Short-answer Responses Research Articles

National Collegiate Athletic Association Athletic Trainers’, Head Coaches’, and Student-Athletes’ Perceptions of Professional Titles Used in Sport PsychologyA

The purpose of this convergent mixed-methods study was to explore National Collegiate Athletic Association (NCAA) Division I athletic trainer (AT), head coach, and student-athlete perceptions of three commonly used sport psychology professional titles in the United States: Certified Mental Performance Consultant (CMPC), mental conditioning coach, and sport psychologist. Participants included 73 ATs, 79 head coaches, and 76 student-athletes. Participants completed an online questionnaire that assessed their previous exposure to these professionals, the services they believed these professionals could provide, their confidence in sport psychology consultation from these professionals, and their stigma tolerance of these professionals. A series of Friedman tests found that ATs and student-athletes perceived significantly more confidence in the services of a sport psychologist compared to a CMPC and a mental conditioning coach. A series of Kruskal-Wallis tests revealed that student-athletes perceived significantly more stigma in using services from all three professionals than head coaches and ATs. Participants reported that sport psychologists could provide mental performance and mental health services, while CMPCs and mental conditioning coaches primarily provided mental performance services. However, short answer responses from many ATs and head coaches about CMPCs demonstrated some doubt and misunderstanding of this professional title.

Cultural adaptation and evaluation of a school-based positive psychology intervention among Chinese middle school students: A mixed methods program design study.

With the recognition of positive psychology within China, there is a pressing need for evidence-based positive psychology interventions (PPIs) tailored to the cultural context of Chinese schools. The goals of the present study were to (a) culturally adapt the Well-Being Promotion Program using the ecological validity model and (b) conduct a preliminary evaluation of its effectiveness. Within a randomized controlled trial, we collected data from 107 eighth-grade students randomly assigned to the intervention (n = 55) or control group (n = 52). A mixed methods approach was used, with analysis of covariance to assess program effectiveness, and content analyses of students' short-answer responses collected from the intervention group. Qualitatively, more than half of students reported having positive feelings and an increase in happiness due to the program. Quantitatively, the study found that the intervention was associated with a significant increase in adaptability, a subcategory of psychological suzhi, following the intervention. Gender breakdown revealed that the intervention had a significant positive effect on boys' cognitive quality, but not girls'. Additionally, it marginally impacted girls' self-management and boys' adaptability quality. However, caution is warranted in interpreting the quantitative results due to limitations, such as a small sample size and a relatively low response rate at Time 2. This pilot study contributes to the literature by bridging the gap between evidence-based PPIs developed in Western contexts and their culturally responsive implementation in Chinese schools. Consequently, the results should be considered as initial evidence warranting further examination of effectiveness, yet with significant potential to advance future cultural adaptations of PPIs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

What supports do autistic adolescents and adults need? Perspectives of self-reporting adults and caregivers.

Increasingly, autistic adolescents and adults are accessing occupational therapy. However, limited evidence exists on the type of supports that are important to them. Examining the patterns of supports valued by autistic adolescents and adults will inform the design of occupational therapy services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important. This study involved two anonymous online surveys. Survey one involved 54 items and was distributed to caregivers of autistic adolescents and/or adults. Survey two included 41 items and was distributed to self-reporting autistic adults. Surveys sought closed and open-ended responses about the support needs of autistic individuals living in Australia. Quantitative data were analysed as counts and frequencies of responses, whereas short-answer responses were analysed through content analysis. There was no consumer or community involvement in the completion of this project. A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Quantitative data from both autistic adolescents' and adults' closed-answer responses showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Content analysis of open-ended responses, performed separately for each participant group, revealed six categories: employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance. Results highlight that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy practice. Differences between the priorities of autistic individuals and their caregivers highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs. Increasingly, autistic adolescents and adults are accessing occupational therapy services. However, limited information exists regarding the type of supports that are important to them. Understanding what supports are valued by autistic adolescents and adults will support occupational therapists deliver effective and individualised services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important to them. This study involved two anonymous online surveys. Survey one was completed by caregivers of autistic adolescents and/or adults. Survey two was completed by self-reporting autistic adults. Surveys included both open-ended and closed-answer responses to better understand the support needs of autistic individuals living in Australia. A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Closed-answer response questions from both the caregivers and self-reporting autistic adolescents and adults showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Open-ended response questions revealed six main priorities including, employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance. This study found that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy. Further, participant responses highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs.

Patient and Provider Satisfaction With a Geomapping Tool for Finding Community Family Physicians in Ontario, Canada: Cross-Sectional Online Survey Study.

Language-concordant health care, or health care in a patient's language of choice, is an important element of health accessibility that improves patient safety and comfort and facilitates an increased quality of care. However, prior research has found that linguistic minorities often face higher travel burdens to access language-concordant care compared to the general population. This study intended to assess patient experiences and satisfaction with an online interactive physician map that allows patients to find family physicians who speak their preferred language in and around Ottawa, Ontario, Canada, as a means of identifying areas of improvement. This study used an online survey with questions related to user satisfaction. Responses to Likert-scale questions were compiled as summary statistics and short-answer responses underwent thematic analysis. The study setting was Ottawa and Renfrew County, Ontario, and the surrounding region, including the province of Quebec. A total of 93 respondents completed the survey and self-identified as living in Ontario or Quebec. Overall, 57 (61%) respondents were "very satisfied" or "somewhat satisfied" with the map, 16 (17%) were "neither satisfied nor dissatisfied," and 20 (22%) were "very dissatisfied" or "somewhat dissatisfied." We found no significant differences in satisfaction by preferred language, age group, physician attachment, or intended beneficiary. A total of 56 respondents provided short-answer responses to an open-ended question about map improvements. The most common specific suggestion was to show which physicians are accepting new patients (n=20). Other suggestions included data refreshes (n=6), user interface adjustments (n=23), and additional languages (n=2). Some participants also provided positive feedback (n=5) or expressed concern with their inability to find a family physician (n=5). Several comments included multiple suggestions. While most patients were satisfied with the online map, a significant minority expressed dissatisfaction that the map did not show which family physicians were accepting new patients. This suggests that there may be public interest in an accessible database of which family physicians in Ontario are currently accepting new patients.

Long-acting injectable ART to advance health equity: a descriptive analysis of US clinic perspectives on barriers, needed support and programme goals for implementation from applications to the ALAI UP Project.

Approval of the first long-acting injectable antiretroviral therapy (LAI ART) medication heralded a new era of HIV treatment. However, the years since approval have been marked by implementation challenges. The "Accelerating Implementation of Multilevel Strategies to Advance Long-Acting Injectable for Underserved Populations (ALAI UP Project)" aims to accelerate the systematic and equitable delivery of LAI ART. We coded and analysed implementation barriers according to the Consolidated Framework for Implementation Research (CFIR) domains, desired resources and programme goals from questionnaire short-answer responses by clinics across the United States responding to ALAI UP's solicitation to participate in the project between November 2022 and January 2023. Thirty-eight clinics responded to ALAI UP's solicitation. The characteristics of LAI ART as an innovation (cost, complexity of procurement, dosing interval, limited eligibility) precipitated and interacted with barriers in other CFIR domains. Barriers included obtaining coverage for the cost of medication (27/38 clinics) (outer setting); need for new workflows and staffing (12/38) and/or systems to support injection scheduling/coordination (16/38), transportation and expanded clinic hours (13/38) (inner setting); and patient (10/38) and provider (7/38) education (individuals). To support implementation, applicants sought: technical assistance to develop protocols and workflows (18/38), specifically strategies to address payor challenges (8/38); additional staff for care coordination and benefits navigation (17/38); opportunities to share experiences with other implementing clinics (12/38); patient-facing materials to educate and increase demand (7/38); and support engaging communities (6/38). Clinics' LAI ART programme goals varied. Most prioritized delivering LAI ART to their most marginalized patients struggling to achieve viral suppression on oral therapy, despite awareness that current US Food and Drug Administration approval is only for virally suppressed patients. The goal for LAI ART reach after 1 year of implementation ranged from ≤10% of patients with HIV on LAI ART (17/38) to ≥50% of patients (2/38). Diverse clinic types are interested in offering LAI ART and most aspire to use LAI ART to support their most vulnerable patients sustain viral suppression. Dedicated resources centred on equity and relevant to context and population are needed to support implementation. Otherwise, the introduction of LAI ART risks exacerbating, not ameliorating, health disparities.

A qualitative analysis of college women’s experiences with dieting

Objective Dieting is a known risk factor for disordered eating, yet many college women engage in this behavior. Given the popularity of diets, and the risks associated with dieting, it is important to enhance understanding of dieters’ experiences. This study utilized a qualitative approach to investigate college women’s experiences of dieting. Participants Eighty-four woman-identifying undergraduates [42% White, 24% Asian, 20% Black, 14% other; Mage = 19.18 (1.77)] who endorsed dieting were included in the study. Methods Participants provided short-answer responses to open-ended questions. Data were analyzed using a thematic analysis approach. Results The following themes were identified: A complicated relationship, variability of experiences, and social factors. Subthemes highlighted the complexity of college women’s dieting behavior. Conclusions Results provide important insight into college women’s dieting experiences and their consequences. Future qualitative research should aim to understand how to apply these findings to eating disorder prevention efforts.

The cyborg method: A method to identify fraudulent responses from crowdsourced data

Crowdsourcing is an essential data collection method for psychological research. Concerns about the validity and quality of crowdsourced data persist, however. A recent documented increase in the number of invalid responses within crowdsourced data has highlighted the need for quality control measures. Although a number of approaches are recommended, few have been empirically evaluated. The present study evaluated a Cyborg Method that used automated evaluation of participant meta-data and a review of short answer responses. Two samples were recruited – in the first, the Cyborg Method was applied after data collection to gauge the extent to which invalid responses were collected when a priori quality controls were absent. In the second, the Cyborg Method was applied during data collection to determine if the method would proactively screen invalid responses. Results suggested that Cyborg Method identified a substantial portion of invalid responses and both automated and human evaluation components w necessary. Furthermore, the Cyborg Method could be applied proactively to screen invalid responses and substantially reduced the per participant cost of data collection. These results suggest that the Cyborg Method is a promising means by which to collect high quality crowdsourced data.

Affirmation, Friendship, and Volunteerism: Understanding and Facilitating what Makes LGBTQA+ Young People in Australia Feel Good About Themselves

IntroductionLesbian, gay, bisexual, trans, queer or asexual (LGBTQA+) young people are at heightened risk of suicidality and psychological distress. Interventions in various forms are required to address this issue, which should be informed by the strengths, capacity and insight of LGBTQA+ young people.MethodsAn online survey was promoted to LGBTQA+ young people (aged 14–21) via targeted social media advertising and community organisation dissemination, in late 2019. In addition to a range of health and wellbeing questions, all participants were asked, ‘What makes you feel good about yourself?’ The open-text responses were subject to a detailed, inductive thematic analysis.ResultsIn total, 4751 young people provided a short answer response to the question of what makes them feel good about themselves. The length of responses ranged from a few words to several paragraphs. Six key themes were identified. These included LGBTQA+ young people finding value in connection with significant others and finding affirmation for their gender and sexuality through their presentation and engagement with the world. In addition, participants talked about how they liked to engage with people they identified with or saw as role models, and how their creative outlets or making a positive difference in the world (e.g., through volunteering) helped them feel good about themselves.ConclusionsWhile ensuring that young LGBTQA+ people have access to mental health services and social/support programs is important, it is also essential that we acknowledge young people’s agency and the significance of everyday, informal acts which support young LGBTQA+ people to achieve desires for connection, acceptance, contribution, belonging and self-expression.Policy ImplicationsFindings reported in this paper offer some valuable insights for policy and programming, particularly in acknowledging and centring young people’s agency and capacity to make decisions and take action to express themselves, to find community and affirm their identity.

Pride and Community Connection for Indigenous 2SLGBTQ+ Youth: the Intersectionality of Identity for Indigenous Adolescents in the United States

Two-Spirit and lesbian, gay, bisexual, transgender, queer, and gender-diverse (2SLGBTQ+) adolescents and young adults (AYA) in Indigenous communities face disparate physical and mental health outcomes in the absence of connection to culture and Indigenous identity. There are limited data on the unique needs and strengths of this population. This work aimed to highlight the barriers and needs of 2SLGBTQ+ AYA and the link between cultural connection, pride, and resilience and positive health outcomes for these adolescents. This analysis of 15–25-year-old participants is derived from a mixed-methods study, which assessed the barriers to seeking and accessing care for 2SLGBTQ+ individuals. Survey and short-answer responses were collected through REDCap, and an analysis was performed using SAS 9.4 (quantitative) and ATLAS.ti (qualitative short answer). Responses demonstrate high levels of pride and connectedness among 2SLGBTQ+ AYA and that affirming healthcare is critical in supporting positive outcomes. Results also suggest a need for increased education regarding Indigenous worldviews, health, barriers to care, and historical contexts besides gender diversity. In conclusion, results indicate that pride and connection are inherent in 2SLGBTQ+ AYA communities, which can serve as protective factors to improve health outcomes. Using this knowledge, providers can support youth clinically as well as through policy and advocacy action. Family, community, and health provider support allow for identity formation and expression. Findings can also be applied to gender-diverse AYA in non-Indigenous communities.

Rural parents’ adherence to infant feeding guidelines to prevent allergy: a cross sectional study in New South Wales

BackgroundResponding to international research showing that early introduction of common food allergens can reduce the chance of developing allergies, in 2016 the Australasian Society of Clinical Immunology and Allergy (ASCIA) revised allergen introduction guidelines, recommending earlier introduction of allergens to infants in their first year. Australia has high food allergy rates, and limited understanding of adherence to allergen introduction guidelines, especially in rural areas. This project explored rural parent adherence to ASCIA guidelines.MethodsThis was a mixed method cross sectional study using an online survey including multiple-choice and qualitative short answer responses. The sample were 336 women from two rural health districts in New South Wales. All were aged 18 or over, and either pregnant or had delivered a baby since July 2018. Descriptive statistics were used to measure behavioural alignment with the recommended guidelines, thematic analysis was used to analyse attitudes and explanations.ResultsIn 84.3% of children, feeding adhered to all four guidelines studied, including no elimination of allergens during pregnancy (98%), age of introduction of solids (97.7%), continuation of breast milk/cow’s milk formula during introduction of solids (95%), and age of introduction of allergens (92.9%). Adherence was not significantly correlated with the education (X2 = 17.9, P = .056), prior history of allergy [neither mother (X2 = 0.945,P = .623) nor previous children (X2 = 0.401,P = .818)], or primary care received during pregnancy. More than 90% of participants agreed or strongly agreed that the guidelines are realistic, trustworthy, and important for the health of their child. However, thematic analysis revealed that parents’ perceptions of a child’s individual progress, and medical conditions or other circumstances, such as challenges with breastfeeding, will often take precedence over adherence to specific guideline recommendations.ConclusionsHigh rates of adherence with ASCIA guidelines found here are comparable with findings from metropolitan studies and encouraging for future population health. Participant comments on the guidelines imply to rural policymakers that there are multiple influences on parent decisions about infant feeding, often including parents’ own intuition and experiences. Further studies to improve understanding of the role of information, carers, and other influences on parent decision-making concerning feeding attitudes and behaviours will be necessary to optimise adherence in rural areas.

Gender bias in colorectal surgery fellowship letters of recommendation

BackgroundAs leaders strive to create equitable surgical pipelines, one process under scrutiny is letters of recommendation (LORs). We sought to review the Colon and Rectal Surgery (CRS) Resident Candidate Assessment questionnaire and LORs for gendered differences. MethodsThis retrospective observational study of letters of recommendation to CRS fellowship during the 2018–2019 application cycle utilized linguistic Inquiry and Word Count (LIWC2015) software to assess letter length and themes comparing differences by applicant and referee gender. Results103 applicants (35 ​% women) with 363 LORs (16 ​% written by women) were included. Short answer responses were longer for women applicants, while LORs were longer for men applicants (368 vs 325 words p ​= ​0.03). Men applicants' strengths had more technical skill descriptors, while women applicants’ strengths had more emotional language and cognitive and perceptual words. ConclusionsThis study found significant differences between LORs written for CRS fellowship applicants based on gender.

Long Covid requires a global response centred on equity and dialogue

ABSTRACT Long Covid, or Post-Covid Conditions, is a global health problem. Yet we know strikingly little about the different experiences of Long Covid patients cross-nationally. To address this shortcoming, we conducted an online survey of Long Covid patients active on social media in the U.S. (n = 334, October to December 2021) and Brazil (n = 144, January to April 2022). Our analysis of short answer responses indicates patient dissatisfaction with medical care provided for Long Covid in both the U.S. and Brazil. For Long Covid patients in Brazil, there were additional concerns raised about the lack of local expertise about their condition. Based on these results, we urge policymakers to expand the education of medical professionals in order to raise awareness of Long Covid. Experts in the Global North should also be encouraged to engage in dialogue with patient groups and experts in the Global South, in order to better understand how local contexts shape the experience of Long Covid.

Using historical evidence: The semantic profiles of Ancient History in senior secondary school

This paper presents findings from the Australian Research Council funded ‘Disciplinarity, Knowledge and Schooling’ project (DISKS) which investigates knowledge-building practices in Australian secondary schools and gave rise to the ground-breaking notions of ‘semantic waves’ (Maton, 2013) and ‘power pedagogy’ (Martin, 2013). In this paper, we investigate student writing in senior secondary school Ancient History. We focus on how students use evidence in their responses to different types of exam questions. Our research question focuses on the extent to which key features of responses to short answer questions appear in extended responses and vice versa. This focus arose through findings that teachers in our study tended to view short answer questions as a ‘mini’ version of extended responses and prepared students accordingly. The similarities and differences are important to identify as extended responses make a significant contribution to the overall exam grade. To better understand the use of evidence in responses to different types of exam questions, the study draws on the dimension of Semantics in Legitimation Code Theory (Maton, 2013). We use the newly developed wording and clausing tools (Doran & Maton, 2018, forthcoming) to analyse the relative strength of context dependence in responses to Year 12 exam questions. Context dependence is particularly relevant to how students use evidence, as it involves relating the concrete particulars of specific historical artefacts, events, and the behaviours of historical figures to more abstract concepts in the discipline of history that are not bound to one historical setting. Our analysis tracks relative shifts in context dependence in student texts to generate semantic profiles of their exam responses. Findings show that although teachers may use the writing of short answer questions as preparation towards the high-stakes extended writing tasks, short answer responses are not ‘minature’ versions of extended responses. We argue that the differences are teachable and propose the use of model texts to make these features visible to students. Beyond the timeframe of secondary school education, learning to use evidence, particularly for the development of arguments, may provide a robust foundation for tertiary level writing tasks where students need to control degrees of context dependence.

An exploratory mixed methods study of multiracial Americans' race choices on the 2020 census.

We asked Multiracial emerging adults' about how they racially identified on the 2020 census, why they checked those boxes, their feelings about the options available to them, and how they would change the census options. After identifying the different themes, we looked at how groups differed on outcomes of Multiracial experiences, critical reflection, and self-esteem. We recruited a sample of 424 Multiracial emerging adults between the ages of 18 and 29 (67.1% female, Mage = 23.5). They responded to short-answer questions and survey items. Short-answer responses were coded into categories based on the themes identified, and associations with scales were examined using an analysis of variance and t test. Three themes were identified for reasons for selections on the census: identity-driven, accuracy-driven, and externally driven. Five themes represented participants' feelings about the census options, which were narrowed down to two themes (okay with the census options vs. add more census options). The accuracy-driven group reported higher scores for shifting racial expressions, challenges with racial identity, and critical reflection, as well as lower scores for self-esteem. In addition, individuals who wanted more options added to the census scored higher on challenges with racial identity and critical reflection. Multiracial emerging adults who seek to objectively report their racial background on the census regardless of how they identify shift racial expressions and report lower self-esteem, and like those who want more options added to the census, they experience more identity challenges but are more racially aware. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Remote Synchronous Laceration Repair Instruction With Summary Feedback.

Social distancing and quarantine requirements imposed during the COVID-19 pandemic necessitated remote training in many learning situations that formerly focused on traditional in-person training. In this context, we developed an adaptive approach to teaching laceration repair remotely while allowing for synchronous instruction and feedback. In April 2020, 35 family medicine residents from 4 programs in the Midwest United States participated in a real-time, remotely-delivered, 2-hour virtual procedure workshop of instruction in suture techniques for laceration repair. Paired-sample t tests compared scores of learner self-confidence obtained during pre- and posttests. We interpreted short-answer responses with a mixed-methods analysis. Residents submitted photos and videos of suture techniques and received formative feedback based on a predefined rubric. All residents completed the pre- and posttests. The posttest scores for self-confidence across the participants showed significant improvement for all suture techniques. Of the 67 short-answer responses, 38 responses (56.7%) were positive; 9 (13.4%) negative; 8 (11.9%) neutral; and 12 (17.9%) a combination of positive and negative. The workshop was rated by 34 residents (97.1%) as either "about the same as prior training experiences," "better than prior training experiences," or "much better than prior training experiences." Learners reported that a remotely-delivered, real-time, synchronous suture technique workshop was a valuable experience. Further research is needed to establish the efficacy of this platform to promote procedural competence.

(006) Characterizing Unmet Needs of Female Cancer Survivors Seeking Sexual Health Education Through Social Media

Abstract Introduction As targeted therapies lead to improved cancer survival, there remains an unmet need to address consequences of those treatments on survivors’ sexual health and satisfaction. Online education around sexuality after cancer is becoming more widespread, and recent work has shown that cancer survivors prefer to receive information about sexual side effects early and often. Objective We sought to describe the population of survivors seeking this information through social media, while further characterizing the needs of this growing population. Methods An investigator-designed online survey was made available through the social media page of a sexual health after cancer program. Participation was anonymous and voluntary, and the investigator-generated, 10-item instrument included multiple choice questions assessing age, cancer diagnosis and treatment characteristics, presence and type of sexual health concerns, and the type of utilization of online resources for health-related information. The final question allowed for a short answer response of educational needs. Descriptive analyses of the multiple-choice questions, and qualitative content analysis of the open response themes were assessed and described. Results 301 female cancer survivors completed the survey. Most respondents were 44 years old or younger (66%), and most had breast cancer (89%). Leukemia/lymphoma, cervical, uterine, ovarian, colon/other bowel, melanoma, and brain malignancy survivors also participated. Most participants reported painful sex (36%) or low desire (34%) as their most bothersome problem. Vaginal dryness (20%), body image issues (7%), and problems with orgasm (4%) were also reported. Participants’ most bothersome symptom stratified by cancer diagnosis is depicted in Figure 1. Most respondents were very or somewhat likely to seek sexual health information online (81%), particularly on Instagram (80%). 161 participants described additional information they sought online in a free-response question, which were included in the qualitative analyses. These participants expressed a need for more information regarding their concerns about low desire (25%), pain/discomfort during sex (15%), changing body image (11%), and vaginal dryness (11%). 35% sought product recommendations and 14% requested information about how to address their cancer treatments’ side effects. Survivors also asked for advice in navigating relationships, resuming sex lives, and dating after cancer (17%). Notably, participants expressed gratitude for the accessible, evidenced-based information and the sense of community that the page fostered. Conclusions Female cancer patients, particularly premenopausal survivors, are seeking sexual health information online about desire, body image, and relationships/dating, as well as genitourinary concerns after cancer. Their utilization of online forums highlights the need for improved access to survivorship resources, and more open communication with their providers and other patients, especially pertaining to potentially sensitive topics like sexuality and intimacy after cancer. Future work will allocate resources to providing a range of sexual health-related online education during and after treatment. Disclosure No

Medical Students’ Perspectives on Opportunities to Engage in the Clinical Care of COVID-19 Patients during the Pandemic

Recent disease modeling suggests that pandemics are likely to increase in frequency and severity. As such, medical educators must learn from their experiences with coronavirus disease 2019 (COVID-19) to develop systematic strategies for ensuring that medical students receive hands-on training in the management of emerging diseases. Here, we outline the process by which the Florida International University Herbert Wertheim College of Medicine developed and updated guidelines for student participation in the care of patients with COVID-19 and report on students' experiences. During the 2020-2021 academic year, Florida International University Herbert Wertheim College of Medicine students were not permitted to care for patients with COVID-19; however, academic year 2021-2022 guidelines did permit fourth-year students on subinternships or Emergency Medicine rotations to voluntarily care for patients with COVID-19. At the end of the 2021-2022 academic year, students completed an anonymous survey about their experience caring for patients with COVID-19. Likert-type and multiple-choice questions were analyzed using descriptive statistics and the short-answer responses were analyzed qualitatively. One hundred two students (84%) responded to the survey. Sixty-four percent of respondents opted to provide care for patients with COVID-19. Most students (63%) cared for patients with COVID-19 during their required Emergency Medicine Selective. Twenty-eight percent of students wished they had more COVID-19 patient care opportunities, and 29% did not feel prepared to care for patients with COVID-19 on their first day of residency. Many graduating students felt unprepared to care for patients with COVID-19 during residency and many wished they had had more opportunities to care for patients with COVID-19 during medical school. Curricular policies must evolve to allow students to gain competency in the care of patients with COVID-19 so that they are prepared for day one of residency.

Impact of early waves of the COVID-19 pandemic on family medicine residency training: Analysis of survey data.

To identify how graduating and incoming family medicine residents (FMR) experienced changes to their education during the early waves of the COVID-19 pandemic. The Family Medicine Longitudinal Survey was modified with questions related to the impact of COVID-19 on FMR and their training. Short-answer responses underwent thematic analysis. Responses to Likert scale and multiple-choice questions were reported as summary statistics. Department of Family and Community Medicine at the University of Toronto in Ontario. Graduating FMR in spring 2020 and incoming FMR in fall 2020. Residents' perceptions of the impact of COVID-19 on clinical skills acquisition and preparedness for practice. Surveys response rates were 124 of 167 (74%) and 142 of 162 (88%) for graduating and incoming residents, respectively. Important themes for both cohorts included reduced access to clinical environments, reduced patient volumes, and lack of exposure to procedural skills. While the graduating cohort indicated they felt confident to begin practising family medicine, they described being impacted by the loss of a tailored learning environment, including canceled or altered electives. In contrast, incoming residents reported the loss of core skills, such as physical examination competency, as well as the loss of face-to-face communication, rapport, and relationship-building opportunities. However, both cohorts endorsed gaining new skills during the pandemic, including conducting telemedicine appointments, pandemic planning, and interfacing with public health. Based on these results, residency programs can specifically tailor solutions and modifications to address common themes across cohorts to facilitate optimal learning environments in pandemic times.

The 0.19-mg Fluocinolone Acetonide Implant for the Treatment of Diabetic Macular Edema: An Expert Consensus.

To better understand the level of agreement among retina specialists on the role of inflammation in diabetic retinopathy (DR) and diabetic macular edema (DME), and the use of 0.19-mg fluocinolone acetonide (FAc) implant in DME treatment, a consensus survey was drafted and disseminated to retina specialists across the United States. Using the modified Delphi method, a list of 12 consensus statements were generated by the coauthors based on short-answer responses to an initial survey. In total, 56 retina specialists completed the entire consensus survey. Except for two multiple-choice questions, there were 10 consensus statements that used a modified Likert scale to indicate their level of agreement to the statement: Agree = 3, Mostly Agree = 2, Mostly Disagree = 1, Disagree = 0. Percentage agreement and 95% confidence intervals (CIs) were calculated, and a consensus threshold was set at > 80% agreement for each statement. Seven of 10 consensus statements using the modified Likert scale reached consensus, including those on the role of inflammation in pathophysiology of DR/DME, injection burden and patient adherence, and efficacy and safety of the FAc implant. The remaining three statements displayed high agreement with average scores > 80%, but the 95% CIs were below threshold. These included the impact of the FAc implant on DR progression, FAc as baseline therapy for DME, and the effectiveness of the steroid challenge to mitigate intraocular pressure risk after FAc use. Two multiple-choice questions focused on clinical situations in which corticosteroids would be used as baseline therapy for DME (pseudophakic eye [73%], recent stroke/myocardial infarction [66%], and pregnancy/breastfeeding [66%]) and which delivery route satisfies the steroid challenge for the FAc implant (intravitreal [100%], sub-tenon/periocular [73%], and topical [57%]). Physicians highly agreed on the role of inflammation in pathophysiology of DR/DME, injection burden and patient adherence, and efficacy and safety of the FAc implant. However, full consensus was not found on the impact of the FAc implant on DR progression, FAc as baseline therapy for DME, and the effectiveness of the steroid challenge to mitigate intraocular pressure risk after FAc use. [Ophthalmic Surg Lasers Imaging Retina. 2023;54(3):166-173.].

"I am busy enough…": Navigating challenges experienced by Medicaid providers serving pregnant people living with substance use disorders in Alabama.

Perinatal substance use is a clinical and public health concern. The purpose of the study was to understand the perspectives and experiences of perinatal healthcare providers serving pregnant people who receive Medicaid and are living with a substance use disorder. We conducted a secondary data analysis of the responses from perinatal healthcare providers who completed a survey to assess the state of Alabama's capability to effectively identify and treat individuals with substance use disorder. We analyzed short answer responses using consensus coding. Nine-hundred and ninety-five Medicaid providers completed the survey, 36 of the respondents identified that they were employed in an obstetric practice. Health insurance limitations, a lack of time and resources, and limited treatment options were the primary barriers indicated in the participants' responses. Structural and health system barriers negatively impact the capacity of perinatal healthcare providers in Alabama to serve pregnant people who receive Medicaid and are living with a substance use disorder. Perinatal healthcare providers need educational opportunities, training, and up-to-date resources to provide supportive, comprehensive care programming for perinatal populations with substance use disorders.