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Item Active Learning on Center Stage: Theater as a Tool for Medical Education(Association of American Medical Colleges, 2019-01-30) Hobson, Wendy L.; Hoffmann-Longtin, Krista; Loue, Sana; Love, Linda M.; Liu, Howard Y.; Power, Christine M.; Pollart, Susan M.; Obstetrics and Gynecology, School of MedicineIntroduction: Knowledge and skill development related to communication must incorporate both affective and behavioral components, which are often difficult to deliver in a learning activity. Using theater techniques and principles can provide medical educators with tools to teach communication concepts. Methods: This 75-minute faculty development workshop presents a variety of techniques from theater and adapts them for use in medical education. Using examples related to diversity and inclusion, this session addresses general educational and theater principles, role-play, sociodrama, applied improvisation, and practical aspects of involving theater partners. The session materials include a PowerPoint presentation with facilitator notes, interactive activities to demonstrate each modality, and an evaluation. The sessions can be extended to longer formats as needed. Results: Forty-five participants at Learn Serve Lead 2016: The AAMC Annual Meeting attended the 75-minute session. We emailed 32 participants 5 months after the conference, and eight responded. Participants reported that their confidence level in using theater techniques as a tool for medical education increased from low-to-medium confidence presession to high confidence postsession. All survey respondents who were actively teaching said they had made changes to their teaching based on the workshop. All commented that they appreciated the active learning in the session. Many indicated they would appreciate video or other follow-up resources. Discussion: Principles and techniques from theater are effective tools to convey difficult-to-teach concepts related to communication. This workshop presents tools to implement activities in teaching these difficult concepts.Item Advice to Clinicians on Communication from Adolescents and Young Adults with Cancer and Parents of Children with Cancer(MDPI, 2022-12-21) Srinivas, Meghana; Kaye, Erica C.; Blazin, Lindsay J.; Baker, Justin N.; Mack, Jennifer W.; DuBois, James M.; Sisk, Bryan A.; Pediatrics, School of MedicineEffective communication is integral to patient and family-centered care in pediatric and adolescent and young adult (AYA) oncology and improving healthcare delivery and outcomes. There is limited knowledge about whether AYAs and parents have similar communication preferences and needs. By eliciting and comparing communication advice from AYAs and parents, we can identify salient guidance for how clinicians can better communicate. We performed secondary analysis of semi-structured interviews from 2 qualitative communication studies. In one study, 80 parents of children with cancer during treatment, survivorship, or bereavement were interviewed. In the second study, AYAs with cancer during treatment or survivorship were interviewed. We asked AYAs and parents to provide communication advice for oncology clinicians. Using thematic analysis, we identified categories of advice related to three overarching themes: interpersonal relationships, informational preferences, and delivery of treatment, resources, and medical care. AYAs and parents provided similar advice about the need for compassion, strong connections, hopefulness, commitment, and transparent honesty However, AYAs placed additional emphasis on clinicians maintaining a calm demeanor.Item Alleviating the emotional burden on families during organ donation requests in neurologic patients declared with brain death: the role of timing and circumstances of death(Springer Nature, 2025-03-11) Powla, Plamena P.; Turaka, Deekshitha; Fakhri, Farima; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public HealthOrgan donation requests to families often occur during moments of profound grief and create an emotional burden that is compounded by the varying emotional responses to circumstances surrounding death. These responses, in turn, interact with the timing of the request to influence authorization decisions. Understanding the interplay between timing and circumstances of death is crucial for improving authorization rates and addressing the organ donor shortage. The Organ Retrieval and Collection of Health Information for Donation database was used to identify 3,289 potential donors with neurologic mechanisms of brain death. Multivariate logistic regression with interaction between timing and circumstance was used to estimate authorization rates. Results show no significant differences in authorization for requests made within 12 h of death, regardless of circumstance. However, significant differences in authorization were observed between requests made at the time of brain death and those made 12 or more hours later for natural causes, as well as those at 24 or more hours for homicide, motor vehicle accidents, and non-motor vehicle accidents. These findings indicate that the optimal timing for organ donation requests may depend on the emotional intensity of the situation. While quicker requests may be more effective in less emotionally charged cases, extending the time for families to grieve in highly distressing circumstances does not appear to negatively impact authorization rates. Tailoring the timing of donation requests to the circumstances of death, balancing sensitivity with the need for prompt decision-making, could reduce families' emotional burden, ease pressure in decision-making, and help address the shortage of organ donors.Item Barriers to Post-Discharge Monitoring and Patient-Clinician Communication: A Qualitative Study(Elsevier, 2021) Brajcich, Brian C.; Shallcross, Meagan L.; Johnson, Julie K.; Joung, Rachel Hae-Soo; Iroz, Cassandra B.; Holl, Jane L.; Bilimoria, Karl Y.; Merkow, Ryan P.; Surgery, School of MedicineIntroduction: As postoperative length of stay has decreased for many operations, the proportion of complications occurring post-discharge is increasing. Early identification and management of these complications requires overcoming barriers to effective post-discharge monitoring and communication. The aim of this study was to identify barriers to post-discharge monitoring and patient-clinician communication through a qualitative study of surgical patients and clinicians. Materials and methods: Semi-structured interviews and focus groups were held with gastrointestinal surgery patients and clinicians. Participants were asked about barriers to post-discharge monitoring and communication. Each transcript was coded by 2 of 4 researchers, and recurring themes related to communication and care barriers were identified. Results: A total of 15 patients and 17 clinicians participated in interviews and focus groups. Four themes which encompassed barriers to post-discharge monitoring and communication were identified from patient interviews, and 4 barriers were identified from clinician interviews and focus groups. Patient-identified barriers included education and expectation setting, technology access and literacy, availability of resources and support, and misalignment of communication preferences, while clinician-identified barriers included health education, access to clinical team, healthcare practitioner time constraints, and care team experience and consistency. Conclusions: Multiple barriers exist to effective post-discharge monitoring and patient-clinician communication among surgical patients. These barriers must be addressed to develop an effective system for post-discharge care after surgery.Item Case Delays and Insufficient Client Communications(2015) Hook, Sara Anne; Faklaris, CoriReal-life legal practice doesn't fit neatly into the bounds of legal ethics that we all learned in law school. There are always questions and pitfalls that you'll need to figure out to make certain you're in compliance today. This seminar compiles the toughest current challenges attorneys face in protecting their professional reputations. Our experienced attorney faculty will help you get the tools you need to do the right thing without fear of disciplinary action or litigation. •Clarify allowable and prohibited conduct in social media. •Discover and avoid hidden conflicts of interest. •Find out how to properly handle case delays. •Prepare for the ethical challenges a virtual law office presents. •Protect client confidentiality in online communications and in data storage.Item A case study of community response to a health crisis from a communication perspective(2016-11) Goodin, Lisann; Parrish-Sprowl, JohnThe city of Austin is a small community in Southern Indiana that experienced a large HIV/AIDS outbreak which infected over 180 people. Due to rapid spread of the disease from shared needles during intravenous drug use, a public health emergency was declared in March 2015. This epidemic was a symptom of the overall communal health issues within the area related to drugs, crime, prostitution and poverty. These problems affect residents’ physical and mental health, however, often go unaddressed due to limited resources, healthcare and education. Organizations within the area were affected by the epidemic, and many provided a response to help combat the issue. The purpose of this study is to examine how organizations respond to a health crisis from a communication perspective. Research question one is, what was the level of coordination between the seven organizations during the HIV/AIDS epidemic? Research question two is, what was the public’s response to the effort made by the seven organizations? This study interviewed seven participants and a thematic analysis was conducted that discovered four themes: coordinated response, uncoordinated activities, response time, and inadequate response. In response to research question one, the levels of coordination were infrequent with the seven agencies. Research question two found multiple areas that indicated the agencies approach ineffective in adequately informing the public. The agencies’ efforts displayed a lack of coordination and poor timely response to the crisis. These issues show it is imperative that we develop a resilient health system to operate systemically. By implementing communication for whole health, it would provide a resilient system for agencies to understand and develop coordination and collaboration between each other. With a sense of coordination, they would then be able to execute ways of promoting and living out better physical and mental health (Parrish-Sprowl and Parrish-Sprowl, 2016).Item Communicating Risk for Obesity in Early Life: Engaging Parents Using Human-Centered Design Methodologies(Frontiers Media, 2022-06-28) Cheng, Erika R.; Moore, Courtney; Parks, Lisa; Taveras, Elsie M.; Wiehe, Sarah E.; Carroll, Aaron E.; Pediatrics, School of MedicineObjective: Pediatricians are well positioned to discuss early life obesity risk, but optimal methods of communication should account for parent preferences. To help inform communication strategies focused on early life obesity prevention, we employed human-centered design methodologies to identify parental perceptions, concerns, beliefs, and communication preferences about early life obesity risk. Methods: We conducted a series of virtual human-centered design research sessions with 31 parents of infants <24 months old. Parents were recruited with a human intelligence task posted on Amazon's Mechanical Turk, via social media postings on Facebook and Reddit, and from local community organizations. Human-centered design techniques included individual short-answer activities derived from personas and empathy maps as well as group discussion. Results: Parents welcomed a conversation about infant weight and obesity risk, but concerns about health were expressed in relation to the future. Tone, context, and collaboration emerged as important for obesity prevention discussions. Framing the conversation around healthy changes for the entire family to prevent adverse impacts of excess weight may be more effective than focusing on weight loss. Conclusions: Our human-centered design approach provides a model for developing and refining messages and materials aimed at increasing parent/provider communication about early life obesity prevention. Motivating families to engage in obesity prevention may require pediatricians and other health professionals to frame the conversation within the context of other developmental milestones, involve the entire family, and provide practical strategies for behavioral change.Item Communication about ADHD and its treatment during pediatric asthma visits(Springer, 2014-02) Sleath, Betsy; Sulzer, Sandra H.; Carpenter, Delesha M.; Slota, Catherine; Gillette, Christopher; Sayner, Robyn; Davis, Stephanie; Sandler, Adrian; Department of Pediatrics, IU School of MedicineThe objectives of the study were to examine provider-family communication about attention deficit disorder during pediatric asthma visits. Children with asthma, aged 8 through 16 and their parents were recruited at five pediatric practices. All medical visits were audio-taped. There were 296 asthmatic children enrolled into the study and 67 of them also had attention deficit hyperactivity disorder (ADHD). ADHD communication elements suggested by national guidelines were discussed infrequently. Providers were more likely to discuss, educate, and ask one or more questions about ADHD medications if the visit was non-asthma related. Providers included child input into the ADHD treatment regimen during 3% of visits and they included parent input during 4.5% of visits. Only one child and three parents asked questions about ADHD. Providers may neglect essential aspects of good ADHD management and communication in children who have ADHD plus another chronic condition such as asthma. Providers should set appropriate treatment expectations, establish target symptoms, and encourage children and parents to ask questions so mutual decision-making can occur.Item Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity (COOPERATE): a Qualitative Analysis of a Tailored Coaching Program for Black Patients with Chronic Pain(Springer, 2024) Matthias, Marianne S.; Bolla, Arya L.; Bair, Sophia M.; Adams, Jasma; Eliacin, Johanne; Burgess, Diana J.; Hirsh, Adam T.; Medicine, School of MedicineBackground: Racial inequities in pain treatment are well-documented and persist despite national priorities focused on health equity. The COOPERATE (Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity) intervention was a patient-centered, tailored intervention aimed at improving health equity by targeting patient activation-the knowledge and confidence to manage one's health. COOPERATE led to significant and sustained increases in patient activation, significant short-term increases in communication self-efficacy (confidence to communicate with clinicians), and more intervention participants experienced clinically significant (≥ 30%) reductions in pain at 3 months than control group participants. Objective: To understand how participants experienced the intervention, including their perspectives on its effects on their health and healthcare experiences. Design: Semi-structured qualitative interviews. Participants: Black veterans with chronic pain who participated in the COOPERATE intervention. Key results: Participants described acquiring new tools and cultivating skills to use in their clinic visits, including preparing for their visit (writing an agenda, listing questions); asking focused, effective questions; and expressing concerns and communicating goals, values, and preferences. Participants indicated that by putting these tools to use, they felt more confident and able to take ownership of their own pain care; for some, this led to better pain management and improved pain. Participants expressed mixed views of disparities in pain care, with some believing race and racism did not play a role in their care, while others valued being part of an intervention that helped equip them with tools to exercise autonomy over their healthcare. Conclusions: Black patients with chronic pain described gaining greater confidence to self-manage and communicate with their clinicians after participating in the COOPERATE intervention. With its focus on empowering individuals, the COOPERATE intervention represents a promising approach to help advance equity in pain care.Item Communication at diagnosis of venous thromboembolism: Lasting impact of verbal and nonverbal provider communication on patients(Elsevier, 2022-01-15) Hernandez-Nino, Jackeline; Thomas, Mary; Alexander, Andreia B.; Ott, Mary A.; Kline, Jeffrey A.; Emergency Medicine, School of MedicineBackground: Establishing trust and effective communication can be challenging in the emergency department, where a prior relationship between patient and provider is lacking and decisions have to be made rapidly. Venous thromboembolism (VTE) represents an emergent condition that requires immediate decision making. Objective: The aim of this paper was to document the experiences, perceptions, and the overall impact of health care provider communication on patients during the diagnosis of VTE in the emergency department. Methods: This was a qualitative method study using semistructured interviews to increase understanding of the patient experience during the diagnosis of VTE and impact of the health care provider communication on subsequent patient perceptions. Results: A total of 24 interviews were conducted. Content analysis revealed that certain aspects of health care providers' communication-namely, word choice, incomplete information, imbalance between fear over reassurance and nonverbal behavior-used to deliver and explain VTE diagnosis, treatment, and prognosis increases patients' fears. Conclusion: These interviews elucidate areas for improvement of communication in the emergency care setting for acute VTE.