Members Of Health Care Team Research Articles

Electronic distance based clinical skills training development in family medicine in Namibia.

Workplace-based evaluation is one of the most important, but challenging aspects of medical education. The aim was to improve the assessment of the rural community-based clinical training for undergraduate 3rd and 4th year family medicine students at the University of Namibia (UNAM) and implement a paperless process. An online module was developed on the Moodle platform to include a study guide, an electronic portfolio, and electronic resources (e-books and apps) to replace the current paper version of the logbook. We explored local resources by engaging with students and clinical trainers on how to best conduct the initial implementation. Engagement also entailed motivating students to actively participate in the implementation process. All 3rd and 4th year community-based education end service (COBES) students are now submitting proof of clinical learning electronically with the use of their phones in their online portfolio and using online resources. In addition, students in the practical family medicine module that has been introduced in the 6th year since 2023 are now also using an electronic portfolio and these assessment tools.Contribution:Overall feedback from students and supervisors indicates a positive atmosphere of learning and constructive feedback on performance from all team members, hopefully improving work-based assessments and ultimately patient care. More members of the primary health care team were involved and the carbon footprint has also been decreased.

Well-being in newly qualified doctors: exploring the value of peer-led reflective sessions

IntroductionFollowing the COVID-19 pandemic and ongoing pressures within the National Health Service, there has been an increasing concern about the well-being of junior doctors in the UK. Newly qualified doctors...

Standardized Onboarding Increases Intention to Stay With the Organization

Advanced practice providers (APPs) are valuable members of health care teams integrated through orientation and onboarding. Comprehensive onboarding is crucial to retention and satisfaction in this group. A standardized onboarding program for new hire APPs was developed after a system-wide needs assessment showed poor satisfaction. Participants were surveyed upon completion of the program and compared with a preintervention cohort. An 80% increase in positive responses was noted in the intervention cohort when asked whether they intend to stay in their role for at least 1 year. Participants also identified recommendations for content in future programs.

Barriers to ethical treatment of patients in clinical environments: A systematic narrative review.

It is essential that healthcare providers display ethical behavior toward their patients. Despite development of codes of ethics for clinical practice, the occurrence of unethical behaviors toward patients is alarmingly high. The present study was conducted to identify the barriers to ethical treatment of patients in clinical environments. Through systematic narrative review, the present study investigated the barriers to ethical treatment of patients. This study was carried out in line with Assessment of Multiple Systematic Reviews 2 and Preferred Reporting Items of Systematic reviews and Meta-Analyses guidelines. Ethical challenges in clinical environments can be classified into two categories: "organizational factors" and "personal factors." Organizational factors consist of three domains: managers and regulations, organizational environment, and human resources. Personal factors consist of two domains: factors related to patients and their families and factors related to care providers. Research shows that encouraging healthcare teams to adopt ethical behaviors through education and having them persistently observe ethics in their clinical practice will not completely bridge the gap between theory and practice: it seems that the clinical environment, the personal characteristics of healthcare team members and patients, and the organizational values of the healthcare system pose the greatest barrier to bridging this gap. Accordingly, in addition to raising healthcare providers' awareness of the existing issues in clinical ethics, measures should be taken to improve organizational culture and atmosphere.

Healthcare Team Members’ Views on Social Determinants of Health Screening and Referral Practices in a Pediatric Emergency Department

Healthcare Team Members’ Views on Social Determinants of Health Screening and Referral Practices in a Pediatric Emergency Department

A compulsory school in need of a physiotherapist - an interview study

ABSTRACT Physical activity among schoolchildren is declining. Increased physical activity and motor training in school have shown good effects on health, learning and school performance. Physiotherapists can cooperate with school staff, but there are challenges in terms of environment and working methods. The study aim was to explore the attitude of compulsory school staff to physiotherapeutic competence in school and in student health care. Interviews were conducted with school staff and student health care team members. Data were analysed with qualitative content analysis. Based on categories and subcategories, a theme was identified as The physiotherapist as a piece of the student health care team puzzle. The staff were positive about the competence, gave suggestions on work areas, and could see advantages to including a physiotherapist on staff. More studies are needed in the field, especially regarding inclusion of physiotherapists in teams that work to promote health and prevent illness and injury.

Healthcare team resilience during COVID-19: a qualitative study

BackgroundResilience, in the field of Resilience Engineering, has been identified as the ability to maintain the safety and the performance of healthcare systems and is aligned with the resilience potentials of anticipation, monitoring, adaptation, and learning. In early 2020, the COVID-19 pandemic challenged the resilience of US healthcare systems due to the lack of equipment, supply interruptions, and a shortage of personnel. The purpose of this qualitative research was to describe resilience in the healthcare team during the COVID-19 pandemic with the healthcare team situated as a cognizant, singular source of knowledge and defined by its collective identity, purpose, competence, and actions, versus the resilience of an individual or an organization.MethodsWe developed a descriptive model which considered the healthcare team as a unified cognizant entity within a system designed for safe patient care. This model combined elements from the Patient Systems Engineering Initiative for Patient Safety (SEIPS) and the Advanced Team Decision Making (ADTM) models. Using a qualitative descriptive design and guided by our adapted model, we conducted individual interviews with healthcare team members across the United States. Data were analyzed using thematic analysis and extracted codes were organized within the adapted model framework.ResultsFive themes were identified from the interviews with acute care professionals across the US (N = 22): teamwork in a pressure cooker, consistent with working in a high stress environment; healthcare team cohesion, applying past lessons to present challenges, congruent with transferring past skills to current situations; knowledge gaps, and altruistic behaviors, aligned with sense of duty and personal responsibility to the team. Participants’ described how their ability to adapt to their environment was negatively impacted by uncertainty, inconsistent communication of information, and emotions of anxiety, fear, frustration, and stress. Cohesion with co-workers, transferability of skills, and altruistic behavior enhanced healthcare team performance.ConclusionWorking within the extreme unprecedented circumstances of COVID-19 affected the ability of the healthcare team to anticipate and adapt to the rapidly changing environment. Both team cohesion and altruistic behavior promoted resilience. Our research contributes to a growing understanding of the importance of resilience in the healthcare team. And provides a bridge between individual and organizational resilience.

Perception of Violence by Psychiatric Nurses: Behind the scenes

IntroductionViolence in psychiatric settings poses significant challenges for healthcare professionals, particularly nurses. This study examines psychiatric nurses’ perceptions of violence and its impact on the quality of care they provide.ObjectivesThe primary objective is to assess the influence of violence on the quality of care in psychiatric settings, with a focus on the experiences and perspectives of nurses.MethodsWe employed a questionnaire-based survey administered to 30 psychiatric nurses working in both inpatient and outpatient psychiatric units of the Razi hospital Manouba. The survey gathered information on the prevalence of violence, types of violence encountered, and the impact on nursing practice.ResultsOf the 30 respondents, 75% identified as female and 25% identified as male. Most of them had more than five years of experience. The primary results revealed that all the psychiatric nurses reported experiencing at least one incident of violence during their psychiatric nursing careers. Regarding exposure to verbal violence, the results indicated that 52% encountered it sometimes, 22% often, 17% very often. Regarding physical violence, 30% experienced it rarely, 26% sometimes, 13% often, and 13% very often. For sexual violence, 56% reported never experiencing it, 8% rarely, 26% sometimes, and 8% very often. These incidents had varying effects on nurses’ emotional well-being, job satisfaction, and the quality of care they were able to provide. 53% of nurses reported experiencing emotional distress and feelings of anxiety as a result of violence, 13% felt anger and frustration. One nurse declared he was not affected emotionally. Most of the respondents (75%) indicated that their job satisfaction had been negatively affected by violent incidents. 40% of respondents stated that violence has a negative impact on their relationship with patients, but they make efforts to maintain care quality. Whereas, 20% found ways to strengthen connections despite challenging experiences.The most commonly endorsed strategies to cope with violence included attempting to master their emotions by remaining calm and patient (78% of respondents), seeking assistance or the presence of other healthcare team members (65%), and maintaining a safe distance from patients (69%). Fewer participants reported raising their voice and adopting a position of authority (30%), while a minority indicated engaging in additional training on the management of violent situations (20%). These results illustrate the diverse range of personal coping strategies.ConclusionsViolence in psychiatric settings has a multifaceted impact on psychiatric nurses, affecting both their emotional well-being and the quality of care they provide. Strategies for managing and preventing violence, as well as supporting nurses in coping with these challenges, are essential for maintaining high-quality psychiatric care.Disclosure of InterestNone Declared

Human Rights and Code of Ethics: Perspectives of Nurses and Patients

Human rights and ethics are essential to healthcare, particularly for those working in the nursing profession. The rights and well-being of patients are greatly affected by the activities of nurses, who are at the forefront of patient care. This article examines the relationship between the nursing code of ethics and human rights from the viewpoints of patients and nurses. Through an examination of the legal and ethical frameworks that direct nursing practice, together with the experiences and expectations of patients, this article aims to clarify the complex dynamics that exist between healthcare team members and their patients.

Clinical Insights Into the Use of Speech Amplification Devices for Managing Hypophonia: Interviews With Speech-Language Pathologists.

The purpose of this qualitative interview study was to identify themes regarding considerations in the usage of speech amplification device usage for people with Parkinson's disease (PD) and hypophonia from the perspective of speech-language pathologists (SLPs). Eligible participants included SLPs currently practicing in the United States or Canada with experience working with clients with PD for at least 2 years. Ten SLPs participated in 60-min interviews conducted via Zoom. A semistructured interview guide was created prior to the interviews. The interviews were transcribed following their completion, and an iterative coding process was used to identify themes using thematic analysis. Three main themes were identified from the interviews. The first theme encapsulated how clinicians described amplification devices as a potential treatment tool, which highlighted the nuances that may impact selecting an amplification device as a treatment option such as increased hypophonia or dysarthria severity and cognitive decline. The second theme highlighted how device selection depends on the individual needs of the user. Individual client characteristics (such as disease symptoms and individual needs and preferences) may impact the choice of amplification device. The last theme outlined the importance of involving family members in all stages of device use and involving other health care team members on a case-by-case basis. The insights provided by the SLP participants help to understand the clinical decisions that are made when determining device candidacy, selecting a device, and evaluating device success. These insights can be used to improve research studies of augmentative management of hypophonia and guide more personalized management decisions.

Novice Chinese Bariatric Nurses' Perceptions of Their Role as Bariatric Case Managers: A Qualitative Study.

Bariatric case managers (BCM) are integral healthcare team members for patients undergoing bariatric surgery in China. As the demand for bariatric surgery increases in China, the number of BCMs has also risen. However, more is needed to know about the perceptions of novice bariatric nurses toward their role as case managers. This study aims to investigate the perceptions of novice Chinese bariatric nurses toward their roles during the early stages of their careers. This qualitative study employed semi-structured individual interviews with 15 novice bariatric nurses who received training as BCMs. The interviews were audio-recorded, transcribed line-by-line, and analyzed thematically. The study was conducted in a bariatric surgery center of a public tertiary hospital in Southern China. Three themes emerged from the data related to the perceptions of being a BCM: "negotiating the ambiguity of the BCM role," "establishing a core set of behaviors for the BCM role," and "identifying areas of competence to develop a BCM role framework." The novice bariatric nurses expressed both positive and negative feelings toward their role. They highlighted the need for further training to improve their qualifications and the importance of support from colleagues, and hospital management. The findings illuminate the role of the BCM in China. Future research should investigate effective and acceptable job descriptions and cooperation modes between BCMs, colleagues and hospital management. We recommend using these findings to develop training programs for novice BCMs and improve their capacity to provide quality care to patients undergoing bariatric surgery.

Patterns of Medical Residents' Preferences for Organizational Socialization Strategies to Facilitate Their Transitions: A Q-study.

To facilitate various transitions of medical residents, healthcare team members and departments may employ various organizational socialization strategies, including formal and informal onboarding methods. However, residents' preferences for these organizational socialization strategies to ease their transition can vary. This study identifies patterns (viewpoints) in these preferences. Using Q-methodology, we asked a purposeful sample of early-career residents to rank a set of statements into a quasi-normal distributed grid. Statements were based on previous qualitative interviews and organizational socialization theory. Participants responded to the question, 'What are your preferences regarding strategies other health care professionals, departments, or hospitals should use to optimize your next transition?' Participants then explained their sorting choices in a post-sort questionnaire. We identified different viewpoints based on by-person (inverted) factor analysis and Varimax rotation. We interpreted the viewpoints using distinguishing and consensus statements, enriched by residents' comments. Fifty-one residents ranked 42 statements, among whom 36 residents displayed four distinct viewpoints: Dependent residents (n = 10) favored a task-oriented approach, clear guidance, and formal colleague relationships; Social Capitalizing residents (n = 9) preferred structure in the onboarding period and informal workplace social interactions; Autonomous residents (n = 12) prioritized a loosely structured onboarding period, independence, responsibility, and informal social interactions; and Development-oriented residents (n = 5) desired a balanced onboarding period that allowed independence, exploration, and development. This identification of four viewpoints highlights the inadequacy of one-size-fits-all approaches to resident transition. Healthcare professionals and departments should tailor their socialization strategies to residents' preferences for support, structure, and formal/informal social interaction.

Diversity, equity, and inclusion (DEI) in medical education: DEI at the bedside

BackgroundThe ability to recognize and address bias is an important communication skill not typically addressed during training. We describe the design of an educational curriculum that aims to identify and change behavior related to diversity, equity, and inclusion (DEI). “DEI at the Bedside” uses the existing infrastructure of bedside teaching and provides a tool to normalize DEI discussions and develop skills to address bias during a neurology inpatient rotation. MethodsAs part of traditional clinical rounds, team members on an inpatient service shared experiences with DEI topics, including bias. The team developed potential responses should they encounter a similar situation in the future. We report the results of our needs assessment and curriculum development to evaluate the feasibility of incorporating a DEI educational curriculum in the neurology inpatient setting. ResultsForty-two DEI experiences were recorded. Medical students were the most frequent discussants (44%). Direction of bias occurred between healthcare team members (33%), against patients (31%), and patients against healthcare team members (28%). Experiences ranged from microaggressions to explicit comments of racism, sexism, and homophobia. ConclusionsBased on needs assessment data, we developed a DEI educational curriculum for the inpatient neurology setting aimed to improve knowledge and skills related to DEI topics as well as to normalize conversation of DEI in the clinical setting. Additional study will demonstrate whether this initiative translates into measurable and sustained improvement in knowledge of how bias and disparity show up in the clinical setting and behavioral intent to discuss and address them.

Aphasia disrupts usual care: “I’m not mad, I’m not deaf” – the experiences of individuals with aphasia and family members in hospital

Purpose Communication difficulties are highly prevalent in the stroke population, with implications for patient experience, safety and outcomes. This study explores the experiences of people with aphasia and family members regarding healthcare communication in acute and subacute stroke settings. Methods and materials A phenomenological approach was used to understand participants’ experiences. Participants took part in a focus group and data were analysed using an inductive thematic approach. Results For individuals with aphasia (n = 4) and family members (n = 2), five themes were generated: “aphasia makes it hard to communicate,” “hospital staff focus on the patient’s medical status only,” “people with aphasia do not get the help they need to improve,” “staff lack the skills to communicate with people with aphasia,” and “staff are crucial to improving healthcare communication.” Conclusions The stroke team has expertise in the medical management of stroke but struggle to communicate with patients with aphasia. Patients’ experience of healthcare communication is often one-way and limited to following instructions, with missed opportunities to discuss core topics such as prognosis, rehabilitation, and person-specific needs. Patients and families assert that all members of the stroke healthcare team should be able to adapt communication to accommodate patients.

Abstract B043: The caregiver burden of patients with Glioblastoma multiforme (GBM) and feeling of regret for treatment decisions associated with GBM standard of care using qualitative analysis

Abstract The purpose of this study was to identify areas where caregivers of patients with Glioblastoma multiforme (GBM) experienced feelings of regret in association to the treatment decisions related to standard of care. The standard of care for GBM consists of maximal surgical resection, chemotherapy, and radiation. This often leads to physical, cognitive, and physiological deficits. Due to the rapid onset and disease progression, patients and their caregivers must quickly make medical decisions regarding whether to pursue treatment and to what extent to continue treatment. The study sample included 101 letters written by female caregivers belonging to a Facebook group, “We are the wives of GBM and this is our story.” Members of the Facebook group were recruited to write letters to GBM healthcare providers describing their experiences as caregivers for spouses/partners of patients with GBM. This study was a secondary analysis of the narratives in the letters (UNCW IRB 22-0103) focusing on treatment decision-making. The research approach used in this study was Reflexive Thematic Analysis using NVivo qualitative data management software. Team members individually and collaboratively completed the six phases of reflexive thematic analysis: 1) data familiarization, 2) systematic data coding, 3) generating initial themes, 4) developing and reviewing themes, 5) refining and naming themes, and 6) writing the report to provide insight into study participants’ experiences. Six main themes were identified: 1) communication with different providers, 2) disease trajectory communication, 3) involvement with palliative care, 4) reliance on peer-to-peer communication, 5) description of side effects, 6) reflection on treatment decisions. Of 101 letters analyzed, 7 caregiver/patient dyads decided against treatment and 10 caregivers expressed regret in pursuing treatment. Nearly 40% of the letters indicated struggles by caregivers when communicating with health care team members about the disease, treatments, and their anticipated side effects. Nineteen caregivers relied on information from other caregivers (peer-to-peer communication) likely due to difficulties in getting information directly from health care providers. When describing care teams, only 20% of the letters mentioned palliative care as part of care teams. These caregivers struggled to obtain proper disease trajectory information, information about side effects of treatment options, and expressed patterns of miscommunication or low communication with providers. The lack information by providers about the GBM disease trajectory, its impacts on the patient and their families, and the fact that caregivers relied on peer-peer communication suggests the caregivers did not receive adequate information about the GBM disease trajectory and progression from their health care team which limited their understanding. This data suggests caregivers may have advocated for different treatment decisions and options if they had received adequate information from the health care team. Citation Format: Marlee S. Wallace, Megan P. Chard, Elizabeth A. James, Barbara J. Lutz, Laurie A. Minns. The caregiver burden of patients with Glioblastoma multiforme (GBM) and feeling of regret for treatment decisions associated with GBM standard of care using qualitative analysis [abstract]. In: Proceedings of the AACR Special Conference on Brain Cancer; 2023 Oct 19-22; Minneapolis, Minnesota. Philadelphia (PA): AACR; Cancer Res 2024;84(5 Suppl_1):Abstract nr B043.

Could pharmacy technicians play a role in supporting the appropriate and safe use of traditional and complementary medicines?

Across the world traditional and complementary medicine (T&CM) product use is prevalent with some countries reporting greater than 50% of the population using these products. T&CM products are primarily self-selected through retail outlets including pharmacies. Pharmacists across the world generally agree they should play a role in ensuring the appropriate and safe use of T&CM products but report being time and resource poor to do so. In this commentary, it is proposed that pharmacy technicians as members of the pharmacy workforce, who with adequate education, and supportive technologies could support pharmacists in providing guidance to consumers and patients about the appropriate and safe use of T&CM products. Pharmacy technicians play a crucial role in the pharmacy workforce, serving as integral members of healthcare teams fulfilling a wide array of tasks essential for the efficient functioning of pharmacies and ensuring the safe dispensation of medications. They have been described by pharmacists as the “the face of the pharmacy” in the community setting and relied on not only for mitigating and triaging problems, but also be primarily responsible for developing rapport, eliciting trust and even loyalty from pharmacy patrons. As such, there is a momentous opportunity for pharmacy technicians to play a role in providing T&CM advice and triaging the need for pharmacists’ intervention where harm, or risk of is identified.

Teaching Conflict Management Skills to Medical Students: A Scoping Review.

Conflict management skills include the ability of team members to actively use appropriate methods and strategies in different conflict situations. Considering the necessity of effective training in conflict management skills for medical students as a member of healthcare teams, this scoping review study aimed at reviewing the appropriate methods for teaching conflict management to medical students. In this scoping review, PubMed, Eric, ProQuest, Web of Science (WoS), and Scopus databases were systematically searched until May 21, 2023. Titles, abstracts, and full texts were screened separately by 2 researchers. The quality of the articles was assessed using the Best Evidence Medical Education (BEME) tool. Then, a descriptive synthesis was performed, and the results were reported. The Kirkpatrick model was used to evaluate the educational outcomes assessment. Out of 2888 retrieved studies, 19 studies were included. Although active and interactive teaching methods such as roleplay, group discussion, and interactive workshops were the most frequently used methods, the results did not pronounce the superiority of one method over others. Based on the results of this scoping review, further research should evaluate the effectiveness of conflict management training methods by focusing on the randomized controlled trial design and using standard and valid tools to assess educational outcomes.

Instructional strategies and challenges for implementing teledentistry in dental hygiene curricula: A qualitative study.

Research has documented the implementation of telecommunications and virtual technology use in health care disciplines to expand accessibility. Despite the current trend of digital innovations in healthcare systems, telehealth technology is not readily adopted in the dental hygiene profession yet. Currently, no standardized educational framework exists in dental hygiene curricula to prepare professionals with the technical skill set and professional knowledge necessary for telehealth applications. The aims and objectives of this research were (1) to investigate existing dental hygiene educators' pedagogical frameworks for incorporating telehealth technology into dental hygiene curricula, (2) explore these educators' instructional strategies for teaching telehealth technology, and (3) examine the theoretical implications and practical outcomes of teaching telehealth technology for professional development and transferrable work-force ready skills. A nine-item, open-ended, semi-structured interview guide was prepared and approved by the Institutional Review Board (IRB) in January 2023 to qualitatively investigate accredited entry-level dental hygiene programs in the United States. Thematic interpretational analysis was conducted using NVivo software. A total of 54 of the 328 dental hygiene programs volunteered for participation. Thirteen full-time and part-time dental hygiene educators met inclusion criteria. The core salient themes identified included (a) curriculum mapping, (b) technology integration, (c) professional collaboration, and (d) supplemental skill set. These findings provide guidance to dental hygiene programs for bridging the teledentistry knowledge gap in curriculum development. Incorporating telehealth applications into dental hygiene curricula prepares future dental hygienists with the specialized training needed to function as a member of contemporary health care teams addressing access to care.

The association between quality of clinical education and assertiveness in operating room and anesthesia nursing students: A cross-sectional study

BackgroundAssertiveness provides a nurse with the foundation for establishing successful relationships with patients, family members, and healthcare team members. Clinical education creates a unique opportunity to prepare students for professional identity because knowledge alone is not enough to provide safe care, and without clinical education, training efficient and competent people will be very difficult and impossible. This study aimed to determine the association between the quality of clinical education and assertiveness of operating room and anesthesia students. MethodIn this analytical cross-sectional study, 230 students who were in the second year of undergraduate education participated. The research was conducted in the 2022 academic year at the Department of Nursing School, Shiraz University of Medical Sciences. Clinical Education Quality Assessment Questionnaire and Gambler and Ritchie Assertiveness Questionnaire were data collection instruments. Statistical methods used included descriptive statistics such as mean, standard deviation, independent t-test, Chi-square test, and regression analysis. ResultsOut of 230 students participating in this study, 103 were operating room nursing students, and 127 were anesthesia nursing students. One hundred forty-one students were female, and 89 were male, 79 % of whom were aged 18–32 years. A significant relationship was found between the quality of clinical education and interest in the field, the number of children, and employment during education (P = 0.01). Also, a significant relationship was observed between decisiveness and the main variables (P = 0.01). The correlation analysis results showed students who scored higher on assertiveness had reported the quality of their clinical training higher (r = 0.23, p < 0.001). ConclusionAssertiveness as a communication style can play an important role in improving performance and quality of care in tense, stressful care settings. Improving assertiveness can be considered as a useful factor in the clinical training of the operating room and anesthesia nursing students. Therefore, it is suggested that the instructors should include instruction on assertiveness in nursing education courses.

THRIVE: A Theory-Based Program to Support Hospital Nursing Assistants.

Nursing assistants are vital healthcare team members who often experience personal challenges to professional success. The Transformational Healthcare Readiness through Innovative Vocational Education (THRIVE) program is designed to combat these challenges through coaching and curriculum that is steeped in adult learning and social theories. The program's goal is to increase retention and success of newly hired nursing assistants through personal and professional support. Components of THRIVE can be adapted in a variety of healthcare settings.