissipation is the most important design limitation for Internet of Things (IoT) enabled Wireless Sensor Networks (WSNs). In order to prolong the life of WSNs, the energy of nodes must be used in an effective way. Clustering is a strategy that may effectively use the energy of the sensors, extending the life and scalability by managing the network load balance. The energy usage for network operation is reduced by using an evolutionary algorithm called Genetic Algorithm (GA). The Stochastic Cluster Head Selection Model (SCHSM) is described in the proposed protocol by taking the factors such as distance, node energy, density and capacity of nodes for developing the fitness function. The proposed protocol is designed for multiple movable sink nodes and this greatly improves the energy balancing factor in the network. For minimizing the communication gap among sensors and sinks, movable sinks can be placed carefully. Simulation results are analyzed for the system effectiveness.

KEPALA SEKOLAH SEBAGAI PEMIMPIN PENDIDIKAN MENGENAI KESENJANGAN DAN PENYIMPANGAN DI SDN NO 50/VI LUBUK MENTILIN

Abstract This research aims to find out the principal as an educational leader regarding gaps and deviations at SDN 50/VI Lubuk Mantilin Kec. Anchor. This research includes evaluative research using the Descrepancy Model. Measuring the effectiveness of the program is carried out by comparing two things at the end of the program, namely the beginning and end of program implementation, namely comparing ideal conditions with real conditions regarding school principal standards. Variables are measured with instruments in the form of questionnaires. The results show that there are two main problems, namely gaps and deviations in the elementary school environment in Lubuk Mantilin Village.. The resuits of the first research are as follows, firstly, the gap includes several things a) leaderships quality gap, b) resource gap, c) treatment gap, d) implementations gap, e) communication gap. And as for the second result, the following are several devications that may accur, a) administrative deviatus, b) ethial deviations, c) devications in curriculum implementation, d) principal deviations in assesment. The results of the two studies show that there are action to overcome and reprimand the accurrenre of gaps and deviations at SDN 50/VI Lubuk Mentilin based on 8 national educatonal standards, namely content standards, process standards, graduate competency standards, standards for educators and education staff. Keywords : school principal, educational leader, disparities and iregularities

Enhancing software engineering with visual design and multimedia: An empirical and theoretical exploration

This article delves into the critical role of visual design and multimedia integration within software engineering, emphasizing their significance in enhancing user engagement, comprehension, and collaboration among stakeholders. Through a comprehensive analysis of theoretical frameworks, quantitative research findings, and practical applications, this study elucidates the benefits and challenges associated with embedding visual and multimedia elements in software systems. It presents empirical evidence from controlled studies and case analyses to demonstrate the tangible improvements in software usability, educational efficacy, and project management efficiency. Moreover, the article explores future directions, highlighting emerging technologies and methodologies that promise to further revolutionize the integration of visual design in software engineering. The findings underscore the pivotal role of visual and multimedia elements in bridging communication gaps, fostering collaborative environments, and enhancing the overall software development process.

DEVELOPING COMMUNICATIVE COMPETENCE OF STUDENTS AT ENGLISH LESSONS

In the article the importance of developing communicative competence of students at English lessons, as one of the backgrounds for forming an individual is considered. The recent studies of solving this issue, as one of the necessary conditions in learning a foreign language, are overviewed. In the article the notion “communicative competence” and its components are determined: grammatical competence, discourse competence, that is the ability to build sentences in discourse for the purpose of forming meaningful integrity from a set of utterances, sociolinguistic competence, which lies in understanding the right usage of language standards, that depend on a particular context and strategic competence, which determines language techniques, that are used when interlocutors have a communication gap as a result of imperfect language knowledge. These techniques include: correction, paraphrase, parable, repetition and pause. The article exercises, tasks for developing communicative competence worked out by its author. Special attention is paid to the brainstorming activities, as an example, the author gives spidergram “Teacher”. The developed approach allows to monitor communicative competence development of students and to fulfil additional methodological approaches for developing creative activities of students.

854 Bridging the Communication Gap in Surgery: A Quality Improvement Initiative to Improve Surgical Juniors’ Confidence in Navigating Difficult Conversations and Documentation

Abstract Aim In response to the challenges faced by surgical juniors in communicating with critically ill patients and their families, particularly after emergency surgery, we initiated a comprehensive two-pronged QIP. Our aims were 1) to enhance skills and confidence of surgical juniors in navigating difficult conversations, and 2) to improve documentation of post-operative patient and NOK discussions after ITU step-down to ward, in-line with NICE guidelines (CG83-1.13). Method A retrospective analysis of 14 laparotomy patients in September 2023, revealed that only 36% had documented NOK discussions 3-5 days post-operatively, falling short of best practice guidelines recommending documentation within 12 hours. Only 33% of the 10 patients requiring ITU admission, received documented NOK updates post-step-down to the ward. Interventions to address this included developing a communication skills workshop and implementing colored cards in notes folders to visually identify patients needing NOK discussions. Results Pre- and post-workshop surveys, utilizing a 1-to-5 scale, measured confidence levels of junior doctors for difficult discussions, with 13 and 9 respondents, respectively. High confidence scores (4 or 5) for different discussion types showed substantial improvement post-workshop: DNACPR (31% vs. 89%), end-of-life (31% vs. 55%), emotionally charged (31% vs. 78%). Furthermore, 100% of participants post-workshop were highly likely (4 or 5) to utilizing communication frameworks e.g., SPIES. Conclusions Our interventions have demonstrated a significant improvement in the confidence of surgical juniors when navigating challenging conversations. Our ongoing efforts include expanding our ‘communication in surgery’ workshop series, which we hope to present, and a re-audit of NOK discussion documentation to objectively measure positive changes post-intervention.

Improving young patient- practitioner communication about sexual health during medical visits.

Young people face barriers that lead to gaps in sexual and reproductive health care communications. Issues such as discomfort discussing sexual health lead to inadequate delivery of services resulting in unintended pregnancies and STIs. Closing this communication gap between patients and health care practitioners would improve communication and health outcomes. The objective of this study was to gain feedback from focus groups about: (a)barriers and facilitators to communication surrounding sexual health and (b)the feasibility and acceptability of a question prompt list (QPL) and informational video emphasizing asking questions about sexual health during medical visits as tools young people could use to be more involved during visits. Three focus groups were conducted: two with young adults (n=14) and one with practitioners (n=5) of sexual/reproductive health care services. Practitioners were recruited from healthcare clinics. Young adults were aged 18-22 years old. Participants identified barriers to communication such as embarrassment over sexual health topics and practitioner assumptions about patients' base of knowledge. A facilitator to communication was patient-friendly language. Focus group participants offered suggestions on how to improve the QPL as well as themes that should be covered in an educational video. Participants viewed the QPL and educational video as useful for encouraging conversations between patient and practitioner. Many barriers obstruct communication between young adults and practitioners on topics relating to sexual health. Both the QPL and an educational videocould be used to enhance patient-practitioner communication.

Looking London Talking Tokyo?

Patient disagreement and dissatisfaction with their healthcare providers may be reflective of ineffective communication during the doctor-patient interaction. Such disagreement and dissatisfaction has significant repercussions for the therapeutic relationship. We explore factors that may result in such inadequate communication. While acknowledging that gaps in communication may persist despite the best efforts of both the patient and the physician, we consider strategies to bridge these gaps.

Association Between Health Literacy and Understanding of Doctors' Explanations: The Yamagata Study.

In Japan, the doctor-patient relationship has traditionally been characterized by a power imbalance that may contribute to communication gaps. To date, however, the link between patients' health literacy levels and their understanding of doctors' explanations of medical conditions and treatment has yet to be fully examined in Japan. The purpose of this study was to investigate the association between patients' health literacy level and their understanding of doctors' explanations. This was a cross-sectional study analyzing data derived from 11,217 questionnaires collected in July 2021 from participants of the Yamagata Study, a community-based cohort study implemented by Yamagata University since 2009. The results showed lower health literacy was associated with poorer understanding of physicians' explanations, adjusting for potential confounding factors. In addition to low health literacy, factors associated with lower comprehension were being male, not having a regular family doctor, and having lower self-perceived levels of health and happiness. The results suggest that health care professionals need to communicate with patients according to their health literacy level and ensure they fully understand their medical condition and treatment. Medical providers need to create a better health-literate environment to enable patients and families to make decisions by themselves. [HLRP: Health Literacy Research and Practice. 2024;8(3):e175-e183.].

IMU Data-Driven and PCA-Based Approach to Establish Quantifiable and Practically Applicable Measures for V2 Technique Elements in Cross-Country Skiing.

Quantifying movement coordination in cross-country (XC) skiing, specifically the technique with its elemental forms, is challenging. Particularly, this applies when trying to establish a bidirectional transfer between scientific theory and practical experts' knowledge as expressed, for example, in ski instruction curricula. The objective of this study was to translate 14 curricula-informed distinct elements of the V2 ski-skating technique (horizontal and vertical posture, lateral tilt, head position, upper body rotation, arm swing, shoulder abduction, elbow flexion, hand and leg distance, plantar flexion, ski set-down, leg push-off, and gliding phase) into plausible, valid and applicable measures to make the technique training process more quantifiable and scientifically grounded. Inertial measurement unit (IMU) data of 10 highly experienced XC skiers who demonstrated the technique elements by two extreme forms each (e.g., anterior versus posterior positioning for the horizontal posture) were recorded. Element-specific principal component analyses (PCAs)-driven by the variance produced by the technique extremes-resulted in movement components that express quantifiable measures of the underlying technique elements. Ten measures were found to be sensitive in distinguishing between the inputted extreme variations using statistical parametric mapping (SPM), whereas for four elements the SPM did not detect differences (lateral tilt, plantar flexion, ski set-down, and leg push-off). Applicability of the established technique measures was determined based on quantifying individual techniques through them. The study introduces a novel approach to quantitatively assess V2 ski-skating technique, which might help to enhance technique feedback and bridge the communication gap that often exists between practitioners and scientists.

Quantifying inconsistencies in the Hamburg Sign Language Notation System

The advent of machine learning (ML) has significantly advanced the recognition and translation of sign languages, bridging communication gaps for hearing-impaired communities. At the heart of these technologies is data labeling, crucial for training ML algorithms on a huge amount of consistently labeled data to achieve models that generalize well. The adoption of language-agnostic annotations is essential to connect different sign languages, as single-language databases often provide limited lexicon examples, insufficient for training robust ML algorithms. This study critically examines the Hamburg Sign Language Notation System (HamNoSys), which describes the signer’s initial position and body movements, in contrary to the meanings of glosses. Despite HamNoSys’s utility in standardizing transcriptions across various sign languages, our investigation uncovers inconsistencies within HamNoSys that may negatively impact the development of accurate and reliable ML models. By analyzing HamNoSys labels across five sign languages, we identified a lack of standardized annotation procedures and the complexities within HamNoSys that introduce biases and errors. Our findings underscore the urgent need for unified, standardized data annotation guidelines to enhance the accuracy and efficiency of sign language recognition technologies. This research highlights the importance of addressing annotation challenges and advocates for a comprehensive, diversified database to improve the generalization of ML models.