24 Feb Female Underrepresented-Minority Medical Students Report Highest Rates of Discrimination
Posted at 17:48h
in Author Interviews, Education, Gender Differences, JAMA, Race/Ethnic Diversity, Yale
MedicalResearch.com Interview with:
Katherine A. Hill, BA, BS
Yale School of Medicine
New Haven, Connecticut
MedicalResearch.com: What is the background for this study?
Response: Previous studies have shown that mistreatment is a common and damaging experience for medical students. However, there is little research on whether the prevalence of medical student mistreatment varies by demographic factors such as student sex, race/ethnicity, and sexual orientation.
Dr. Perumalswami[/caption]
Chithra R. Perumalswami, MD, MSc
Research Fellow
Center for Bioethics & Social Sciences in Medicine
University of Michigan
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Dr. Munzer[/caption]
Tiffany G. Munzer, MD
Department of Pediatrics
University of Michigan Medical School
Ann Arbor
MedicalResearch.com: What is the background for this study?
Response: There’s been such a rise in the prevalence of tablet devices and the recommendation for families of young children has been to engage in media together because children learn the most from screens when they’re shared with an adult. However, little is known about how toddlers and adults might behave and interact using a tablet.
Dr. Rattray[/caption]
Nicholas A. Rattray, Ph.D.
Research Scientist/Investigator
VA HSR&D Center for Health Information and Communication
Implementation Core, Precision Monitoring to Transform Care (PRISM) QUERI
Richard L. Roudebush Veterans Affairs Medical Center
Indiana University Center for Health Services & Outcomes Research
Regenstrief Institute, Inc.
Indianapolis, Indiana
on behalf of study co-authors re:
Rattray NA, Flanagan ME, Militello LG, Barach P, Franks Z, Ebright P, Rehman SU,
Gordon HS, Frankel RM
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: End-of-shift handoffs pose a substantial patient safety risk. The transition of care from one doctor to another has been associated with delays in diagnosis and treatment, duplication of tests or treatment and patient discomfort, inappropriate care, medication errors and longer hospital stays with more laboratory testing. Handoff education varies widely in medical schools and residency training programs. Although there have been efforts to improve transfers of care, they have not shown meaningful improvement.
Led for the last decade by Richard Frankel, Ph.D., a senior health scientist at Regenstrief Institute and Indiana University and professor at Indiana University School of Medicine, our team has studied how health practitioners communicate during end-of-shift handoffs. In this current study, funded by VA Health Services and Research Development, we conducted interviews with 35 internal medicine and surgery residents at three VA medical centers about a recent handoff and analyzed the responses. Our team also video-recorded and analyzed more than 150 handoffs.
Published in the Journal of General Internal Medicine, this study explains how the person receiving the handoff can affect the interaction. Medical residents said they changed their delivery based on the doctor or resident who was taking over (i.e., training level, preference for fewer details, day or night shift). We found that handoff communication involves a complex combination of socio-technical information where residents balance relational factors against content and risk. It is not a mechanistic process of merely transferring clinical data but rather is based on learned habits of communication that are context-sensitive and variable, what we refer to as “recipient design”.
In another paper led by Laura Militello, we focus on how residents cognitively prepare for handoffs. In the paper published in The Joint Commission Journal of Quality and Patient Safety®, researchers detailed the tasks involved in cognitively preparing for handoffs. A third paper, published in BMC Medical Education, reports on the limited training that physicians receive during their residency. Residents said they were only partially prepared for enacting handoffs as interns, and clinical experience and enacting handoffs actually taught them the most.
Josephine Funck Bilsteen, MSc
Department of Pediatrics, Hvidovre University Hospital, Hvidovre,
Section of Epidemiology, Department of Public Health
University of Copenhagen
Copenhagen, Denmark
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The background of this study is that there is increasing recognition of the longer-term health and social outcomes associated with preterm birth such as independent living, quality of life, self-perception and socioeconomic achievements. However, much less is known about differences in education and income among adults born at different gestational weeks in the term period.
In this study shorter gestational duration, even within the term range, was associated with lower chances of having a high personal income and having completed a secondary or tertiary education at age 28 years. This is the first study to show that adults born at 37 and 38 completed weeks of gestation had slightly lower chances of having a high income and educational level than adults born at 40 completed weeks of gestation.