Browsing by Subject "physicians"
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Item Assessment of the Influence of Demographic and Professional Characteristics on Health Care Providers' Pain Management Decisions Using Virtual Humans(2016-05) Boissoneault, Jeff; Mundt, Jennifer M.; Bartley, Emily J.; Wandner, Laura D.; Hirsh, Adam T.; Robinson, Michael E.; Department of Psychology, School of ScienceDisparities in health care associated with patients’ gender, race, and age are well documented. Previous studies using virtual human (VH) technology have demonstrated that provider characteristics may play an important role in pain management decisions. However, these studies have largely emphasized group differences. The aims of this study were to examine dentists’ and physicians’ use of VH characteristics when making clinical judgments (i.e., cue use) and to identify provider characteristics associated with the magnitude of the impact of these cues (β-weights). Providers (N=152; 76 physicians, 76 dentists) viewed video vignettes of VH patients varying in gender (male/female), race (white/black), and age (younger/older). Participants rated VH patients’ pain intensity and unpleasantness and then rated their own likelihood of administering non-opioid and opioid analgesics. Compared to physicians, dentists had significantly lower β-weights associated with VH age cues for all ratings (p<0.001; d>0.69). These effects varied by provider race and gender. For pain intensity, professional differences were present only among non-white providers. White providers had greater β-weights than non-white providers for pain unpleasantness but only among men. Provider differences regarding the use of VH age cues in non-opioid analgesic administration were present among all providers except non-white males. These findings highlight the interaction of patient and provider factors in driving clinical decision making. Although profession was related to use of VH age cues in pain-related clinical judgments, this relationship was modified by providers’ personal characteristics. Additional research is needed to understand what aspects of professional training or practice may account for differences between physicians and dentists and what forms of continuing education may help to mitigate the disparities.Item Daily Situational Brief, December 16, 2014(MESH Coalition, 12/16/14) MESH CoalitionItem Daily Situational Brief, May 16, 2011(MESH Coalition, 5/16/2011) MESH CoalitionItem Disclosing Medical Mistakes: A Communication Management Plan for Physicians(2013-04) Petronio, Sandra; Torke, Alexia M.; Bosslet, Gabriel T.; Isenberg, Steven; Wocial, Lucia D.; Helft, Paul R.Introduction: There is a growing consensus that disclosure of medical mistakes is ethically and legally appropriate, but such disclosures are made difficult by medical traditions of concern about medical malpractice suits and by physicians’ own emotional reactions. Because the physician may have compelling reasons both to keep the information private and to disclose it to the patient or family, these situations can be conceptualized as privacy dilemmas. These dilemmas may create barriers to effectively addressing the mistake and its consequences. Although a number of interventions exist to address privacy dilemmas that physicians face, current evidence suggests that physicians tend to be slow to adopt the practice of disclosing medical mistakes. Methods: This discussion proposes a theoretically based, streamlined, two-step plan that physicians can use as an initial guide for conversations with patients about medical mistakes. The mistake disclosure management plan uses the communication privacy management theory. Results: The steps are 1) physician preparation, such as talking about the physician’s emotions and seeking information about the mistake, and 2) use of mistake disclosure strategies that protect the physician-patient relationship. These include the optimal timing, context of disclosure delivery, content of mistake messages, sequencing, and apology. A case study highlighted the disclosure process. Conclusion: This Mistake Disclosure Management Plan may help physicians in the early stages after mistake discovery to prepare for the initial disclosure of a medical mistakes. The next step is testing implementation of the procedures suggested.Item Examining Influential Factors in Providers’ Chronic Pain Treatment Decisions: A Comparison of Physicians and Medical Students(Office of the Vice Chancellor for Research, 2014-04-11) Free, Charnelle A.; Hollingshead, Nicole A.; Meints, Samantha M.; Middleton, Stephanie; Hirsh, Adam T.Reports have found that chronic pain management guidelines are unclear and conflicting. Due to this confusion, it is critical to understand factors that influence providers’ treatment decisions for chronic pain. Little is known about which factors providers use to make treatment decisions or whether providers of different training levels endorse using similar factors. The purpose of this study was to examine the factors that providers report using to make their chronic pain treatment decisions. We hypothesized that providers would: (1) prioritize objective factors over subjective factors, (2) be particularly interested in information about patients’ substance use, and (3) endorse using different factors depending on their training level (physicians vs. medical students). Eighty-five providers (35 medical students, 50 physicians) viewed 16 computer-simulated patients; each included a picture with text describing the patients’ condition (i.e., chronic lower back pain, open to any treatment, presence/absence of depression). After making treatment decisions, participants selected from a list the factors they used and would have used (if the information had been available) to make their treatment decisions. Most providers reported being influenced by patients’ pain histories (97.6%) and pain descriptions (95.3%). Providers indicated they would have used information about patients’ previous treatments (97.6%), average pain ratings (96.5%), and current pain (96.5%) had this information been available. Compared to physicians, medical students endorsed more often that they would have used patients’ employment and/or disability status (p<.01), illicit drug use (p=.09), and alcohol use (p=.08) to make treatment decisions. These results indicate that providers rely on objective and subjective information to make pain treatment decisions, and compared to physicians, medical students place a stronger emphasis on patients’ substance abuse and social history when making treatment decisions. Future studies should examine additional provider and patient factors that influence decisions for specific pain treatment options.Item Making Science Make Sense: Applied Improvisation in Health and Life Sciences(Office of the Vice Chancellor for Research, 2016-04-08) Hoffmann-Longtin, Krista; Rossing, JonathanAbstract Both in and out of the classroom, physicians and scientists must speak in a way that generates excitement about their disciplines (Berrett, 2014). They also must communicate vividly to funders and policy makers about their work and why it matters. In every context, these experts must tell engaging stories, respond spontaneously to the needs of the moment, and explain their work in terms nonscientists can understand. In response, some universities have turned to the techniques of improvisational theater to help scientists to speak more spontaneously, responsively, and engagingly. Over the past year, we have conducted a series of workshops (N=54) for a variety of audiences including, doctoral and post-doc students in the sciences, for educators, for physicians and research scientists, and for doctoral nursing students. The workshops help participants make stronger connections to their multiple audiences. They include content on improvisation skills such as presence and listening, acceptance, recognizing offers, and storytelling to help scientists translate their research in ways that engage their audiences. This approach moves faculty toward understanding communication as a process of collaborative meaningmaking, thus helping them to address the “curse of knowledge” by which experts forget the time when they were novices in their field (Bass, 2015). This poster will report on four key areas of the intervention and evaluation: 1) the need for communication training in the health professions and sciences, 2) the development of the programs, 3) the program efficacy and outcomes. Higher education presents unique challenges for the practice of applied improvisation. While enthusiasm for the work has grown in industry, some audiences within the academy seem resistant to the methods, especially within the sciences. This poster will also address the ways expertise, prestige, and rank affect the practice of applied improvisation in higher education, and we will propose strategies for mitigating resistance.Item Using COVID-19 Narratives to Think Deeply About Physicians’ Conflicting Roles and Responsibilities(Indiana University, 2020) Olivera, Jesus; Gunderman, Richard; Radiology and Imaging Sciences, School of MedicineItem Virtual Handover of Patients in the Pediatric Intensive Care Unit During the Covid-19 Crisis(Dovepress, 2021-06) Temsah, Mohamad-Hani; Abouammoh, Noura; Ashry, Ahmed; Al-Eyadhy, Ayman; Alhaboob, Ali; Alsohime, Fahad; Almazyad, Mohammed; Alabdulhafid, Majed; Temsah, Reem; Aljamaan, Fadi; Jamal, Amr; Halwani, Rabih; Alhasan, Khalid; Al-Tawfiq, Jaffar A.; Barry, Mazin; Medicine, School of MedicineObjective: A key measure to mitigate coronavirus disease 2019 (COVID-19) has been social distancing. Incorporating video-conferencing applications in the patient handover process between healthcare workers can enhance social distancing while maintaining handover elements. This study describes pediatric intensive care unit (PICU) physicians' experience using an online video-conferencing application for handover during the COVID-19 pandemic. Design: Qualitative content analysis. Setting: PICU at a university hospital in Riyadh, Saudi Arabia. Subjects: PICU Physicians. Interventions: Due to the pandemic, the hospital's PICU used Zoom® as a remote conferencing application instead of a face-to-face handover. Following institutional review board approval, data were collected over two weeks (1 Jul 2020 to 14 Jul 2020). Measurements: An online survey was conducted using open-ended questions to capture demographic data and the perceived efficacy of remote handovers. Thematic framework analysis process included open coding, creating categories, and abstraction. Main Results: All 37 PICU physicians who participated in the handover completed the survey. The participants comprised six attendings, nine specialists, and 22 residents. While 20 (54.1%) physicians reported attending 1-5 Zoom handovers by the time of the study, some (n. 6, 16.2%) had more than ten virtual handovers. They had variable previous teleconferencing experiences. Most physicians (78.4%) were comfortable conducting a remote handover. Most found that Situation-Background-Assessment-Recommendation handover elements were properly achieved through this remote handover process. The perceived advantages of online handover included fewer interruptions, time efficiency, and facilitation of social distancing. The perceived disadvantages were the paucity of nonverbal communication and teaching during virtual meetings. Conclusion: Video-conferencing applications for online handovers could supplement traditional face-to-face intensive care unit patient handover during outbreaks of infectious diseases. The use of video streaming and more emphasis on teaching should be encouraged to optimize the users' experience.