Pregnancy in physicians: A scoping review.
Ontology highlight
ABSTRACT: Background
The personal health and professional impact of physician pregnancy requires further study. We performed a comprehensive scoping review of physician pregnancy to synthesize and assess the evidence to aid decision-making for relevant stakeholders.Methods
A search of 7 databases resulted in 3733 citations. 407 manuscripts were included and scored for evidence level. Data were extracted into themes using template analysis.Results
Physician pregnancy impacted colleagues through perceived increased workload and resulted in persistent stigmatization and discrimination despite work productivity and academic metrics being independent of pregnancy events. Maternity leave policies were inconsistent and largely unsatisfactory. Women physicians incurred occupational hazard risk and had high rates of childbearing delay, abortion, and fertility treatment; obstetric and fetal complication rates compared to controls are conflicting.Conclusions
Comprehensive literature review found that physician pregnancy impacts colleagues, elicits negative perceptions of productivity, and is inadequately addressed by current parental leave policies. Data are poor and insufficient to definitively determine the impact of physician pregnancy on maternal and fetal health. Prospective risk-matched observational studies of physician pregnancy should be pursued.
SUBMITTER: Casilla-Lennon M
PROVIDER: S-EPMC8688196 | biostudies-literature | 2022 Jan
REPOSITORIES: biostudies-literature
Publications
Pregnancy in physicians: A scoping review.
Casilla-Lennon Marianne M Hanchuk Stephanie S Zheng Sijin S Kim David D DD Press Benjamin B Nguyen Justin V JV Grimshaw Alyssa A Leapman Michael S MS Cavallo Jaime A JA
American journal of surgery 20210721 1
<h4>Background</h4>The personal health and professional impact of physician pregnancy requires further study. We performed a comprehensive scoping review of physician pregnancy to synthesize and assess the evidence to aid decision-making for relevant stakeholders.<h4>Methods</h4>A search of 7 databases resulted in 3733 citations. 407 manuscripts were included and scored for evidence level. Data were extracted into themes using template analysis.<h4>Results</h4>Physician pregnancy impacted collea ...[more]
Similar Datasets
Project description:Background Concepts of moral distress (MD) among physicians have evolved and extend beyond the notion of psychological distress caused by being in a situation in which one is constrained from acting on what one knows to be right. With many accounts involving complex personal, professional, legal, ethical and moral issues, we propose a review of current understanding of MD among physicians. Methods A systematic evidence-based approach guided systematic scoping review is proposed to map the current concepts of MD among physicians published in PubMed, Embase, PsycINFO, Web of Science, SCOPUS, ERIC and Google Scholar databases. Concurrent and independent thematic and direct content analysis (split approach) was conducted on included articles to enhance the reliability and transparency of the process. The themes and categories identified were combined using the jigsaw perspective to create domains that form the framework of the discussion that follows. Results A total of 30 156 abstracts were identified, 2473 full-text articles were reviewed and 128 articles were included. The five domains identified were as follows: (1) current concepts, (2) risk factors, (3) impact, (4) tools and (5) interventions. Conclusions Initial reviews suggest that MD involves conflicts within a physician’s personal beliefs, values and principles (personal constructs) caused by personal, ethical, moral, contextual, professional and sociocultural factors. How these experiences are processed and reflected on and then integrated into the physician’s personal constructs impacts their self-concepts of personhood and identity and can result in MD. The ring theory of personhood facilitates an appreciation of how new experiences create dissonance and resonance within personal constructs. These insights allow the forwarding of a new broader concept of MD and a personalised approach to assessing and treating MD. While further studies are required to test these findings, they offer a personalised means of supporting a physician’s MD and preventing burn-out.
| S-EPMC9442489 | biostudies-literature
Project description:BackgroundIn Canada, Ontario Health Teams (OHTs) are a new model for integrated healthcare. Core to OHTs are family physicians (FPs) and their ability to collaborate with other FPs and healthcare providers. Whereas the factors for intra-organizational collaboration have been well-studied, inter-organizational collaboration between FPs and other healthcare organizations as an integrated care network, are less understood. This paper aims to explore the structural factors, processes, and theoretical frameworks that support FPs' collaboration for integrated healthcare.MethodsA scoping review was undertaken based on Joanna Briggs Institute (JBI) methodology for scoping review and using the Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Review (PRISMA_ScR) checklist. A search for academic and relevant grey literature published between 2000-2021 was conducted across databases (MEDLINE, EMBASE, EBSCOhost).Thematic analysis was used to identify the key findings of the selected studies.ResultsThirty-two studies were included as eligible for this review. Three structural components were identified as critical to FPs' successful participation in inter-organizational partnerships: (1) shared vision/values, (2) leadership by FPs, and (3) defined decision-making procedures. Also, three processes were identified: (1) effective communication, (2) a collective sense of motivation for change, and (3) relationships built on trust. Three theoretical frameworks provided insight into collaborative initiatives: (1) Social Identity Approach, (2) framework of interprofessional collaboration, and (3) competing values framework.ConclusionFPs hold unique positions in healthcare and this review is the first to synthesize the best evidence for building collaborations between FPs and other healthcare sectors. These findings will inform collaboration strategies for healthcare integration, including with OHTs.
| S-EPMC9869511 | biostudies-literature
Project description:BackgroundGender disparities in emergency medicine (EM) persist, with women underrepresented in leadership positions and faced with unique challenges, such as gender discrimination and harassment. To address these issues, professional development programs for women have been recommended.ObjectivesThe purpose of this scoping review was to examine current women's professional development programs for EM and develop a collection of program characteristics, meeting topics, and tips for success that can be useful to new or existing women's professional development programs.MethodsThe authors systematically searched research databases for literature detailing current women's professional development programs for EM physicians. Studies detailing professional development programs for female physicians in EM were included.ResultsAfter 149 unique articles were screened, 11 studies met inclusion criteria, describing 10 professional development programs for women in EM. The most commonly cited program objectives included providing mentors and role models (n = 9, 90%), offering career advice and promoting professional advancement and leadership skills (n = 5, 50%), increasing academic recognition for women (n = 4, 40%), and promoting work-life balance and integration (n = 2, 20%). The most common topics covered in program sessions included mentorship and coaching, compensation and/or negotiation, leadership skills, and career advancement and promotion. Challenges and barriers to the success of these programs included a lack of funding and support, difficulty in recruiting participants, lack of institutional recognition and support, lack of time, and difficulty in sustaining the program over time.ConclusionsThe study's findings can inform the development of programs that promote gender equity and support the advancement of women in EM.
| S-EPMC10958937 | biostudies-literature
Project description:ObjectiveCommunication during consultations between referring and consultant physicians is often cited as a source of adverse events, medical error and professional incivility. While existing literature focuses on the role of referring physicians, few studies acknowledge the role of consultant physicians in enhancing communication during consultations. This scoping review aims to identify and synthesise available recommendations to enhance the communication practices of consultants during real-time consultations.DesignA scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.Data sourcesMedline, EMBASE and PsycINFO databases were searched from inception to August 2022.Eligibility criteria for selecting studiesEnglish-language publications which describe recommendations, strategies or frameworks to improve the communication practices of consultant physicians during real-time consultations with referring physicians.Data extraction and synthesisThe search strategy included the following concepts: consultation, physician, communication, interprofessional relations and best practice. Two authors independently performed each phase of title and abstract screening, full-text review and data extraction. Discrepancies were resolved by a third author. Extracted data were iteratively analysed and summarised thematically.ResultsSixteen publications met the inclusion criteria. Synthesis of available recommendations identified organisation, expertise and interpersonal skills as three overarching and interconnected dimensions of communication demonstrated by consultants during effective consultations. Twelve studies identified interpersonal skills as being critical in alleviating the widespread professional incivility that is reported during consultations. Existing recommendations to improve the communication practices of consultants are limited as they lack standardised interventions and fail to comprehensively address all three elements identified in this review.ConclusionThis scoping review synthesises available recommendations to improve the communication practices of consultant physicians during real-time consultations. An opportunity exists to develop communication tools or educational interventions based on the findings of this review to enhance interphysician consultation encounters.
| S-EPMC10668268 | biostudies-literature
Project description:ObjectiveTo identify the advantages and disadvantages that group practices have on patients, physicians and healthcare systems.Study designA scoping review was performed based on the methodology proposed by Arksey and O'Malley, and refined by Levac et al. Titles and abstracts were screened by two reviewers. A quantitative analysis was performed to assess the type, year and region of publication, as well as the population studied. A qualitative descriptive analysis was performed to identify common themes.Study settingMEDLINE, EMBASE and Cochrane databases were searched from database inception to October 2018 for papers which assessed outcomes relevant to the research question.ResultsOur search strategy returned 2408 papers and 98 were included in the final analysis. Most papers were from the USA, were surveys and assessed physician outcomes. Advantages of group practices for patients included improved satisfaction and quality of care. Studies of physicians reported improved quality of life and income, while disadvantages included increased stress due to poor interpersonal relationships. Studies of healthcare systems reported improved efficiency and better utilisation of resources.ConclusionsGroup practices have many benefits for patients and physicians. However, further work needs to be done assessing patient outcomes and establishing the elements that make a group practice successful.
| S-EPMC7798803 | biostudies-literature
Project description:BackgroundHealth care professionals are increasingly using smartphones in clinical care. Smartphone use can affect patient quality of care and clinical outcomes.ObjectiveThis scoping review aimed to describe how physicians use smartphones and mobile apps in clinical settings.MethodsWe conducted a scoping review using the Joanna Briggs Institute methodology and reported the results according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. We used the following databases in our literature search: MEDLINE, Embase, Cochrane Library, Web of Science, Google Scholar, and gray literature for studies published since 2010. An additional search was also performed by scanning the reference lists of included studies. A narrative synthesis approach was used.ResultsA total of 10 studies, published between 2016 and 2021, were included in this review. Of these studies, 8 used surveys and 2 used surveys with focus group study designs to explore smartphone use, its adoption, experience of using it, and views on the use of smartphones among physicians. There were studies with only general practitioners (n=3), studies with only specialists (n=3), and studies with both general practitioners and specialists (n=4). Physicians use smartphones and mobile apps for communication (n=9), clinical decision-making (n=7), drug compendium (n=7), medical education and training (n=7), maintaining health records (n=4), managing time (n=4), and monitoring patients (n=2) in clinical practice. The Medscape medical app was frequently used for information gathering. WhatsApp, a nonmedical app, was commonly used for physician-patient communication. The commonly reported barriers were lack of regulatory oversight, privacy concerns, and limited Wi-Fi or internet access. The commonly reported facilitator was convenience and having access to evidence-based medicine, clinical decision-making support, and a wide array of apps.ConclusionsSmartphones and mobile apps were used for communication, medical education and training, clinical decision-making, and drug compendia in most studies. Although the benefits of smartphones and mobile apps for physicians at work were promising, there were concerns about patient privacy and confidentiality. Legislation is urgently needed to protect the liability of health care professionals using smartphones.
| S-EPMC10131676 | biostudies-literature
Project description:BackgroundIllness presenteeism (IP) is the phenomenon where individuals continue to work despite illness. While it has been a prevalent and longstanding issue in medicine, the recent onset of the COVID-19 pandemic and the growing movement to improve physician wellness brings renewed interest in this topic. However, there have been no comprehensive reviews on the state of literature of this topic.PurposeThe main aim of this scoping review is to explore what is known about presenteeism in physicians, residents, and medical students in order to map and summarize the literature, identify research gaps and inform future research. More specifically: How has illness presenteeism been defined, problematized or perceived? What methods and approaches have been used to study the phenomenon? Has the literature changed since the pandemic?MethodUsing the Arksey and O'Malley framework several databases will be searched by an experienced librarian. Through an iterative process, inclusion and exclusion criteria will be developed and a data extraction form refined. Data will be analyzed using quantitative and qualitative content analyses.Potential implications of resultsBy summarizing the literature on IP, this study will provide a better understanding of the IP phenomena to inform future research and potentially have implications for physician wellness and public health.
| S-EPMC10903841 | biostudies-literature
Project description:ObjectiveTo determine if e-learning interventions are efficient to review Neonatal Resuscitation Program (NRP) and to prevent performance deterioration in neonatal resuscitation of already-certified healthcare professionals.Study designIn this scoping review, we searched for manuscripts published until June 2020 in five databases. We included all studies on e-learning use for NRP review in already-certified healthcare providers.ResultsAmong 593 abstracts retrieved, 38 full-text articles were assessed for eligibility. Five studies were included. Four studies evaluated the effectiveness of e-learning interventions immediately or months after their completion by providers. These interventions did not consistently enhance their NRP knowledge and their performance. One study showed that a growth mindset can influence positively neonatal resuscitation performance after an e-learning simulation.ConclusionThere is not enough evidence to conclude that e-learning interventions can prevent neonatal resuscitation knowledge and performance decay in already-certified providers. More research is needed on the use of e-learning simulation-based scenarios to improve NRP retention.
| S-EPMC9107007 | biostudies-literature
Project description:BackgroundSevere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a novel virus responsible for causing the novel coronavirus disease of 2019 (COVID-19).ObjectiveThis article discusses the clinical manifestations of COVID-19 in pregnant patients, the effects of pregnancy on the course of COVID-19 disease, and the impact of COVID-19 on pregnancy outcomes.DiscussionThe physiological and mechanical changes associated with pregnancy increase maternal susceptibility to infections and complicate intubation and mechanical ventilation. The most common symptoms of COVID-19 in pregnant patients are cough and fever, although many infected individuals are asymptomatic. The majority of pregnant women diagnosed with COVID-19 disease have a mild course of illness and will recover without needing to deliver, but the risks of critical illness and need for mechanical ventilation are increased compared to the general population. Risk factors for death and severe disease include obesity, diabetes, and maternal age > 40 years. Women in their third trimester have the highest risk for critical illness, intensive care unit admission, and need for mechanical ventilation. Adverse fetal outcomes of maternal COVID-19 infection include increased risk of miscarriage, prematurity, and fetal growth restriction. Vertical transmission of SARS-CoV-2 is possible but has not been conclusively proven.ConclusionsCOVID-19 is a potentially deadly infection, but data are limited concerning the pregnant population. Pregnant patients appear to present similarly to the general population, with fever and cough being the most reported symptoms in studies. Knowledge of these presentations and outcomes can assist clinicians caring for these patients.
| S-EPMC7605788 | biostudies-literature
Project description:BackgroundPhysicians require the expertise to care for an increasingly aging population. A robust understanding of geriatric educational interventions is needed to improve geriatric training for physicians.ObjectiveTo map the breadth of geriatric educational interventions for residents (in non-geriatric specialties).MethodsWe used a scoping review methodology. We searched MEDLINE, Embase, EMCare, CENTRAL, ERIC, and Scopus from 2004 to September 2019 for search terms related to "educational approaches" AND "geriatric" AND "residents." Two authors independently selected eligible studies, extracted data (categorized by educational approaches and Kirkpatrick level outcomes), and critically appraised studies using the Mixed Methods Appraisal Tool.ResultsThere were 63 included studies, with a total of 6976 participants. Twelve studies had comparators, including 5 randomized controlled trials. Fifty-three studies (84%) described multicomponent interventions, incorporating combinations of didactic or self-directed approaches with interactive, simulation, experiential, and/or group-based learning. Use of curricular process was explicitly reported in 34 studies (59%). Most studies met at least 4 of 5 Mixed Methods Appraisal Tool criteria. Studies commonly measured outcomes at Kirkpatrick levels 1 and 2 (reaction and learning), with 15 studies measuring performance outcomes (Kirkpatrick levels 3 and 4b). All included studies had at least one positive result.ConclusionsAll educational interventions had positive outcomes; however, curriculum-informed multicomponent interventions were the most common. This scoping review demonstrates that robust methodology with comparators, longer-term designs, and use of higher-level Kirkpatrick outcome measures is possible but not commonly used. Clear direction for future research is provided.
| S-EPMC8527951 | biostudies-literature