Introducing the System for Observing Medical Alliances (SOMA): A Tool for Studying Concordance in Patient-Physician Relationships.
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SUBMITTER: Friedlander ML
PROVIDER: S-EPMC7199191 | biostudies-literature | 2019 Dec
REPOSITORIES: biostudies-literature
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Introducing the System for Observing Medical Alliances (SOMA): A Tool for Studying Concordance in Patient-Physician Relationships.
Friedlander Myrna L ML Kangos Kelsey K Maestro Kieran K Muetzelfeld Hannah H Wright Scott T ST Silva Nicole Da ND Kimber Justin J Helmer Drew A DA McAndrew Lisa M LM
The Counseling psychologist 20191201 5
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Project description:BackgroundVerbal communication plays an important role in the patient-physician relationship. Research shows that language concordance, when a healthcare professional communicates fluently in the patient's preferred language, contributes to patient satisfaction and improves healthcare outcomes. Yet, many medical schools worldwide, including most institutions in the Arab world, use English as the language of instruction. As a result, students lack confidence and feel unprepared to communicate effectively with the local population. This manuscript describes the development, implementation and early perceptions of an Arabic language program for medical students in the United Arab Emirates.MethodsIn 2020, the learning communities at Khalifa University College of Medicine and Health Sciences launched a pilot program implementing a Peer Assisted Learning (PAL) framework to teach Arabic medical terminology and language to both native and non-native Arabic speaking medical students. A web-based survey was administered to the first two cohorts of students to assess satisfaction with the classes and the program's impact on students' communication skills during clinical encounters.ResultsEarly perceptions of the program were very positive, with 43/48 students (89.6%) reporting that they used the information during home visits and clinical rotations, and 42 students (87.5%) admitting that the classes made them feel more comfortable in communicating with the Arabic speaking local patient population.ConclusionThis paper explores a new educational approach to address the challenge of language barriers in healthcare. A feasible, low cost program using peer assisted learning can improve students' comfort in communicating with patients in the local language.
| S-EPMC9807417 | biostudies-literature
Project description:ObjectiveTo examine the predictors of patient-physician race/ethnicity concordance among diabetes patients in an integrated delivery system.Data sourceKaiser Permanente's Northern California Diabetes Registry of 2005.Study designLogistic regression predicted concordance for each racial/ethnic group. Availability of a concordant physician, whether a patient chose their physician, and patient language were main explanatory variables.Data collection/extraction methodsThe study population consisted of 109,745 patients and 1,750 physicians.Principal findingsPatients who chose their physicians were more likely to have a same race/ethnicity physician with OR of 2.2 (95 percent CI 1.74-2.82) for African American patients, 1.71 (95 percent CI 1.44-2.04) for Hispanic patients, 1.11 (95 percent CI 1.04-1.18) for white patients, and 1.38 (95 percent CI 1.23, 1.55) for Asian patients. Availability of a same race/ethnicity physician was also a predictor of concordance for African American patients (OR 2.7; 95 percent CI 2.45-2.98) and marginally significant for Hispanic patients (OR 1.02; 95 percent CI 1.01-1.02), white patients (OR 1.02; 95 percent CI 1.00-1.04), and Asian patients (OR 1.05; 95 percent CI 1.03, 1.07). Limited English language was a strong predictor of concordance for Hispanic patients (OR 4.81; 95 percent CI 4.2-5.51) and Asian patients (OR 9.8; 95 percent CI 7.7, 12.6).ConclusionPatient language, preferences, and the racial composition of the physician workforce predict race/ethnicity concordance.
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Project description:BackgroundPhysician engagement has become a key metric for healthcare leadership and is associated with better healthcare outcomes. However, engagement tends to be low and difficult to measure and improve. This study sought to efficiently characterize the professional cultural dynamics between physicians and administrators at an academic hospital and how those dynamics affect physician engagement.Materials and methodsA qualitative mixed methods analysis was completed in 6 weeks, consisting of a preliminary analysis of the hospital system's history that was used to purposefully recruit 20 physicians across specialties and 20 healthcare administrators across management levels for semi-structured interviews and observation. Participation rates of 77% (20/26) and 83% (20/24) were achieved for physicians and administrators, respectively. Cohorts consisted of equal numbers of men and women with experience ranging from 1 to 35 years within the organization. Field notes and transcripts were systematically analyzed using an iterative inductive-deductive approach. Emergent themes were presented and discussed with approximately 400 physicians and administrators within the organization to assess validity and which results were most meaningful.Results & discussionThis investigation indicated a professional cultural disconnect was undermining efforts to improve physician engagement. This disconnect was further complicated by a minority (10%) not believing an issue existed and conflicting connotations not readily perceived by participants who often offered similar solutions. Physicians and administrators felt these results accurately reflected their realities and used this information as a common language to plan targeted interventions to improve physician engagement. Limitations of the study included its cross-sectional nature with a modest sample size at a single institution.ConclusionsA qualitative mixed methods analysis efficiently identified professional cultural barriers within an academic hospital to serve as an institution-specific guide to improving physician engagement.
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Project description:BackgroundAn especially significant event in the patient-oncologist relationship is the initial consultation, where many complex topics-diagnosis, treatment intent, and often, prognosis-are discussed in a relatively short period of time. This study aimed to measure patients' understanding of the information discussed during their first medical oncology visit and their satisfaction with the communication from medical oncologists.MethodsBetween January and August 2021, patients without prior systemic treatment of their gastrointestinal malignancy (GI) attending the Princess Margaret Cancer Centre (PMCC) were approached within 24 h of their initial consultation to complete a paper-based questionnaire assessing understanding of their disease (diagnosis, treatment plan/intent, and prognosis) and satisfaction with the consultation. Medical oncology physicians simultaneously completed a similar questionnaire about the information discussed at the initial visit. Matched patient-physician responses were compared to assess the degree of concordance.ResultsA total of 184 matched patient-physician surveys were completed. The concordance rates for understanding of diagnosis, treatment plan, treatment intent, and prognosis were 92.9%, 59.2%, 66.8%, and 59.8%, respectively. After adjusting for patient and physician variables, patients who reported treatment intent to be unclear at the time of the consultation were independently associated with lower satisfaction scores (global p = 0.014). There was no statistically significant association between patient satisfaction and whether prognosis was disclosed (p = 0.08).ConclusionAn in-depth conversation as to what treatment intent and prognosis means is reasonable during the initial medical oncology consultation to ensure patients and caregivers have a better understanding about their cancer.
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Project description:The racial gap in infant mortality is a pressing public-health concern, and [B. N. Greenwood et al., Proc. Natl. Acad. Sci. U.S.A. 117, 21194-21200 (2020), 10.1073/pnas.1913405117] suggest that Black newborns are more likely to survive if cared for by Black physicians after birth, even in models that control for numerous variables, including hospital and physician fixed effects, and the 65 most common comorbidities affecting newborns (as described by International Classification of Disease codes). We acquired the data used in the study, covering Florida hospital discharges from 1992 through the third quarter of 2015, to replicate and extend the analysis. We find that the magnitude of the concordance effect is substantially reduced after controlling for diagnoses indicating very low birth weight (<1,500 g), which are a strong predictor of neonatal mortality but not among the 65 most common comorbidities. In fact, the estimated effect is near zero and statistically insignificant in the expanded specifications that control for very low birth weight and include hospital and physician fixed effects.
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Project description:BackgroundMedical students face the challenge of learning vast amounts of complex information. Existing research suggests improved learning outcomes using multimedia resources but reports on their impact on podiatric education are scarce. To explore the potential of multimedia-based learning tools in enriching medical education, this study examined the impact of Osmosis, a platform featuring interactive videos, flashcards, and self-assessment quizzes on podiatric medical student outcomes.MethodsThis quasi-experimental study examined the impact of Osmosis, a multimedia learning platform with videos, flashcards, and quizzes, on podiatric medical students' learning outcomes. Two cohorts (T = Osmosis access, N = 86; C = no access, N = 87) took Pharmacology and Podiatric Medicine courses consecutively. Final exam scores, final course grades, platform usage metrics (median weekly videos watched, flashcards, and quizzes), and student experience surveys were analyzed.ResultsAnalyses revealed no statistically significant differences in final exam scores between the groups in Pharmacology and Podiatric Medicine. While the treatment group exhibited a slight upward trend, further research is required for conclusive evidence. Student perceptions of Osmosis were overwhelmingly positive, with 90.2% of students agreeing that it facilitated concept learning and understanding compared to 54.9% for the textbook. Similarly, 80.4% of the treatment group felt that Osmosis enhanced their test performance, exceeding the 54.9% recorded for the textbook. Correlation analysis indicates a plausible connection between platform usage and academic success, as reflected by moderate positive correlations (r = [0.14, 0.28]) with final grades. Logistic regression analysis revealed that students with Osmosis access were 2.88 times more likely to score 90% or higher on the Pharmacology final exam (p < 0.05) and exhibited increased odds of achieving high (90%+) final course grades in Podiatric Medicine (OR = 2.71).ConclusionsThese findings suggest that Osmosis holds promise as a tool to support podiatric medical student learning. While the lack of statistically significant differences in final exam scores warrants further investigation, the positive student perceptions, high engagement rates, and increased odds of high scores in specific areas indicate the potential for Osmosis to positively impact academic outcomes. Therefore, a multimedia-based resource like Osmosis appears to show promise as a tool to support podiatric medical education. The limitations inherent in the quasi-experimental design necessitate further studies to confirm its effectiveness and long-term impact on podiatric medical education.
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Project description:Replicates of strains used in comparison of microarray to RAPD analysis for the publication. Findings from use of an open-reading frame-specific Campylobacter jejuni DNA microarray to investigate genetic diversity among clinical isolates associated with 5 independent clusters of infection were compared with data from random amplified polymeric DNA (RAPD) and Penner serotyping analyses. The DNA microarray provides a highly specific epidemiological typing tool for analysis of C. jejuni isolates and reveals both divergent and highly conserved gene classes among isolates Set of arrays that are part of repeated experiments Biological Replicate Computed
2005-11-15 | E-GEOD-3610 | biostudies-arrayexpress
Project description:Replicates of strains used in comparison of microarray to RAPD analysis for the publication. Findings from use of an open-reading frame-specific Campylobacter jejuni DNA microarray to investigate genetic diversity among clinical isolates associated with 5 independent clusters of infection were compared with data from random amplified polymeric DNA (RAPD) and Penner serotyping analyses. The DNA microarray provides a highly specific epidemiological typing tool for analysis of C. jejuni isolates and reveals both divergent and highly conserved gene classes among isolates Set of arrays that are part of repeated experiments Keywords: Biological Replicate
2005-11-16 | GSE3610 | GEO
Project description:BackgroundDisputes between physicians and patients is a global problem. In this study, we aimed to explore the factors associated with patient-physician relationships from the perspective of medical personnel in the Guangxi Zhuang Autonomous Region, China.MethodsThis is a cross-sectional study in Guangxi, which was conducted from April 1, 2023, to April 30, 2023. We relied on Health Committees to collect the online questionnaires. Self-administered questionnaire was used, including: general information, perception of the patient-physician relationship, health education behavior and health service satisfaction. Description analyses, chi-square test, the Mantel-Haensel chi-square test, Spearman correlation and ordinal logistic regression were used. Statistically significant was considered at P values < 0.05.ResultsA total of 176,398 valid questionnaires were recovered. A total of 52.4% of the medical personnel perceived the patient-physician relationship as harmonious, 39.2% perceived it as average, and 8.4% perceived it as disharmonious. Statistically significant results in the univariate analysis were included in the ordinal regression analysis. Sex, education, professional categories, years of experience, titles, health status, creation of health education works, participation in health education activities, satisfaction with medical services are factors associated with the perception of patient-physician relationships among medical personnel.ConclusionIn conclusion, encouraging medical personnel to engage in health education activities, enhancing service quality in medical institutions, and prioritizing the health of medical personnel can contribute to a more positive patient-physician relationship. In the future, further support should be provided to medical personnel for health education activities and training in patient-physician relationship.
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Project description:Currently, observations of an agricultural land system (ALS) largely depend on remotely-sensed images, focusing on its biophysical features. While social surveys capture the socioeconomic features, the information was inadequately integrated with the biophysical features of an ALS and the applications are limited due to the issues of cost and efficiency to carry out such detailed and comparable social surveys at a large spatial coverage. In this paper, we introduce a smartphone-based app, called eFarm: a crowdsourcing and human sensing tool to collect the geotagged ALS information at the land parcel level, based on the high resolution remotely-sensed images. We illustrate its main functionalities, including map visualization, data management, and data sensing. Results of the trial test suggest the system works well. We believe the tool is able to acquire the human-land integrated information which is broadly-covered and timely-updated, thus presenting great potential for improving sensing, mapping, and modeling of ALS studies.
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