Browsing by Subject "Patient Care"
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Item Clinical Assessment and Management Examination—Outpatient (CAMEO): Its Validity and Use in a Surgical Milestones Paradigm(Elsevier, 2015-01) Wilson, Adam B.; Choi, Jennifer N.; Torbeck, Laura J.; Mellinger, John D.; Dunnington, Gary L.; Williams, Reed G.; Department of Surgery, IU School of MedicineObjectives Clinical Assessment and Management Examination—Outpatient (CAMEO) is a metric for evaluating the clinical performance of surgery residents. The aim of this study was to investigate the measurement characteristics of CAMEO and propose how it might be used as an evaluation tool within the general surgery milestones project. Design A total of 117 CAMEO evaluations were gathered and used for analysis. Internal consistency reliability was estimated, and item characteristics were explored. A Kruskal-Wallis procedure was performed to discern how well the instrument discriminated between training levels. An exploratory factor analysis was also conducted to understand the dimensionality of the evaluation. Setting CAMEO evaluations were collected from 2 departments of surgery geographically located in the Midwestern United States. Combined, the participating academic institutions graduate approximately 18 general surgery residents per year. Participants In this retrospective data analysis, the number of evaluations per resident ranged from 1 to 7, and evaluations were collected from 2006 to 2013. For the purpose of data analysis, residents were classified as interns (postgraduate year 1 [PGY1]), juniors (PGY2-3), or seniors (PGY4-5). Results CAMEO scores were found to have high internal consistency (Cronbach’s α = 0.96), and all items were highly correlated (≥0.86) to composite CAMEO scores. Scores discriminated between senior residents (PGY4-5) and lower level residents (PGY1-3). Per an exploratory factor analysis, CAMEO was revealed to measure a single dimension of “clinical competence.” Conclusions The findings of this research aligned with related literature and verified that CAMEO scores have desirable measurement properties, making CAMEO an attractive resource for evaluating the clinical performance of surgery residents.Item Pancreatic Cancer Signature Center: Providing the Research Tools Necessary to Advance Pancreatic Cancer Patient Care(Office of the Vice Chancellor for Research, 2012-04-13) Korc, Murray; Kelley, Mark R.; Howard, Tomas J.There were approximately 43,000 new cases of pancreatic ductal adenocarcinoma (PDAC) in the U.S. in 2010, and approximately 37,000 deaths. PDAC thus constitutes the fourth leading cause of cancer deaths, and PDAC patients have a dismal 5-year survival rate of 6%. PDAC is notoriously resistant to chemotherapy and radiation and even with our best treatment options, a complete margin-negative surgical resection, few patients achieving long-term survival. Despite these statistics, surprisingly only a small number of NCI-designated cancer centers have a specialized pancreatic cancer program. The creation of the IUPUI Signature Center for Pancreatic Cancer Research has been the foundation for putting IUPUI, the IU School of Medicine, Purdue University and the IU Simon Cancer Center at the forefront of pancreatic cancer treatment and research across the nation. The Signature Center, comprised of basic, translational and clinical researchers, represents the continuum of the disease from biological / molecular investigation to clinical trials. Funding from the Signature Center Initiative is being utilized to develop genetically engineered mouse models, orthotopic pancreatic cancer models as well as a human pancreatic cancer xenograft model. Establishment and characterization of these in vivo models provides the groundwork to be used by all members in their translational research projects. Additionally, work has begun on a web portal to promote and educate both patients and clinicians about the IUSCC Pancreas Cancer Clinic which became operational in 2010. Taken together the development of these in vivo models as well as web support of the Pancreas Cancer Clinic provides the infrastructure to support pancreas cancer research across the continuum of bench to bedside to practice. The availability of these resources to all members promotes inter-disciplinary collaborations aimed at increasing our understanding of pancreatic cancer so that advancements can be made in diagnosis, prevention and treatment of this malignancy.Item Resources for LGBTQ+ Patient Care(2020-04-08) Menard, Laura M.This presentation will include an introduction to the information environment for clinical practitioners who provide care to LGBTQ+ populations. The following main points are addressed: Where to find information for your practice and your patients How to access information that may be behind a paywall Quick search tips for research & patient-specific questionsItem A Review of the Evidence and Recommendations on Communication Skills and the Patient–Provider Relationship: A Rome Foundation Working Team Report(Elsevier, 2021-11) Drossman, Douglas A.; Chang, Lin; Deutsch, Jill K.; Ford, Alexander C.; Halpert, Albena; Kroenke, Kurt; Nurko, Samuel; Ruddy, Johannah; Snyder, Julie; Sperber, Ami; Medicine, School of MedicineBackground & Aims Over several decades, changes in health care have negatively impacted meaningful communication between the patient and provider and adversely affected their relationship. Under increasing time pressure, physicians rely more on technology than face-to-face time gathering data to make clinical decisions. As a result, they find it more challenging to understand the illness context and fully address patient needs. Patients experience dissatisfaction and a diminution of their role in the care process. For patients with disorders of gut–brain interaction, stigma leads to greater care dissatisfaction, as there is no apparent structural basis to legitimize the symptoms. Recent evidence suggests that practical communication skills can improve the patient–provider relationship (PPR) and clinical outcomes, but these data are limited. Methods The Rome Foundation convened a multidisciplinary working team to review the scientific evidence with the following aims: a) to study the effect of communication skills on patient satisfaction and outcomes by performing an evidence-based review; b) to characterize the influence of sociocultural factors, health care system constraints, patient perspective, and telehealth on the PPR; c) to review the measurement and impact of communication skills training on these outcomes; and d) to make recommendations to improve communication skills training and the PPR. Results Evidence supports the fact that interventions targeting patient–provider interactions improve population health, patient and provider experience, and costs. Communication skills training leads to improved patient satisfaction and outcomes. The following are relevant factors to consider in establishing an effective PPR: addressing health care system constraints; incorporating sociocultural factors and the role of gender, age, and chronic illness; and considering the changing role of telehealth on the PPR. Conclusions We concluded that effective communication skills can improve the PPR and health outcomes. This is an achievable goal through training and system change. More research is needed to confirm these findings.Item Tailoring Dental Appointments for Neurodivergent Children(2025-05) Chelmella, Payton; Van Antwerp, Leah; Department of Occupational Therapy, School of Health and Human Sciences; Steele, JaimeMany neurodivergent children have a difficult time during their dental visits or cannot find a dental office willing to treat them. This doctoral capstone project aimed to give a local pediatric dentist office the information and experience they need to confidently provide care for neurodivergent patients and patients with dental anxiety. Six evidence-based themes about beneficial adaptations and modifications were addressed, including: acclimating to the dentist, desensitization, patient care beyond the chair, child behavior management, adaptive communication, and sensory processing. The capstone student provided the dental team with additional information during the project, but the above themes were emphasized the most. The dental team members completed a pre-survey (9 participants) and post-survey (8 participants) to evaluate their knowledge and confidence in three areas: general knowledge about adaptations and modifications, perceived knowledge about concepts relating to specific adaptations and modifications, and their confidence in implementing specific adaptations and modifications. The results show that the three categories had a statistically significant difference between pre-survey and post-survey results with a medium to large effect size. This project had a strong impact on the dental team’s knowledge and confidence in ways to treat their neurodivergent patients and patients with dental anxiety, therefore, this project shows that occupational therapy has a valuable place in pediatric dental settings.