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   Table of Contents - Current issue
Coverpage
September-December 2022
Volume 5 | Issue 3
Page Nos. 85-134

Online since Monday, January 23, 2023

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ORIGINAL ARTICLES  

Supporting resident wellness through reflection on professional identity: A novel curriculum p. 85
Diana Toubassi, Milena Forte, Lindsay Herzog, Michael Roberts, Carly Schenker, Ian Waters, Erin Bearss
DOI:10.4103/EHP.EHP_1_22  
Background: Interventions to address distress among medical trainees often include reflective practice, as well as peer support. Few, however, have emphasized the role of professional identity formation, increasingly recognized as critical to wellness. The structural aspects of curricular interventions have also received little attention. A novel curriculum was therefore designed and evaluated with the goal of understanding how best to support resident wellness through reflection on professional identity. Materials and Methods: The curriculum consisted of 8 2-hour sessions, each focusing on a theme commensurate with residents’ professional identity at the time of its delivery. Two Family Medicine sites at the University of Toronto participated, with residents divided into small groups by residency year. Qualitative data were collected through feedback forms, and resident and faculty focus groups, transcripts of which were subjected to pragmatic thematic analysis. Results: Four major themes were developed relating to 1) the curriculum’s ability to support resident wellness, 2) the importance of protecting reflection, 3) the impact of participants’ professional developmental stage, and 4) the critical role of facilitators. Conclusions: A curriculum encouraging reflection on professional identity appears to support resident wellness. To optimize impact, structural factors such as robust curricular integration, confidentiality and group member continuity, require care.
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Implementing a combined instruction model on pregnancy options counseling for pre-clinical medical students: Expert physician panel, case-based learning, and pre-recorded lectures p. 96
Lucy D Brown, Sarah Combs, Alexandra McKinzie, McKenzie Barber, Sarah Komanapalli, Cynthia Y Wu, Sara Hardman, Julianne Stout
DOI:10.4103/EHP.EHP_18_22  
Introduction: The Association of Professors of Gynecology and Obstetrics (APGO) recommends that pre-clinical medical students learn how to counsel on pregnancy options as a standard learning topic during undergraduate medical curriculum. Materials and Methods: Second-year medical students viewed pre-recorded lectures and attended a panel on pregnancy options counseling covering adoption, abortion, and pregnancy continuation. Students were then surveyed about their experiences. Results: Participants (n = 57) were primarily female (74%), non-Hispanic (89%), and Caucasian (77%). Students determined that most (80–100%) of the APGO Student Learning Objectives were adequately covered by the panel and pre-recorded lectures. Students reported on a 5-point Likert-type scale a statistically significant increase (P < 0.0001) in their perceived preparedness to counsel across each pregnancy option category: abortion (2.17 ± 0.94 before vs. 3.5 ± 0.94 after), adoption (1.81 ± 0.86 before vs. 2.56 ± 1.04 after), and continuation of pregnancy (2.52 ± 1 before vs. 3.38 ± 0.95 after). Eighty-seven percent of the respondents felt that the panel was inclusive of diverse viewpoints. Discussion: Students appreciated the pre-recorded lectures and case-based panel as providing important exposure to pregnancy options counseling. Students noted a significantly increased preparedness to counsel a newly diagnosed pregnant patient on abortion, adoption, and pregnancy continuation, most notably with abortion counseling. The overwhelmingly positive reception of the panel highlights the desire of medical students to learn about these issues. Conclusion: This study demonstrates the efficacy of combined instruction modalities, including traditional didactics, case-based learning, and an expert provider panel, in educating students on pregnancy options counseling.
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Are the pre-internship expectations of interns in medical field met during internship?: Experience from Tanzania p. 105
Karpal S Sohal, Sira S Owibingire, Philipo F Garinga, Evarist M Wilson, Shaban D Shaban
DOI:10.4103/EHP.EHP_32_21  
Background: The transition period from an undergraduate student to an independent practitioner across healthcare professionals is challenging as new graduates experience a social, professional, and economic life that may be different from their prior expectations. Objective: The aim of this article is to determine the pre-internship expectations of the interns and to what level these expectations were met during internship. Materials and Methods: The study participants were interns posted at the Muhimbili National Hospital who had completed at least 6 months of internship training. A structured questionnaire was used to collect data regarding their social, economic, and career expectations before and during the internship. Data were analyzed using Statistical Package for Social Sciences version 23. The χ2 test was used to assess the association between variables, and the significance level was set at P < 0.05. Results: The median age of participants was 26 years, and the male-to-female ratio was 1.7:1. The overall mean pre-internship expectation score was 9.6 ± 3.6, whereas the mean scores were 3.6 ± 2.0, 3.7 ± 1.5, and 2.2 ± 1.4 for social, career, and economic expectations, respectively. The overall average expectation score during the internship was 6.1 ± 4.2. The mean scores were 1.9 ± 2.2, 3.0 ± 1.5, and 1.2 ± 1.5 for social, career, and economic expectations, respectively. There was a significant average difference between the expectation scores before and during the internship period. Conclusion: The pre-internship expectations of students in the field of health sciences are not met during the internship. The career expectations are relatively better met; however, social and economic expectations are largely not achieved during the internship period.
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Knowledge and expressed practices regarding needle stick injury among housekeeping staff: A descriptive survey p. 114
Vandna Pandey, Nancy Kurien, Sandhya Kumari, Sangeeta Meena, Santosh Borana, Saroj
DOI:10.4103/EHP.EHP_20_22  
Background: Needle stick injury (NSI) is an accidental skin penetrating wound from a hollow bore needle. It is one of the most common occupational hazards for health care workers. Aims: The study aimed to assess the level of knowledge and expressed practices regarding needle stick injuries among housekeeping staff. Setting and Design: The research design was a descriptive survey, and research was conducted on housekeeping staff employed at a tertiary care hospital. Materials and Methods: 225 housekeeping staff were selected using non-probability convenience sampling. A self-structured questionnaire and checklist were used to assess their knowledge and practices regarding needle stick injuries. SPSS was used for the analysis of data through descriptive and inferential statistics. Results: In the present study, out of 225 subjects, 11.11% of respondents had poor, 37.33% had average, 36.88% had good, and 14.66% had excellent knowledge regarding NSI. Knowledge was significantly associated with education and year of working experience. In total, 4% of the respondents had poor, 34.66% had average, 35.11% had good, and 26.22% had excellent expressed practices regarding NSI. Expressed practices were significantly associated with education and prior exposure to NSI. A moderate positive correlation was present between knowledge and expressed practices. Conclusion: The study concluded that knowledge and practices about needle stick injury were average among housekeeping staff. The areas of concern identified were: risks associated with NSIs, no use of personal protective equipment (rubber gloves), and recapping of needles. These gaps in knowledge and expressed practices can be addressed by educating them.
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RESEARCH METHODOLOGY Top

Reduce, reuse, and recycle: Saving resources by repurposing data to address evaluation questions p. 120
Shannon Oldham Sampson, Yuyan Xia, Joshua McConnell Parsons, Roberto Cardarelli
DOI:10.4103/EHP.EHP_14_22  
Introduction: In program evaluation, time, and energy of program leaders and participants are often at a premium, and survey fatigue is a methodological challenge. Finding ways to reduce survey fatigue and burden on participants while also working to include multiple sources of evidence to answer evaluation questions is a key task of evaluators. Materials and Methods: Rasch modeling was used to build scales from Accreditation Council for Graduate Medical Education (ACGME) milestone data. Results: Existing data for related constructs were repurposed to address evaluation questions with minimal threat to construct validity. Discussion: This work illustrates a novel way to reuse and recycle existing data to build scales by using a psychometrically-sound survey development and measurement approach.. Conclusion: This work illustrates an innovative methodology to combat participant survey fatigue and include multiple sources of evidence to answer evaluation questions.
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BRIEF REPORT Top

Surveying entry-level curriculum content in home modifications for occupational therapy programs p. 125
Margaret Eleanor Meyer, Victoria Priganc
DOI:10.4103/EHP.EHP_22_22  
Importance: There is increased attention on the role the physical home environment plays in successful engagement in occupation. Objective: To examine how home modification content is integrated into the core curriculum in entry-level OT programs in the United States. Design: Web-based survey research. Participants: Program directors or their representatives. Results: All respondents include home modification instruction in their curriculum, however instructional time, where content lies in the curriculum, and resources vary widely. Sixty-eight percent do not utilize content experts and 34% do not offer hands-on learning experiences. Conclusion and Relevance: There is a risk for disparity in the scope and quality of home modification education provided to OT students that could negatively impact service delivery in this increasingly in-demand area of practice.
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PERSPECTIVE Top

The value of vicarious experiences in health professions education p. 130
Roma Forbes
DOI:10.4103/EHP.EHP_15_22  
Vicarious experiences are an educational approach that, when used effectively, can harness the benefits of learning with and from others. As a major source of self-efficacy, vicarious experiences can be used in myriad ways to enhance learning. With key design strategies including careful selection of people and tasks to observe, prompting, discourse, and collaboration, this faculty development paper outlines how health professions educators can capture the benefits of vicarious experiences in, and out of, the traditional classroom setting.
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