Project description:ObjectiveTo study relationships between clinical skill measures assessed at the beginning of general internists' careers and their career outcomes and practice characteristics.Data sourcesGeneral Internist Community Tracking Study Physician Survey respondents (2000-2001, 2004-2005) linked with residency program evaluations and American Board of Internal Medicine board certification examination score records; n = 2,331.Study designCross-sectional regressions of career outcome and practice characteristic measures on board examination scores/success, residency evaluations interacted with residency type, and potential confounding variables.Principal findingsFailure to achieve board certification was associated with $27,206 (18 percent, p < .05) less income and 14.9 percent more minority patients relative to physicians scoring in the bottom quartile on their initial examination who eventually became certified (p < .01). Other skill measures were not associated with income. Scoring in the top rather than bottom quartile on the board certification examination was associated with 9 percent increased likelihood of reporting high career satisfaction (p < .05). Among physicians trained in community hospital residency programs, lower evaluations were associated with 14.5 percent higher share of minority patients (p < .05). Both skill measures were associated with practice type.ConclusionsThere are associations between early career skill measures and career outcomes. In addition, minority patients are more likely to be treated by physicians with lower early career clinical skills measures than nonminority patients.
Project description:Euthanasia of companion animals is a challenging responsibility in the veterinary profession since veterinarians have to consider not only medical, but also legal, economic, emotional, social, and ethical factors in decision-making. To this end; an anonymous questionnaire-based survey of Austrian equine veterinarians examines the attitudes to the euthanasia of equine patients in a range of scenarios; to identify factors which may influence decisions on the ending of a horse's life. This paper describes the distributions of demographic and attitude variables. Mann-Whitney U tests were used to test the associations of gender, work experience, and equine workload with attitudes in relation to euthanasia statements and case scenarios. In total, 64 respondents (response rate = 23.4%) completed the questionnaire. The study showed that veterinarians consider contextual and relational factors in their decision-making. They are aware of owners' emotional bonds with their horses and financial background, however, requests for convenience euthanasia are typically rejected. Although some significant differences between the tested variables emerged, the attitudes of the veterinarians were shown to be largely shared. In conclusion, veterinarians are aware of the multiple factors that influence their decision-making and gave indications as to the weight of animal- and owner-related factors in the handling of euthanasia.
Project description:BackgroundMalawi has one of the lowest physician densities in the world, at 1.1 doctors per 100,000 population. Undergraduate training of doctors at the national medical school has increased considerably in recent years with donor support. However, qualified doctors continue to leave the public sector in order to work or train abroad. We explored the postgraduate plans of current medical students, and the extent to which this is influenced by their background.MethodsA self-administered questionnaire was developed after discussion with students and senior staff. This included questions on background characteristics, education before medical school, and future career plans. This was distributed to all medical and premedical students on campus over 1 week and collected by an independent researcher. One reminder visit was made to each class. Chi-squared tests were performed to investigate the relationship of student characteristics with future career plans.ResultsOne hundred and forty-nine students completed the questionnaire out of a student body of 312, a response rate of 48%. When questioned on their plans for after graduation, 49.0% of students plan to stay in Malawi. However, 38.9% plan to leave Malawi immediately. Medical students who completed a 'premedical' foundation year at the medical school were significantly more likely to have immediate plans to stay in Malawi compared to those who completed A-levels, an advanced school-leaving qualification (P = 0.037). Current premedical students were slightly more likely to have immediate plans to work or train in Malawi compared to medical students (P = 0.049). However, a trend test across all the years was not significant. When asked about future plans, nearly half of students intend to work or train outside Malawi.ConclusionsThe majority of respondents plan to leave Malawi in the future. The effectiveness of the substantial upscaling of medical education in Malawi may be diminished unless more medical students plan to work in Malawi after graduation.
Project description:Increasing numbers of young video gamers view esports (i.e., competitive video gaming) as a career opportunity, rather than just a recreational activity. Previous studies have explored the motivational differences between esport and recreational gamers and the motivational changes through career journey to become a professional esport player. The present study explored the predictors of career plans to become a professional esport player, with a specific focus on gaming motivations. Gaming time, gaming motivations, and esport-related playing experience were also examined among Hungarian gamers with competitive gaming experience (N = 190), such as years spent in esports, medium and frequency of participating in esport tournaments, the effort put into training before the tournaments, and the plans to become a professional esport player. Binary logistic regressions were carried out and results showed that the gaming motivations of competition, skill development, and social motivations predicted career planning as a professional esport player. Additionally, results showed that younger players were more likely to seek career opportunity as professional esport players than older players. Future studies should focus on novice esport players' psychological exposure to the hypercompetitive scene of esports, such as high expectations or the risk of becoming problematic videogame users due to their motivational changes.
Project description:BackgroundClinical trial participants have a right to be informed throughout the entire process of human subject research. As part of this pillar of research ethics, participants and other stakeholders should be made aware of research findings after a trial has been completed. Though participants have both a right, and a desire to be informed of research outcomes, studies show that they rarely receive communication about study findings. Our aim was (1) to understand what, if any, role communication plans play in current global health clinical research protocols and (2) to use our findings to develop a communication plan template tailored to clinical research carried out in low-and-middle-income countries (LMIC) while minimizing colonial assumptions. While the template was drafted in the LMIC context, the principles are universally applicable and should be considered best practices for all global health clinical trials.MethodsWe carried out a mixed-method study over a period of 6 months to understand the role of communication with study participants and other stakeholders in clinical trials. The semiquantitative analysis included mining publicly available clinical trial protocols for communication-related language. Qualitative interviews (n = 7) were used to gather knowledge and insight from clinical trial experts to inform the development of a communication plan template.ResultsNone of the 48 mined clinical trial protocols included a communication plan. Of the 48, 21% (n = 21) protocols included communication-related language, and 10% (n = 5) described plans to share trial results with participants.ConclusionThe use of communication plans in global health clinical trials is lacking. To our knowledge, this is the first in-depth analysis of communication plans in clinical trials to date. We recommend that researchers utilize the developed communication plan template throughout the entire research process to ensure a human-centered approach to participant communication. This communication plan should apply to all phases of a research trial, with a particular emphasis on plans to share results in an accessible and engaging manner once the trial has been completed.
Project description:Shelter medicine has grown considerably over recent years with many shelters hiring veterinarians for the first time or expanding their veterinary teams. As a result, there is a dearth of shelter veterinarians and retention has become a key concern for the field. The goal of this study was to describe veterinarians' perceptions of shelter medicine, and their feelings of job satisfaction, loneliness, and professional fulfillment. The sample included 52 shelter veterinarians, 39 previous shelter veterinarians and 130 non-shelter veterinarians (n = 221) who each completed an online survey. Current and previous shelter veterinarians had comparable perceptions regarding the appeal of most shelter medicine duties, although there were differences in the duties they performed within their job. More current shelter veterinarians participated in population management, policy development, administrative duties, and decision-making for individual patients (euthanasia, treatment, and adoptability). Considering other employment attributes, we found previous shelter veterinarians had lower mean rankings than current and non-shelter veterinarians regarding their interactions with administrative staff, ability to be part of a multiple veterinarian team and the availability of mentorship. Loneliness and professional fulfillment were mostly comparable between the groups, although previous shelter veterinarians were more likely to report they felt unhappy (X 2 = 16.60, p = 0.02) and left out at work (X 2 = 12.43, p = 0.02). Our findings suggest veterinarians who participate in decision-making for patients and shelter management procedures may be more willing to continue working in shelter medicine. Animal shelters should also employ strategies to improve workplace relationships and offer career development opportunities to improve job satisfaction and retention of veterinarians within the field.
Project description:IntroductionAntimicrobial resistance is (AMR) an emerging global public health problem. Rationale use of antibiotic can prevent the rise of antimicrobial resistance. The objective of this study was to understand the knowledge, attitude and practice on antibiotic usage and AMR among the veterinarians and para-veterinarians in Bhutan.MethodA cross-sectional questionnaire survey among the veterinarians and para-veterinarians was conducted from June to July 2020. A score of one to the correct answers and zero for the wrong answers was allotted to each respondent answers. The total score was added and those who scored above the mean was categorized as having good knowledge and favourable attitude.ResultA total of 219 animal health workers participated in this study. The mean knowledge score was 12.05 ±1.74 with 38.8% of the respondents having good knowledge on antibiotic use and AMR. Similarly, the mean scores for the attitude level were 8.32±1.61 with 51% them having favorable attitude towards antibiotic usage and AMR. The mean practice score was 3.83±1.06 with 77% of them having good practices on antibiotic use. The respondents who read national plan on AMR were found to have good knowledge on antibiotics and AMR (AOR: 2.39; 95% CI: 1.19-4.82). The female respondents (AOR: 2.16; 95% CI: 1.01-4.61), respondents from the eastern region (AOR: 2.53; 95% CI: 1.18-5.44), west central (AOR: 3; 95% CI: 1.30-6.92), animal health supervisors (AOR: 9.77; 95% CI: 1.98-48.29), and livestock production supervisors (AOR: 2.77; 95% CI: 1.21-6.35) have favorable attitude towards antibiotics and AMR.ConclusionsOur study identified that most animal health workers in Bhutan had poor knowledge on antibiotics usage and AMR. Therefore, regular awareness education on antibiotics and AMR in the form of refresher course/training must be provided to the animal health workers in the country to avoid inappropriate use of antibiotics.
Project description:The transition from medical student to junior doctor is a challenge; the UK General Medical Council has issued guidance emphasizing the importance of adequate preparation of medical students for clinical practice. This study aimed to determine whether a junior doctor-led simulation-based course is an effective way of preparing final year medical students for practice as a junior doctor.We piloted a new 'preparation for practice' course for final year medical students prior to beginning as Foundation Year 1 (first year of practice) doctors. The course ran over three days and consisted of four simulated stations: ward round, prescribing, handover, and lessons learnt. Quantitative and qualitative feedback was obtained.A total of 120 students attended (40 on each day) and feedback was collected from 95 of them. Using a scale of 1 (lowest) to 5 (highest), feedback was positive, with 99% and 96% rating 4 or 5 for the overall quality of the program and the relevance of the program content, respectively. A score of 5 was awarded by 67% of students for the ward round station; 58% for the handover station; 71% for the prescribing station, and 35% for the lessons learnt station. Following the prescribing station, students reported increased confidence in their prescribing.Preparation for practice courses and simulation are an effective and enjoyable way of easing the transition from medical student to junior doctor. Together with 'on-the-job' shadowing time, such programs can be used to improve students' confidence, competence, and ultimately patient safety and quality of care.