Peer Perceptions Research Articles

Perceptions of Parental Leave Among Ophthalmologists

Benchmarking attitudes surrounding parental leave among posttraining North American ophthalmologists may reveal possible areas for intervention. To evaluate perceptions of current parental leave policy and culture among posttraining North American ophthalmologists. This nonvalidated survey used a 19-item online questionnaire. A convenience sample of 186 self-identified North American-based ophthalmologists who had completed training was obtained using listservs, residency program coordinators, and social media. Data collection occurred from May to July 2022. Descriptive analysis demonstrated response frequencies. Pearson χ2 comparison of means was performed for categorical variables. Two-tailed t tests were performed for continuous variables. Among the 186 surveys completed, 105 respondents (56.5%) identified as female, 76 (40.9%) worked in academia, 133 (71.5%) were 1 to 20 years out of training, and 156 (83.9%) had children. Attitudes toward stop-the-clock policies, or delays in tenure/promotion/partnership review when taking leave, were mixed. Of 171 respondents, 78 (45.6%) thought that stop-the-clock policies should be optional, 39 (22.8%) thought that they should be required, and 31 (18.1%) thought that they should be removed. Of 76 academicians responding, 56 (73.7%) and 49 (64.5%) were unaware if their institution had a stop-the-clock policy for tenure review or promotion review, respectively. Male and female respondents differed in feeling comfortable with taking leave (36 of 66 [54.5%] vs 67 of 90 [74.4%], respectively; P = .04), as well as in their ratings of stress about peer perception on a scale of 0 to 10 (3.70 vs 4.81, respectively; P = .05). Private practitioners and academicians differed in confirmation of leave options for both parents (52 of 101 [51.5%] vs 49 of 69 [71.0%], respectively; P = .02) and ratings of financial stress (7.10 vs 5.43, respectively; P = .004) and research considerations (1.60 vs 3.85, respectively; P < .001). Results of this survey study support the hypothesis that demographic factors affect attitudes toward parental leave among posttraining ophthalmologists; policies could be better publicized. Feelings regarding policies and leave were mixed. These findings should be viewed as hypothesis generating because the survey was not validated and the associations provided could be due to confounding factors.

Real and assumed sexual minority status: Longitudinal associations with depressive symptoms.

Sexual minority status persists in being linked to poorer adolescent mental health. Using a longitudinal sample (N=845), we examined how youth's own same-gender attraction and their perceptions of peers' beliefs about their same-gender attraction (i.e., assumed attraction) were associated with trajectories of depressive symptoms from grade eight (when students are typically 13-14 years old) to grade 10. Reporting either same-gender attraction, assumed same-gender attraction or both were associated with higher initial levels of depressive symptoms that persisted over time compared to youth with real and assumed other-gender attraction only. These links were partially mediated by experiences of discrimination. Findings suggest the importance of understanding adolescent perceptions of peer beliefs in the association between same-gender attraction and depressive symptoms.

Attitudes and risky sexual behavior among youth in Kampala, Uganda: Empirical analyses of risk factors by gender.

This study sought to examine gender differences and the influence of peer and parental perceptions on sexual risk behaviors among an at-risk sample of youth living in Kampala, Uganda. Using the cross-sectional Kampala Youth Survey (2014) based in Kampala, Uganda (n = 1134), bivariate and multivariable logistic regressions were conducted to determine the odds of sexual risk behaviors based on peer and parental influence variables and gender. The perceptions of peer, adult, and parental opinions on sexual activity were significantly associated with varying levels across all risky sexual behaviors explored. When indexed and adjusted for other variables, females compared to males were at increased odds of participating in 3-4 risky sexual behaviors (OR: 0.63, 95% CI: 0.44, 0.90) and 5-6 risky sexual behaviors (OR: 0.38, 95% CI: 0.21, 0.68) compared to zero risky sexual behaviors. Adolescent sexual risk behaviors are subject to peer and parental influence and vary between genders. This study emphasizes the importance of peer influences in adolescent sexual risk behaviors. Many of these youth are orphans, which may explain the lack of association between parental influences and sexual risk behavior. School-based and community-based interventions may be effective at preventing risky sexual behaviors for this vulnerable population.

Associations between COVID-19 vaccine uptake, race/ethnicity, and political party affiliation.

Despite widespread availability of vaccines, COVID-19 is a leading cause of death in the United States (US), and sociodemographic disparities in vaccine uptake remain. Race/ethnicity, partisanship, and perception of peer vaccination status are strong predictors of vaccine uptake, but research is limited among some racial/ethnic groups with small populations. The current study used an online survey to examine the relationship between these factors among a diverse sample of US adults (n = 1,674), with oversampling of racial and ethnic minorities. Respondents provided sociodemographic information and answered questions regarding COVID-19 vaccination status, political affiliation, perception of peers' vaccination status, COVID-19 death exposure, and previous COVID-19 infection. Respondents who identified as Asian American had higher odds of being vaccinated, whereas those who identified as Black/African American or American Indian or Alaska Native (AIAN) had lower odds. Respondents who identified as Independent/Other or Republican had lower vaccination odds. Respondents who perceived anything less than nearly all of their peers were vaccinated had lower vaccination odds. Further, lack of a primary care provider, younger age, and lower educational attainment were associated with lower vaccination odds. Findings may help to determine where additional work is needed to improve vaccine uptake in the US. Results indicate the need for intentional and tailored vaccination programs in Black/African American and AIAN communities; the need to understand how media and political actors develop vaccination messaging and impact vaccine uptake; and the need for additional research on how people estimate, understand, and form decisions around peer vaccination rates.

A longitudinal examination of relations between competitive athletic participation, drinking norms, impulsivity, and sensation seeking and binge drinking throughout college.

College athletes are a high-risk group for heavy drinking and related risky behaviors and consequences. However, most prior work examining drinking behavior in college athletes has been cross-sectional. Drinking norms predict drinking among athletes, but other potential risk factors, including personality traits have received limited attention. Using data from a large sample (n = 2,245) of college students, we examined athletic participation, high-risk personality traits (i.e., impulsivity, sensation seeking), and perceptions of peer drinking behavior (descriptive and injunctive norms) as predictors of binge drinking from prior to college entry through 2 years postcollege. Negative binomial latent growth models were used to examine these predictors of patterns of drinking across the college years. Binge drinking increased through the first 3 years of college before leveling off and decreasing postcollege. Controlling for significant effects of sensation seeking and perceptions of peer attitudes and drinking behaviors, athletic participation at T1 was associated with greater binge drinking at matriculation and greater athletic participation was associated with greater risk across the college years. Normative perceptions and sensation seeking also predicted concurrent drinking in Year 4 of college and impulsivity emerged as an additional predictor. Sensation seeking emerged as a significant predictor of greater postcollege binge drinking. Athletic participation in Year 4 of college indicated no significant risk for greater binge drinking during Year 4 or following graduation. Early participation in competitive athletics was associated with risk for binge drinking, even when accounting for several social and personality factors. Future studies using momentary assessment may be fruitful for identifying within-subject pathways of risk, including athlete specific factors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Role of Parents and Peers in Cyberbullying Perpetration: Comparison among Arab and Jewish and Youth in Israel.

In recent years, several studies have examined the effect of parents and friends on cyberbullying victims. Less is known about their combined effect on cyber perpetrators, especially among Jewish and Arab teens in Israel. We collected data from a representative sample of 350 Jewish and Arab adolescents (aged 15–16) and their parents. We repeated the interviews twice within a year. The survey included measurements of three parental practices: support, monitoring, and protectiveness, as reported by parents at the first time of data collection. We measured the adolescents’ engagement in sensation-seeking and cyberbullying as perpetrators and perceptions about peers’ involvement in these behaviors. Path-analysis models revealed that the perception of peers’ involvement in cyberbullying perpetration was positively linked with involvement in such behavior among Jewish and Arab teens. Contrary to our expectations, no parental practice had a direct effect on cyberbullying perpetration among teens in either ethnic group.The study presents important and unique findings. The results indicate that youngsters involved in cyberbullying are strongly influenced by their peers. The prevalence of this pattern in both the Jewish and the Arab populations indicates its universal nature. On a practical level, it may be suggested that bullying behaviors may be mitigated by taking measures in formal and informal education. Another aspect of the results is the decline in parental influence on adolescents’ cyberbullying behaviors, especially among Arab teens. This may be an indicator of cultural changes taking place in the Arab population in Israel alongside widening of the generation gap.

Influential children in middle childhood peer culture: Effects of temperament and community culture.

For children in middle childhood, the social world, particularly the behavior and attitudes of their school peers, has been shown to be an important factor in their educational and mental health outcomes. In the school environment, some children seem to influence the attitudes and behavior of their peers more than others. The behavior patterns of children, as reflected in temperamental traits, have been shown to drive peer perception in important ways and might play a role in identifying the individuals and social processes that operate in peer influence. It seems likely that temperamental traits will have different effects on school peers, dependent on characteristics of the school attended. Fourth and fifth grade children from four rural counties in the southeastern portion of the United States were studied. Temperamental characteristics were assessed based on teacher perception of six characteristics. Peer perceptions of the extent to which each child was perceived to influence others in five areas of school culture (e.g., academics, sports) was measured through a peer nomination procedure. Additional status-related perceptions and behaviors of participating children were also assessed by peer nominations. Teacher ratings of temperamental behaviors were submitted to latent profile analyses resulting in a seven-cluster model. Results indicated temperamental profiles were significantly and meaningfully associated with peer perceptions of influence as well as social status. Further, demographic differences between two groups of schools were found to moderate the effects that temperament profile had on peer influence.

Adolescent Athletes’ Perspectives on the Social Implications of Sport-Related Concussion

Purpose: Sport-related concussion can affect many domains of a patient’s health status. Social functioning is an important consideration, especially for adolescent athletes. Our purpose was to explore adolescent athletes’ social perspectives regarding sport and concussion. Methods: Using a qualitative study design we interviewed 12 interscholastic athletes who had sustained a sport-related concussion. The interviews focused on injury details, and explored the physical, psychosocial, emotional, and spiritual components of sport and health. Themes and categories were identified using the consensual qualitative research process by a three-person research team. A comprehensive codebook that captured the main themes and categories resulted. Results: Following concussion, participants discussed two primary themes: perceptions regarding the social aspects of sport and social perspectives regarding their concussion. Specific categories related to the social aspects of sport included: friendships and family and decision to participate based on peers. Specific categories regarding the social perspectives of the concussion included uncertainty of the diagnosis, perceptions of others regarding their injury, being ashamed of the concussion, parent and peer roles, and communication and expectation about their concussion. Conclusions: Participation in sport and removal from sport following a concussion have significant social implications for adolescent athletes. Specifically, the perceptions of peers, parents/guardians, and others regarding the injury can influence reporting of symptoms and recovery following concussion. Limited communication regarding recovery and expectations post-concussion may cause undue social pressures to return to activity prematurely. Providing a supportive environment in which patients can recover from concussion while engaging with peers and teammates is important. Anticipatory guidance, with education regarding the possible signs and symptoms, risk factors pre- and post-injury, and recovery expectations following a concussion are important to include in post-injury management and should be known to all stakeholders.

Professional identity in physical education: a review of literature

Teachers’ professional identity shapes teachers’ educational views, impacting their behaviour, action and decision making. This study was designed with the goal of locating, compiling and analysing articles regarding professional identity in the physical education context and identifying elements that contribute to professional identity construction. We selected professional identity and physical education as search items in Web of Science, ERIC, SPORTDiscuss and Scopus. To investigate the previous decade of research, we limited the study to articles published between 2010 and 2020. This work combines recent publications written in Portuguese, English and Spanish. The database search yielded 27 relevant articles. The themes present in the articles can be divided into two groups: those linked to key actors and influences on physical education teachers’ professional identity, and those related to physical education preservice teachers. The following themes were discovered to influence teachers’ professional identity formation: relationships (established within their acting context), identity negotiation, identity transformation, lifelong learning, peer perception and the class context. The following themes impact preservice teachers’ professional identity formation: teaching practicum experience, prior experiences, a community of practice and the teachers’ body. Professional identity formation is an intricate process characterised by a diverse mix of personal, professional, environmental and social representations that interact in real time.

A comparison of vision-related quality of life between Defocus Incorporated Soft Contact (DISC) lenses and single-vision spectacles in Chinese children

ObjectiveThis study aimed to compare the vision-related quality of life (VRQoL) between Defocus Incorporated Soft Contact (DISC) lenses and single-vision spectacles in Chinese children, in order to evaluate their visual performance and subjective acceptance of this bifocal designed contact lenses treatment. MethodsChinese participants aged 7 to 12 years, with myopia of −4.00 to −0.75 D, astigmatism < 1.50 D, and monocular best-corrected visual acuity 0.0 or better, were recruited in the study. All participants had been wearing DISC lenses, or single-vision spectacles, for the last 6 to 18 months and were requested to complete the routine ocular examination and Chinese version of the Pediatric Refractive Error Profile (PREP 2) questionnaire. The questionnaire consisted of 7 scales: vision, symptoms, appearance, activities, handling, peer perception, and overall score. According to their habitual correction modalities, fifty-four children were allocated to the DISC group and 56 to the single-vision spectacles group. A generalized linear model was fitted to assess variables associated with the PREP 2 score. ResultsParticipants wearing DISC lenses scored significantly higher than those wearing single-vision spectacles for vision, appearance, activities, peer perception, and overall (all P < 0.05). The improvement of VRQoL in the DISC group was mainly represented in appearance, peer perception, and activities. The quality of life improved more for older participants on scales of vision, symptoms, handling, appearance, and overall score (all P < 0.05). The interaction between treatment and age was statistically significant for the activities scale (P < 0.05). ConclusionDISC lens wear significantly improves VRQoL in Chinese children compared with single-vision spectacles for most of the survey scales, especially in the areas of appearance, peer perception, and activities. The benefits provided by DISC lenses contribute to greater satisfaction than single-vision spectacles for myopic children.

2020 rankings for US PharmD programs, research, and overall quality

BackgroundUS News and World Report (USNWR) publishes well-known rankings of graduate health programs. Medicine and nursing are ranked with weighted metrics using multiple criteria, and medical schools are ranked separately according to their focus (research or primary care). USNWR pharmacy school rankings are based on a single-question peer perception survey. ObjectiveThe objective of this study was to develop a simple, transparent framework to rank US colleges and schools of pharmacy in overall quality and separately based on program quality and research quality, using data that are readily available to the academy. MethodsData for three education quality and four research quality metrics were obtained for 2020. Each metric was standardized and ranked, and then each set was summed to determine separate ranks for education and research. Education and research scores were combined using equal weights to provide a single rank for overall quality. A sensitivity analysis was performed to determine the effect of assigning higher proportionate value to education, similar to USNWR medical school rankings. ResultsDistinct ranks were produced for education, research, overall (education: research) 50:50, and overall 60:40. Sensitivity analysis suggests the more disproportionately the education and research factors are weighted, the more ranks change. Mid-ranked schools were most impacted when weightings changed due to relative strength in one factor and relative weakness in the other. When weighted 60:40, nine (7%) mid-ranked programs improved in rank, while 11 (11%) worsened in rank compared to the 50:50 model. ConclusionSeparately ranking education and research can highlight the diverse strengths of pharmacy schools. The proposed model is based on easily obtainable data and is easily reproducible, allowing for annual rankings. These rankings may be used by PharmD and PhD applicants when selecting schools and by pharmacy schools to benchmark true and aspirational peers.

Congruence in Perceived Employee–Peer Overqualification and Organizational Citizenship Behavior

Abstract. Drawing on equity theory and person–group fit theory, we examined the association between (in)congruence in employee and peer overqualification and perceived insider status. We further proposed that perceived insider status is related to employees’ organizational citizenship behavior (OCB). The results of multilevel polynomial regressions using data collected with 211 employees from 55 teams supported the hypothesized congruence effect. Specifically, employees’ perceived insider status was greater, and their OCB was maximized, when employees and their peers had congruent perceptions of their overqualification levels. Furthermore, when both employees and their peers perceived their overqualification levels as low, perceived insider status and OCB were higher than when both perceived their overqualification levels as high. These findings highlight the pivotal role of congruence between employee and peer perceptions of overqualification at work.

Buttressing social return’s influence on travel behaviour

ABSTRACT With peer perceptions of vacation pictures on social media becoming firmly entrenched into the tourist psyche and the destination selection process, this paper buttresses the burgeoning research on social return’s influence on travel behaviour through additional theoretical development and empirical investigation. The paper assesses the cross-cultural construct and predictive validity of the Social Return Scale across the United States of America’s top-five international travel markets (Canada, Mexico, United Kingdom, Japan, and China) using a modified Theory of Planned Behaviour model grounded in Guttman’s means-end chain model and Kenrick’s Fundamental Motives Framework. Results confirm the scale’s superb validity providing researchers with the theoretical and empirical support to confidently utilize the Social Return Scale to measure the perceived social return of different travel experiences across different contexts and cultures.

National Institutional Ranking Framework (NIRF): Analyzing Performance of Top 50 Management Schools

The present study aims to examine the statistical differences in performance across different categories of management schools in India against the five major NIRF performance parameter heads viz., Teaching, Learning & Resources (TLR); Research and Professional Practices (RP); Graduation Outcomes (GO); Outreach and Inclusivity (OI); Peer Perception (PR); and Total Ranking Score (TRS). NIRF announced first ranking results in the year 2016 on the data of 2014-15. We have used the available NIRF ranking results of the top 50 ranked management schools for each of the six announcing years from 2016 to 2021. The study divided management schools into four categories as per their regulatory identity in India. Based on the relative performance and standing of four categories of management schools across five parameters of NIRF, the schools can strategize their efforts to retain and enhance their performance for achieving a higher NIRF ranking in the future. The findings are also pertinent to those management schools which are not ranked by NIRF for taking actionable decisions. This study claims its uniqueness as assessing the relative performance of institutions in the higher education sector in India. The theoretical underpinning of rankings can be a relevant addition to the existing literature of ranking systems for higher educational institutions.

Positivity in peer perceptions over time: Personality explains variation at zero-acquaintance, popularity explains differential change.

People have characteristic ways of perceiving others' personalities. When judging others on several traits, some perceivers tend to form globally positive and others tend to form globally negative impressions. These differences, often termed perceiver effects, have mostly been conceptualized as a static construct that taps perceivers' personal stereotypes about the average other. Here, we assessed perceiver effects repeatedly in small groups of strangers who got to know each other over the course of 2-3 weeks and examined the degree to which positivity differences were stable versus developed systematically over time. Using second-order latent growth curve modeling, we tested whether initial positivity (i.e., random intercepts) could be explained by several personality variables and whether change (i.e., random slopes) could be explained by these personality variables and by perceivers' social experiences within the group. Across three studies (ns = 439, 257, and 311), personality variables characterized by specific beliefs about others, such as agreeableness and narcissistic rivalry, were found to explain initial positivity but personality was not reliably linked to changes in positivity over time. Instead, feeling liked and, to a lesser extent, being liked by one's peers partially explained changes in positivity. The results suggest that perceiver effects are best conceptualized as reflecting personal generalized stereotypes at an initial encounter but group-specific stereotypes that are fueled by social experiences as groups get acquainted. More generally, these findings suggest that perceiver effects might be a key variable to understanding reciprocal dynamics of small groups and interpersonal functioning. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Multigroup analysis of the relationship loneliness, fear of missing out, problematic internet usage and peer perception in gifted and normally developing adolescents.

The current study examined the effects of Internet usage characteristics and peer perception on loneliness. The mediating role of Internet usage characteristics was examined in the relationship between loneliness and peer perception. The sample included 661 Turkish adolescents (Ngirls =379, 57.34%; Ngifted= 211, 31.92%) aged 11–18 years. Structural equation model analyzes were conducted to test the hypothesis model across the group. Moreover, multigroup structural model was conducted to test the differences of the relationships across gifted and normally developing adolescents. The results of the structural model showed that Internet use characteristics did not have a mediating role in the relationship between adolescents’ peer perception and loneliness. On the other hand, problematic Internet use had a full mediator role in the relationship between fear of missing out and loneliness. The results of the multigroup structural model emphasized the similar effects between the research variables in gifted and normally developing adolescents. The results were discussed with the effects of Internet use characteristics and peer perception on loneliness. We also pointed out that gifted and normally developing adolescents have similar social and technological outcomes and that these outcomes influence mental health.

Smoking and drinking behavior, knowledge, and attitudes among urban and rural public-school students in Efate Island, Vanuatu: a comparative study

BackgroundUnderage smoking and drinking are public health issues in Vanuatu. This study aims to describe the behavior, knowledge, attitudes, and perceptions of parents, siblings, and peers regarding smoking and drinking among urban and rural public-school students in Vanuatu.MethodsThis cross-sectional study included 358 students (urban, 217; rural, 141; aged 12–14 years) from the public schools in Efate Island, Vanuatu. Data were collected using self-administered questionnaires. Chi-square and Mann–Whitney U tests were used to determine the rural–urban differences.ResultsUrban students showed a higher prevalence of ever smoking (13.5%), ever drinking (16.9%), intention to smoke (11.1%), and intention to drink (14.0%) compared to rural students (10.3%, 8.3%, 5.8%, and 9.5%, respectively); although a significant difference was only observed in the prevalence of ever drinking. Urban students were more likely to be aware of the health hazards of substance use and showed higher self-efficacy to refuse tobacco and alcohol compared to rural students. Parents in rural areas were less likely to talk about the health hazards of substance use with their children and were more likely to offer tobacco or alcohol to them compared to parents in urban areas.ConclusionsThe results provide evidence of rural–urban differences in the behavior, attitude, knowledge, and perceptions of parental behavior regarding smoking and drinking. The findings suggest that issues related to underage smoking and drinking differ between urban and rural students. Future intervention programs for reducing underage smoking and drinking should be adapted in recognition of urban and rural differences.

Comparing the Effectiveness and Image Quality of Musculoskeletal Ultrasound of First-Year Medical Students After Training by Student Tutors Versus Ultrasound Instructors: A Pilot Study

BackgroundUltrasound is a vital part in many medical schools’ curriculum. Although there is strong support for the use of student tutors (STs), there is a lack in gauging their effectiveness with more difficult organ systems such as the musculoskeletal (MSK) system. We aim to determine the effectiveness of using STs versus expert ultrasound instructors (UIs) when teaching MSK ultrasound.MethodologyMedical students were recruited to participate in an MSK workshop to identify superficial volar arm structures (radial nerve, radial artery, median nerve, ulnar artery, ulnar nerve) using Butterfly iQ. In total, 14 participants were taught by STs and 10 participants were taught by UIs. Participants imaged the five structures and answered surveys gauging their confidence via five-point Likert scales.ResultsThere was no significant difference in confidence or identification accuracy for all five structures between the two groups. However, there was a significant difference in confidence in the understanding of basic ultrasound concepts in favor of the UI group (p < 0.05). A greater number of students were more confident in identifying all five structures when taught by STs, but more students correctly identified the structures when taught by UIs.ConclusionsThe results on confidence could be due to positive peer perception. Both groups scored relatively high in their identification accuracies, promoting the successful use of STs. The successful use of STs in teaching MSK ultrasound opens the possibility to developing peer-led ultrasound curriculum on more complex ultrasound topics in the future.

Development of a Digital Game Intervention Targeting Suicide Prevention in Adolescents Who Misuse Opioids

Background Suicide is the second leading cause of death in adolescents aged 14-18 years. Adolescents who misused prescription opioids are more likely to experience suicidal thoughts and behaviors than adolescents who did not. Compelling evidence shows “serious games” (ie, games for a purpose other than solely entertainment) can promote healthy behaviors, reduce risk factors, enhance protective factors through skill-building, and target prevention. Objective Our primary objective was to design and develop a digital game intervention that models the process of a safety planning intervention. We explored peer and student perceptions around potential warning signs, coping strategies, and seeking help among youth who may be at greater risk of suicide due to misuse of opioids. Methods We conducted 8 focus groups with a total of 30 participants, including 9 high school–aged adolescents (aged 16-18 years), 8 college-aged youth (aged 18-21 years), and 13 providers, as well as 5 interviews with adults who had experience with opioids in their youth (aged 40-47 years) to inform the content of the digital game intervention. Focus groups and interviews were conducted via Zoom between February 2022 and April 2022. A semistructured focus group/interview guide was developed, pilot tested, and used in focus groups and interviews. The guides align constructs from the intersectional ecological model to better identify how to help students cope with social and cultural stressors and how to strengthen individual and community assets. Using this lens, questions were related to potential warning signs of emotional distress, coping strategies, and seeking help to prevent suicidal thoughts and behaviors among youth who misuse opioids. Focus groups and interviews were approximately 60-90 minutes. Debrief summaries were completed after each one. Participants received a $25 gift card and additional mental health and opioid misuse resources following the session. Focus groups and interviews were audiotaped and then transcribed. Results Findings will inform the development of a digital game intervention to prevent suicide among adolescents who misuse opioids. Salient themes were extracted from the focus groups and interviews. They include themes related to previous substance misuse, later diagnosis of a mental health disorder, grief, bullying, stigma, family dynamics, and the role of identity. Potential story lines will focus on improving one’s self-esteem, managing conflict at home, navigating peer influence, addressing concerns about seeking help, and increasing access to resources for seeking help based on identity. Gameplay will incorporate techniques that enhance mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance from dialectical behavioral therapy for adolescents. Conclusions Digital game interventions may play a critical role in preventing suicide among youth who misuse opioids. Next steps include a pilot randomized controlled trial to evaluate the user experience, acceptability, and feasibility of the intervention in fall 2022. Conflicts of Interest None declared. Acknowledgments This study was funded by CTSA grant number KL2 TR001862 from the National Center for Advancing Translational Science (NCATS)/National Institutes of Health (NIH).

Pediatric Emergency Medicine Physicians' Perceptions of Colleagues' Clinical Performance Over Career Span.

The US physician workforce is aging, prompting concerns regarding clinical performance of senior physicians. Pediatric emergency medicine (PEM) is a high-acuity, multitasking, diagnostically complex and procedurally demanding specialty. Aging's impact on clinical performance in PEM has not been examined. We aimed to assess PEM physician's' perceptions of peers' clinical performance over career span. We surveyed 478 PEM physician members of the American Academy of Pediatrics' Section on Emergency Medicine survey study list-serve in 2020. The survey was designed by the investigators with iterative input from colleagues. Respondents rated, using a 5-point Likert scale, the average performance of 4 age categories of PEM physicians in 9 clinical competencies. Additional items included concerns about colleague's performance and preferences for age of physician managing a critically ill child family member. We received 232 surveys with responses to core initial items (adjusted response rate, 49%). Most respondents were 36 to 49 (34.9%) or 50 to 64 (47.0%) years old. Fifty-three percent reported ever having concern about a colleague's performance. For critical care-related competencies, fewer respondents rated the ≥65-year age group as very good or excellent compared with midcareer physicians (36-49 or 50-64 years old). The ratings for difficult communications with families were better for those 65 years or older than those 35 years or younger. Among 129 of 224 respondents (58%) indicating a preferred age category for a colleague managing a critically ill child relative, most (69%) preferred a 36 to 49-year-old colleague. Pediatric emergency medicine physicians' perceptions of peers' clinical performance demonstrated differences by peer age group. Physicians 65 years or older were perceived to perform less well than those 36 to 64 years old in procedural and multitasking skills. However, senior physicians were perceived as performing as well if not better than younger peers in communication skills. Further study of age-related PEM clinical performance with objective measures is warranted.