Prior Personal Experience Research Articles

Factors influencing referral to maternity models of care in Australian general practice.

In the Australian maternity system, general practitioners play a vital role in advising and directing prospective parents to maternity models of care. Optimising model of care discussions and the decision-making process avoids misaligning women with over or under specialised care, reduces the potential for disruptive care transitions and unnecessary healthcare costs, and is critical in ensuring consumer satisfaction. Current literature overwhelmingly focusses on women's decision-making around model of care discussions and neglects the gatekeeping role of the General Practitioner (GP). This study aimed to explore and describe the factors influencing Australian GPs decision-making when referring pregnant women to maternity models of care. This study used a qualitative descriptive approach. General practitioners (N = 12) with experience referring women to maternity models of care in Australia participated in a semi-structured interview. Interviews occurred between October and November 2021 by telephone or videoconference. Reflexive thematic analysis was facilitated by NVivo-12 data management software to codify and interpret themes from the data. Two broad themes were interpreted from the data. The first theme entitled 'GP Factors', incorporated three associated sub-themes including '1) GPs Previous Model of Care Experience', '2) Gaps in GP Knowledge' and '3) GP Perception of Models of Care'. The second theme, entitled 'Woman's Factors', encapsulated two associated sub-themes including the '4) Woman's Preferences' and '5) Access to Models'. This study provides novel evidence regarding general practitioner perspectives of the factors influencing model of care decision-making and referral. Predominant findings suggest that gaps in GP knowledge regarding the available models of care are present and are largely informed by prior personal and professional experience. Most GPs described referring to models of care they perceive positively and centring their model of care discussions on the woman's preferences and accessibility. The exploration and description of factors influencing model of care decisions provide unique insight into the ways that all stakeholders can experience access to a broader range of models of care including midwifery-led continuity of care models aligned with consumer-demand. In addition, the role of national primary health networks is outlined as a means to achieving this.

An exploratory analysis of moderating effects in a non-randomized, quasi-experimental evaluation of a college-based mental health literacy curriculum

Objective: To assess possible moderating variables that influence the effectiveness of a college-based mental health literacy curriculum, Mental Health Awareness and Advocacy (MHAA). Participants: Students at a Western University in the United States (MHAA treatment group: N = 474; Comparison group: N = 575). Methods: Using a non-randomized, quasi-experimental design over six semesters (2017–2019), students in the treatment and control groups reported on key demographic factors, experiences with mental health, and their knowledge, self-efficacy, and behaviors related to mental health literacy in a pretest/post-test format. Linear mixed effects models were used to assess moderation. Results: MHAA curriculum’s efficacy varied based on participants’ current depression and anxiety levels, whether they had prior personal experience with a mental health concern, whether they had been diagnosed with a mental health concern, and whether they had experienced suicidal thoughts. Conclusions: Reducing anxiety and depression among students may increase the efficacy of the MHAA program.

Immersive virtual reality in experiential learning for architecture design education: an action research

PurposeChallenges of conducting site visit activities, a vital component of architecture learning during the recent pandemic have proved our unreadiness in facing the digital future. The lack of understanding of learning technology has affected the education experience. Thus, there is a need to investigate immersive learning technology such as immersive virtual reality (IVR) to replace students’ concrete experience in the current learning setting. This study aims to answer: (1) What is the influence of IVR in experiential learning (EL) in enhancing the personal spatial experience? (2) Does IVR in EL influence students' approach to learning during the architecture design process?Design/methodology/approachThe research was conducted as an action research design approach. Action research was employed in the first-year architecture design studio by the lecturer as a practitioner-researcher. The personal spatial experience survey was performed in the earlier phase to identify the students’ prior spatial experience. Architectural Spatial Experience Simulation (ASES) a learning tool was implemented and assessed with Architecture Design Learning Assessment (ADLA) rubric, which was developed to evaluate EL and student’s approach to learning during the architecture design learning process.FindingsThe outcomes revealed that ASES as a learning tool in EL could improve the participants’ spatial experience, particularly those with minimal prior personal spatial experience. ASES was recognized to enhance the participants’ EL experience and encourage changes in student’s approach to learning from surface to deep learning.Originality/valueThis research benefits the architecture design learning process by offering a learning tool and a framework to resolve challenges in performing site visit activities and digital learning. It also contributes by expanding the EL theory and students’ approach to learning knowledge in the architecture education field.

Engaging diverse learners: lessons learned from a dialogic, technology-enabled social studies curriculum

PurposeThe purpose of this paper is to present insights from the implementation of a dialogic social studies curriculum and its potential to support diverse learners. Policymakers and educators must attend to the learning needs of diverse/minoritized (Note: In this paper, the authors use minoritized and diverse interchangeably) students who have been marginalized in public education. A critical goal is to close racial, ethnic and socioeconomic achievement gaps by increasing, for example, students’ engagement with curriculum and instruction. In this paper, the authors bridge research on dialogic instruction and culturally relevant and responsive education with the goal of informing curricular design and instructional practice.Design/methodology/approachThis conceptual paper discusses the utility of dialogic instruction in improving learning outcomes for minoritized student populations. While some researchers have examined the positive effects of dialogic instruction on underperforming students (e.g. Murphy et al., 2009; Pillinger and Vardy, 2022), few scholars have examined dialogic instruction through a culturally relevant and responsive lens. The authors argue that the application of this critical lens may improve learning outcomes for diverse learners who have been marginalized in public education systems.FindingsThe authors present illustrative vignettes and insights from a pilot study of a novel social studies curriculum. This curriculum applies a social justice lens by guiding students in the exploration of complex social issues that affect them. Given the diversity of their collaborating teachers’ classrooms (55% are racially minoritized students), the authors applied principles of culturally relevant and responsive education (e.g. Ford, 2010; Gay, 2000; Ladson-Billings, 1995) when designing and piloting the curriculum. Prior personal and professional experiences by the first author point to the potential of dialogic instruction to meaningfully support minoritized students’ learning.Originality/valueThis paper builds on two bodies of literature – dialogic instruction and culturally relevant and responsive education – to identify how an innovative social studies curriculum may improve learning for diverse student populations. It calls for the advancement of a research agenda that applies a culturally relevant and responsive lens to inform instructional practice. The authors begin this discussion with two vignettes.

On reflection.

Do any of us have perfect vision? The answer is ‘No’. Our reflections, visually and occasionally intellectually, may not be realistic. You may think that when you look into a mirror you see yourself but if the left arm is raised the person in the mirror raises their right arm. The explanation is twofold. Firstly, you cannot look into a mirror (you can only look at the image created by the mirror) and, secondly, and I am sorry about this, what you see is not a real person. Thus the unreal reflection image cannot have their own right or left orientation although the reflection does bear a relation to the rest of the world in that their/its ‘north, south, east, west’ are the same. Our conscious vision comprises a mental imaging of our visible surroundings and recognition of what is seemingly seen is founded upon whether what we are seeing matches with our prior visual experiences and resultant knowledge, in which case it is recognized. If it cannot be matched, then this new element has to be learned. Things seen for the first time may not be recognized. Thus, everyone’s appreciation of what they envision is related to their own prior personal experiences and is unique to them. Strikingly, whilst glancing at stacks of CDs or books, individual CDs or books of interest leap into consciousness because the attentional visual system is primed by prior knowledge. How many CDs or books of interest are missed is uncertain.

‘Why are we doing this if there’s no connection?’ The importance of prior experience in academic learning on a Master’s programme

ABSTRACT Personal approaches to learning in Higher Education are acknowledged to offer an engaging and motivating approach to learning. This article argues that they can also enable students to learn more effectively, and apply this learning to their professional lives. Previous research has suggested that three of the most difficult facets of Master’s level study for students are abstract thinking, unpredictability, and research skills. This practitioner study found that drawing on students’ prior personal and professional experience is an effective way to develop these skills, because it provides the necessary contextualisation for learning. Interview data from one diverse cohort on a Master’s in Education programme show that the students believed that this approach improved their understanding of these three areas, and their ability to use formal assignments to explore and explain their experience. This more personal and engaged approach to learning addresses a neglected area of higher education: attending to Master’s students’ academic skill development.

N16 Exploring the factors that influence adjustment to and acceptance of an intestinal stoma for IBD: preliminary findings

Abstract Background Adjusting to a stoma can be difficult. During development of a new Patient-Reported Outcome Measure, peoples’ perceptions of factors influencing acceptance of a stoma were explored. Methods Participants aged 18 years+ (confirmed IBD diagnosis, current or prior stoma) were recruited via Crohn’s & Colitis UK. Semi-structured interviews (online/phone January–April 2022) were audio-recorded, transcribed professionally, and analysed thematically. Results Of 29 participants, 16 (55%) were female, 13 (45% male, or non-binary); mean age 53 years (range 22-77 years); with Crohn’s disease (n=11), ulcerative colitis (n=15) and IBD-unclassified (n=3). Mean time from diagnosis to first stoma: 9.3 years; 27 (93%) had a permanent stoma. Four early themes emerged: Diagnosis and treatment: Clinical history before stoma surgery affected peoples’ responses afterwards. Delayed diagnosis, medication, and a declining health trajectory led to ‘no other option’ making it easier to consent to and accept stoma-forming surgery. Relief and control came once practical stoma care was mastered. Those who reported delayed diagnosis and/or not being believed about being seriously unwell, carried that experience forward with them. Challenges of living with a stoma: No-one was ‘pleased’ that they had a stoma, but all (bar one) felt that life was better with, than without one. The stoma was harder to accept when not preceded by extended illness, or when temporary. Challenges included poor facilities for managing the stoma away from home and finding the right appliance to suit. The time needed per day to care for the stoma was burdensome. It took about two years to reach acceptance after stoma surgery. Personality and coping: Participants viewed their stoma in the same way they addressed other challenges: there was no choice but to ‘get on with it’. Problem-solving skills had often been learnt in childhood. Recalling the stark health contrast between life without and with a stoma was helpful in accepting the stoma as part of their identity. Social impacts and influences: Family, intimate partner, and social support were crucial. There is inadequate support for ostomates’ family members, especially children. Partners were accepting of the stoma, but women worried about body image and remaining attractive. People described anticipated and perceived stigma; whilst concerned that the stoma might be ‘obvious’ to others, they also endured negative comments because it was invisible. Conclusion Adjustment to living well with a stoma is influenced by personality, coping style, and social support, informed by prior personal, social and clinical experiences. Public ignorance about stomas and others' stigmatising attitudes often cause the most distress.

Self-Efficacy in Online Teaching during the Immediate Transition from Conventional to Online Teaching in German and Argentinian Universities—The Relevance of Institutional Support and Individual Characteristics

Triggered by the spread of the Coronavirus and the lockdown of universities in spring 2020, universities were required to provide infrastructure for digital teaching within a very short time. Further, all university members needed to develop knowledge and skills for teaching online. This paper presents data from the cross-cultural CRTS-Study (Coronavirus-Related Teaching Situation Study), which compares the experiences, attitudes and needs of university teachers in Germany and Argentina during the first lockdown in the context of the Coronavirus pandemic. The study has been carried out in spring 2020 as a cross-sectional online survey study with university teachers in Germany and Argentina (N = 728). The overall picture reveals a mostly successful implementation of online teaching for university teachers in both countries, with Argentinian university teachers reporting a slightly more positive perspective and slightly higher self-efficacy beliefs in online teaching when compared with the German colleagues. The results of regression analysis hint at the relevance of prior personal experience and institutional support for self-efficacy beliefs in online teaching for both samples. In conclusion, individual experience and training as well as supportive institutional conditions seem to be relevant for the development of digital teaching at universities in both countries.

Does Parents’ Valence toward School Relate to their Perceptions of Invitation to School Involvement?

Parents’ involvement in children's schooling is usually affected by their prior personal experience with schooling. Thus, if we want to assess parents’ involvement in school activities and their children's learning it is crucial to assess their prior personal experience with schooling. This study, therefore, examined the relationship between parents' self-reported valance toward school and their perceptions of invitations to the involvement of the school, teachers, and their child. The study involved 1176 low-income parents of children from 55 primary schools in four regions in Northern Tanzania. A multivariate linear regression model showed that parents' prior schooling experience (school valence) has a statistically significant effect on parents' perceptions of general invitations from school, teachers, and specific invitations from the child. Results showed that the school attributes could affect the relationship between parents' valence and their perceptions of involvement invitations. Possible interventions to promote inclusive parental involvement through supportive schools will be discussed.

Incidentalomas in the head & neck.

Incidental findings (IFs) in the head & neck are a frequent challenge to the reporting radiologist. A combination of complex anatomy, widely varied imaging techniques and the high prevalence of benign pathology, makes safe and appropriate management of head & neck IFs problematic. The non-head & neck radiologist is unlikely to have prior personal experience of the relevant specialties or current involvement with the pertinent multidisciplinary teams, creating unfamiliarity with both the clinical aspects of head & neck disease and the value of examination techniques. This triumvirate of complex anatomy, pathology and imaging creates the perfect environment for excessive investigation and overdiagnosis. In this article, the most frequently encountered and clinically relevant head & neck IFs are summarised. To reflect daily clinical practice, we will firstly consider anatomic abnormalities identified on cross-sectional imaging and ultrasound, followed by a review of PET-CT incidental findings.

Should We Hire Our Current Fellow? Hiring Trends and Preferences in Spine Surgery.

To provide insight into hiring trends/preferences in Academic Orthopaedic Spine Surgery after fellowship training. Fellowship directors (FDs) listed by the North American Spine Society were surveyed regarding new faculty hiring preferences. Surveys were analyzed/stratified by response using the Kruskal-Wallis with Dunn multiple comparisons test, the Fisher exact test, and the Mann-Whitney U test for univariate comparisons. Thirty-two of 52 (61.5%) FDs responded. 32.3% of graduated fellows pursued academic medicine, which was preferred by FDs (3.59 ± 0.67; 1 to 5 scale). From 2015 to 2020, of the 2.25 ± 1.46 faculty members hired per program, 45.8% were former residents/fellows. Top listed hiring qualities were "strong recommendation from a trusted colleague" (84.4%), "prior personal experience, as a resident/fellow" (78.1%), and "amicable personality" (53.1%). Twelve (38%) answered "no", six (19%) "yes", and 14 (44%) "other", regarding if hiring former residents/fellows benefits the field of spine surgery. "Other" answers endorsing in-house hiring most commonly mentioned consistency/stability (28.6%) while those opposed most commonly mentioned lack of diversity of training/novel techniques (42.9%). When considering programmatic size, while the stated perception of FDs regarding in-house hiring at larger (>2 fellows) versus smaller (1 to 2 fellows) programs was equivalent, the mean percentage of in-house hires at larger programs (67.8% ± 35.8%) was significantly greater than that of smaller programs (33.3% ± 44.8%, P = 0.04). In-house hiring in spine surgery appears to occur more commonly than perceived by program leadership, particularly at larger fellowship programs. Further study of hiring preferences and their impact on the field of spine surgery is warranted. Prospective Survey Study.

How Do Chemistry Faculty and Graduate Students Engage in Decision Making on Issues Related to Ethical and Responsible Conduct of Research Including Authorship?

In the United States National Science Foundation and the National Institutes of Health have mandated training STEM doctoral students in the ethical and responsible conduct of research to improve doctoral students' ethical decision-making skills; however, little is known about the process and factors that STEM faculty and graduate students use in their decision-making. This exploratory case study examined how four triads of chemistry faculty and their doctoral students recruited from three research universities in the eastern United States engaged in ethical decision-making on issues of authorship, assignment of credit, and plagiarism. A mixed-methods approach involving the administration of an online survey consisting of three open-ended case studies followed by a think-aloud interview was utilized. Participants were found to use analogical reasoning and base their decision-making on a common core set of considerations including fundamental principles, social contracts, consequences, and discussion with an advisor, often using prior personal experiences as sources. Co-authorship did not appear to impact the doctoral students' ethical decision-making. Gender may play a role in graduate students' decision-making; female doctoral students appeared to be less likely to consider prior experiences when evaluating the vignettes. Graduate students' lack of knowledge of the core issues in the responsible conduct of research, coupled with their lack of research experience, and inability to identify the core considerations may lead them to make bad judgments in specific situations. Our findings help explain the minimal impact that the current responsible conduct of research training methods has had on graduate students' ethical decision-making and should lead to the development of more effective approaches.

Examining drivers of coronavirus disease 2019 (COVID-19) vaccine hesitancy among healthcare workers.

To assess characteristics and perceptions associated with vaccine hesitancy among healthcare workers to increase coronavirus disease 2019 (COVID-19) vaccine uptake in this population. Cross-sectional quantitative survey. A not-for-profit healthcare system in southwestern Virginia. A convenience sample of 2,720 employees of a not-for-profit healthcare system. Between March 15 and 29, 2021, we conducted an Internet-based survey. Our questionnaire assessed sociodemographic and work-related characteristics, vaccine experience and intentions, agreement with vaccine-related perceptions, the most important reasons for getting or not getting vaccinated, and trusted sources of information about COVID-19. We used χ2 analyses to assess the relationship between vaccine hesitancy and both HCW characteristics and vaccine-related perceptions. Overall, 18% of respondents were classified as vaccine hesitant. Characteristics significantly associated with hesitancy included Black race, younger age, not having a high-risk household member, and prior personal experience with COVID-19 illness. Vaccine hesitancy was also significantly associated with many vaccine-related perceptions, including concerns about short-term and long-term side effects and a belief that the vaccines are not effective. Among vaccine-acceptant participants, wanting to protect others and wanting to help end the pandemic were the most common reasons for getting vaccinated. Personal physicians were cited most frequently as trusted sources of information about COVID-19 among both vaccine-hesitant and vaccine-acceptant respondents. Educational interventions to decrease vaccine hesitancy among healthcare workers should focus on alleviating safety concerns, emphasizing vaccine efficacy, and appealing to a sense of duty. Such interventions should target younger adult audiences. Personal physicians may also be an effective avenue for reducing hesitancy among their patients through patient-centered discussions.

P473 Real world experience with the Crohn’s Disease Exclusion Diet (CDED) in a tertiary IBD clinic

Abstract Background The Crohn’s Disease Exclusion Diet (CDED) is a whole-food diet designed to reduce exposure to dietary components, hypothesized to negatively affect the microbiome, intestinal barrier, and immune response. In a clinical study in adults with mild-moderate CD (<5 years duration), an inflammatory phenotype involving the terminal ileum, it induced clinical, biochemical and endoscopic disease remission. We aimed to describe our real-world experience with the CDED, in a clinically diverse CD population. Methods A retrospective cohort study of CD patients prescribed with the CDED, between 1.2018 and 11.21. Patients’ medical background, medical therapy, nutritional status and clinical disease activity as well as adherence and clinical outcomes were documented from patients’ medical files. Results The CDED was recommended to 218 CD patients. Of these, 62 were excluded from the analysis due to lack of medical information (n=11), prior personal experience with the CDED (n=23), patient’s refusal (n=24), and stoma patients (n=4). The CDED was initiated in 155 patients (age 37.7±16.3, 66% men, disease duration 7.8±9.6), 35.3% had colonic/ileo-colonic disease, 23.7% and 25% had a stricturing and penetrating disease respectively, 27.5% had a history of intestinal resection, 19.9% had extra-intestinal involvement, and 7.7% had a severe endoscopic disease at diet initiation. Indications for therapy included patient’s will (44.7%), adjunctive therapy (23.7%), bridge with biologic induction (20.4%), rescue therapy (3.9%), exhaustion/contraindication of other advanced therapy options (1.4%), de-escalation of biologics (0.7%), preparation for surgery (0.7%), and others (3.9%). Upon initiation, 67.3% (n=105) had an active disease [Harvey Bradshaw index (HBI) ≥5 / Calprotectin ≥250 g/l] and 32.7% were in remission. Physician and dietician follow-up at the end of phase 1 was documented in 89 (57.4%) and 74 (47.7%) of patients with an active disease (mean follow-up period 14.6±9.3 weeks). Fifty-eight percent of patients with dietary follow-up (n=43) were fairly-fully compliant to the CDED. Clinical response (drop in HBI>2 points) and remission (HBI<5) at the end of phase 1, were achieved by 58.9% (n=62) and 57.5% (n=60) of patients who were treated for an active disease (n=105). Clinical remission rate at the end of phase 1 was lower among patients with higher baseline HBI score (P for trend=0.028), lower dietary adherence (P for trend<0.001) and a surgical history (P=0.033). Conclusion The CDED may have efficacy across different clinical scenarios. Adherence is reasonable, and is associated with higher remission rates among patients treated for an active disease.

A Cross Section of Teacher Visioning

ABSTRACT Research on teacher visioning has focused mainly on teacher candidates or on graduates from teacher-preparation programs. To explore a broader scope, this qualitative study investigated a cross-section of visions from three literacy teacher educators in three different universities, three elementary teachers, and three teacher candidates. This study was guided by the theory that visions are internal to the individual and shaped by experiences and socializations. The article answers the following research questions: (1) What are the similarities in teachers’ visions across the experience bands? and (2) What influenced teachers’ visions? Coding processes were in vivo coding and pattern coding. Findings revealed that visioning themes were similar across participants, regardless of their educational level or teaching experiences and that prior educational and personal experiences influenced visions.

An Exploration of Self-Reported Medicinal Cannabis Use Among a Sample of Eastern Canadian Postsecondary Students.

In October 2018, prior to the legalization of cannabis in Canada, a survey was completed by 1050 Memorial University of Newfoundland students. Both descriptive quantitative and thematic qualitative data analyzes were used. Approximately 16% of the sample reported ever using cannabis for medicinal purposes (n=175), with only 16.6% of medicinal users reporting authorization by a healthcare provider (HCP). The majority (80.2%) were aware of possible side effects of cannabis. Prior personal experience (65.3%) and peer influence (59.5%) informed participants' medicinal use. Approximately 40% reported having replaced/reduced prescribed medication. Roughly 60% of medicinal users had not disclosed their use to their HCP. Consistent with previous studies, medicinal cannabis use among postsecondary students appears to be largely motivated for mental health related conditions and is grounded in personal experience versus evidence-based guidelines. There is a need for increased communication between HCPs and patients to promote lower-risk use among medicinal cannabis users.

Pediatric Trainee Perspectives on the Decision to Disclose Medical Errors.

The aim of the study was to describe factors that may impact pediatric trainees' willingness to disclose medical errors using clinical vignettes. A single-center cross-sectional anonymous survey of pediatric residents and fellows at a large urban medical center in 2019 was conducted. Trainees were provided with clinical vignettes depicting an error resulting in a serious safety event (SSE), minor safety event (MSE), and near miss safety event (NMSE) and were asked to classify the type of safety event and rate and explain their agreement or disagreement with disclosure. Survey items also evaluated trainees' personal experiences with errors and disclosure. Descriptive and correlational analyses were used to characterize responses. Qualitative content from open-ended survey questions was analyzed using the constant comparative method. Of 126 trainees, 42 (33%) completed the survey. All agreed with disclosing the hypothetical error presented in the vignette resulting in an SSE (100%), with rates falling for the MSE (95%) and NMSE (7%). There were no significant associations between disclosure agreement for the vignettes and trainee demographic features, knowledge of safety events, prior personal experiences with errors, and disclosure. Four themes that emerged from qualitative analysis of trainees' rationales for disclosure or nondisclosure of the vignette errors are harm, parental preferences, ethical principles, and anticipatory guidance. Trainees had high rates of disclosure for the vignette errors cases that depicted SSEs and MSEs but lower rates for NMSEs. Trainees considered the type and level of harm caused, parental preferences, upholding ethical principles, and the need for anticipatory guidance in their rationales for disclosure or nondisclosure of the vignette errors.

Familiarity breeds overconfidence: Group membership and shared experience in the closeness-communication bias

Though both spouses and strangers understand a speaker equally well in a novel communication task, people overestimate their success of communication more with spouses than strangers (Savitsky, Keysar, Epley, Carter, & Swanson, 2011). This phenomenon, termed the closeness-communication bias, is presumed to occur because people anchor their common ground assessments egocentrically and only minimally adjust when they perceive their interlocutors to be similar to themselves. In four experiments on college undergraduates, we investigated whether (1) friendship, (2) college affiliation, (3) minimal groups, and (4) familiarity (as defined as shared experience) affected the closeness-communication bias. As predicted, participants predicted greater prosody comprehension for friends than strangers (ηp2 = 0.56), as did minimal group members (ηp2 = 0.220) and individuals who engaged in a short online chat (ηp2 = 0.116). However, we did not find evidence of the bias when comparing undergraduates speaking to another student from the same college vs. speaking to a student from a rival college (ηp2 = 0.04). Thus, people are more likely to overestimate common ground both when they have prior personal experience with their interlocutors or when they have minimal knowledge about their interlocutors' group characteristics. In addition, the amount of personal experience or prior knowledge influences the magnitude of the bias.

Birth Observation Among African American Women Prior to Pregnancy.

A focused ethnography among African American college students who had observed a live birth prior to their own pregnancy was pursued. Women described two reasons to attend births: curiosity about birth, or a desire to support the birth mother. Women attended the births of friends, family members, or saw their mother give birth to a younger sibling. Themes included pain, operative or traumatic birth, and surprise at the length and/or stages of labor. Some language suggested lingering trauma. Future expectations included painful labor, operative birth or damage, or traumatic labor and birth. Other women felt closer to the infant, or felt more prepared for their own births after observing birth. Prior personal experiences at birth should be explored prenatally.

Abortion attitudes, training, and experience among medical students in Jamaica, West Indies

ObjectiveTo define abortion attitudes, training and experience among medical students in Jamaica, a restricted environment for legal abortion.MethodFrom September to November 2017 we conducted an anonymous online cross-sectional survey among medical students enrolled at the University of West Indies (UWI) in Jamaica. An abortion attitudes sum score was used for analysis. Multivariate regression was applied to evaluate the impact of characteristics and experiences on abortion attitudes.ResultsThe primary outcome was a validated composite abortion attitudes sum score, ranging from zero to forty-five. 1404 students completed the survey for a response rate of 88%. 64% had a positive attitude towards abortion. In multivariate analysis, medical students’ attitudes were favorably impacted by a prior personal or family experience with abortion, identifying as non-religious, being older in age and mixed raced. 1321 (94%) agreed that abortion training should be included in the medical school curriculum. 78.8% reported no abortion training and only 17.9% reported miscarriage management training.ConclusionMedical students at UWI had favorable attitudes towards abortion, despite their limited training in a restrictive environment. Prior personal experience with abortion and being non-religious were the strongest predictor of favorable attitudes. Increased training and clinical exposure may prove to be crucial in improving access of safe abortion.