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Question Survey (question + survey)
Selected AbstractsMigraine Prevention: What Patients Want From Medication and Their Physicians (A Headache Specialty Clinic Perspective)HEADACHE, Issue 5 2006Todd D. Rozen MD Objective.,To document the results of a migraine patients survey, from a headache specialty clinic, in which patients were asked to rank, in order of importance, certain characteristics of migraine preventive treatment. Methods.,A 10-question survey was completed by 150 patients (114 females and 36 males) with a history of migraine who presented to the Michigan Head Pain & Neurological Institute. The patients were asked to rank, in order of importance, characteristics of migraine preventive treatment. Each characteristic was rated individually on a 1 to 10 scale (1 being of little importance and 10 being extremely important). The mean rating of each characteristic was then calculated and the results analyzed. Results/Discussion.,From this migraine preventive treatment survey, the most important thing to migraineurs, from a headache specialty clinic population, is that the prescribing physician involves them in the decision making of choosing a preventive agent. The physician taking time to explain the possible medication side effects is the second most highly ranked characteristic. Migraine preventives with published efficacy in the medical literature are also deemed very important. Migraineurs do not mind using more than 1 preventive agent at one time if greater efficacy can be achieved. Agents that may affect weight and /or cause sedation may be important factors as to why patients (especially females) may not want to take a preventive medication. Natural therapies and once-daily dosing are ranked lower overall but still are important characteristics of preventive treatment. Some gender differences are noted in the ranking of migraine preventive characteristics. [source] Applying a ,stages of change' model to enhance a traditional evaluation of a research transfer courseJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2003Leslie L. Buckley MD MPH Abstract The aim of this study was to utilize an evaluation tool based on Prochaska's model of change in order to assess behaviour change as part of an evaluation process for a research transfer training programme (RTTP). The RTTP was a training programme offered to scientists in a psychiatry department and research institute to gain skills in research transfer. In addition to a traditional course evaluation framework evaluating overall satisfaction with the course and whether or not learning objectives were met, an additional ,stages of change' evaluation tool designed to assess change along a continuum was utilized. This instrument measured change in participants' attitudes, intentions and actions with respect to research transfer practice and consisted of a 12-question survey completed by participants prior to taking the course and 3 months post-course. In two out of the three categories, attitudes and intention to practice, there was positive change from pre- to post-course (P < 0.05). Although there was a trend of increased RT-related action, this was less robust and did not reach significance. For the RTTP transfer course, a ,stages of change' model of evaluation provided an enhanced understanding by showing changes in participants that would otherwise have been overlooked if only changes in RT behaviour were measured. Additionally, evaluating along a change continuum specifically identifies areas for improvement in future courses. The instrument developed for this study could also be used as a pre-course, participant needs assessment to tailor a course to the change needs of participants. Finally, this ,stages of change' approach provides insight into where barriers to change may exist for research transfer action. [source] Group decisions in oncology: Doctors' perceptions of the legal responsibilities arising from multidisciplinary meetingsJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 3 2008MA Sidhom Summary There is growing consensus that multidisciplinary meetings (MDMs) are the optimal means of arriving at a comprehensive treatment plan for cancer patients. However, if a patient was grieved by a decision made by an MDM and wished to recover damages, the courts would find all involved consultants responsible for decisions related to their area of expertise. The aim of this study was to assess (i) whether doctors participating in oncology MDMs are aware that they are individually accountable for the MDM decisions and (ii) whether MDMs are conducted in a way that reflects this individual responsibility. A 35-question survey was developed and peer reviewed. Doctors attending MDMs in four Australian tertiary-care hospitals were invited to respond. One hundred and thirty-six responses (91% response rate) were received from 18 MDMs across 4 hospitals. Only 48% of doctors believe they are individually liable for decisions made by the MDM. This awareness was greater for an MDM where the patient attends, than in those that were ,discussion only' (58 vs 37%; P = 0.036). Seventy-three per cent stated they would like further education about their legal responsibilities in MDMs. Thirty-three per cent of doctors feel that the MDM discussion environment is suboptimal and radiation oncologists are significantly more likely to hold this view. Even though 85% of doctors have disagreed with the final MDM decision in an important way at some time, 71% did not formally dissent on those occasions. Doctors should be made aware of the legal implications of their participation in MDMs. A greater awareness of these responsibilities and improved team dynamics should optimize patient outcomes while limiting exposure of participants to legal liability. [source] Overheard in the Halls: What Adolescents Are Saying, and What Teachers Are Hearing, About Health IssuesJOURNAL OF SCHOOL HEALTH, Issue 7 2007Alwyn T. Cohall MD ABSTRACT Background:, Schools have long been recognized as an excellent place to offer health education and supportive services. Teachers are among the most important influences in the lives of school-aged children and can provide valuable insight into the health issues important to adolescents. The purpose of this study was to examine the potential role general academic teachers may play in facilitating adolescent health promotion efforts. Methods:, To determine what teachers think about the role of health promotion in schools and what tools and topics they would find most helpful as critical advisers to students, we administered a 28-question survey at staff development meetings in 4 New York City schools. Results:, Teachers agreed that schools were an important venue for discussing and providing health messages. More than half of those surveyed reported having overheard student discussions about health once a week or more, and 70% stated that they had been actively approached by students 1-3 or more times per semester with reports of personal problems or health issues. Teachers expressed concern about their ability to handle student mental, behavioral, and reproductive health problems and desired additional staff development workshops to address these needs. Conclusions:, Teachers felt that schools were important places to promote dialogue about health and accept the importance of playing a broader role in the lives of youth beyond education. To enhance the prospect of health-promoting interactions between teachers and students, attention must be paid to developing the overall skill and comfort level of teachers with respect to adolescent health concerns. [source] Survey of long-term follow-up programs in the United States for survivors of childhood brain tumors,PEDIATRIC BLOOD & CANCER, Issue 7 2009Daniel C. Bowers MD Abstract Introduction Despite recognition that childhood brain tumor survivors often suffer multiple late effects following therapy, little is known regarding the long-term follow-up (LTFU) programs for these patients. Methods A 16-question survey was mailed to member institutions of the Children's Oncology Group in the United States. Institutions were asked about the size of their brain tumor program, activities of the LTFU programs and perceived barriers to follow-up. Results One hundred forty-five (74%) of 197 institutions returned surveys. Care for patients <21 years old at diagnosis who are >2 years following completion of therapy was provided at a designated neuro-oncology LTFU clinic (31.2%), a general LTFU program for childhood cancer survivors (30.4%), or a general pediatric oncology program (29.7%). Institutions with a neuro-oncology LTFU clinic were more likely to use neuro-psychological testing following radiation therapy (P,=,0.001), have longer duration of continued surveillance imaging (P,=,0.02), use growth hormone replacement for medulloblastoma survivors (P,<,0.001) and continue the use of growth hormone into adulthood (P,=,0.05) than those with a general pediatric oncology program. Perceived barriers to care of brain tumor survivors included limited access and lack of insurance (32.1%), lack of funding or dedicated time for providers (22.9%), patients' uncertainty about need to follow-up (20.6%), and patients' desire to not be followed in a pediatric cancer program (12.2%). Conclusions Considerable variation exists across institutions in the United States in the delivery of follow-up care for survivors of childhood brain tumors. We encourage additional investigation to better define and implement optimal follow-up care for childhood brain tumor survivors. Pediatr Blood Cancer 2009; 53:1295,1301. © 2009 Wiley-Liss, Inc. [source] Medical Malpractice: Utilization of Layered Simulation for Resident EducationACADEMIC EMERGENCY MEDICINE, Issue 11 2008Nathaniel Ryan Schlicher MD Abstract Objectives:, The authors present a novel approach to the use of simulation in medical education with a two-event layered simulation. A patient care simulation with an adverse outcome was followed by a simulated deposition. Methods:, Senior residents in an academic emergency medicine (EM) program were solicited as simulation research volunteers. Other than stating that the research involved adverse outcomes, no identifying information was given. Seven volunteers participated in a simulation involving a forced error (nurse confederate gave an incorrect medication dose). Six weeks later based on the initial simulation, one physician completed a simulated deposition in a teaching conference conducted by a licensed attorney with malpractice experience. The audience, consisting of residents, attendings, and students, watched a recording of the patient care, witnessed the deposition, and evaluated the experience using a 17-question survey with 5-point Likert scales. Results:, Participants felt that overall the training program was a useful educational tool (mean ± standard deviation [SD] Likert score = 4.63 ± 0.49) that would change aspects of their practice (3.31 ± 0.85). Participants stated that they would be more careful in their documentation (3.88 ± 0.60), review high-risk situations with staff (4.00 ± 0.71), and monitor more carefully for errors (3.95 ± 0.74). There was increased fear of the litigation process (3.95 ± 1.18), but participants felt the experience would help improve the risk profile of their practices (3.71 ± 0.68). Conclusions:, A novel approach to medical education was successful in changing attitudes and provided an expanded educational experience for participants. Layered simulation can be successfully incorporated into educational programs for numerous issues including medical malpractice. [source] An assessment of urologists' training and knowledge of energy-based surgical devicesBJU INTERNATIONAL, Issue 2 2008Daniel S. Lehman OBJECTIVE To assess surgeons' training and current understanding of existing energy-based surgical instrumentation (ESI), we disseminated an online questionnaire to urology residents, fellows and attending urologists. SUBJECTS AND METHODS A two part 24-question survey was disseminated to 1000 urology residents, fellows and attending physicians. The first part of the questionnaire assessed the respondents' demographics and education about ESI; the second part evaluated the respondent's knowledge of surgical energy methods and ESI, and was stratified into nine basic- and six advanced-knowledge questions. RESULTS In all, 136 people (13.6%) viewed the survey and it was completed by 63 (6.3%). Respondents comprised 27 (43%) attending physicians, 14 (22%) minimally-invasive urology fellows and 22 (35%) urology residents. Among participants, 41 (64%) had received no formal didactic training on ESI, and a further 14% of respondents' didactic experience was limited to one lecture. Of the respondents, 70% said that monopolar energy was the mode most often used in surgery. Overall, the participants correctly answered 41% of the questions. Of the nine questions classified as ,basic' knowledge, respondents correctly answered 49%. Of the six questions classified as ,advanced' knowledge, 29% were answered correctly. The highest percentage score was obtained by the attending urologists, with a mean (range) score of 41 (29,86)%, followed by the fellows, with a mean score of 39.5 (29,57)%, and then the residents, at 34 (14,64)%. CONCLUSION Despite widespread and growing use of ESI, there is currently minimal formal training on energy modes and current energy devices being provided to urological surgeons. Both practising and training urologists have a limited understanding of surgical energy modes and of existing ESI. [source] 7 Layered Simulation: A Novel Approach to Medical Malpractice EducationACADEMIC EMERGENCY MEDICINE, Issue 2008Nathaniel Schlicher Overview:, We present a novel approach to the use of simulation in medical education with a two-event layered simulation. A patient care simulation with an adverse outcome was followed by a delayed simulated deposition. Process:, Senior residents in an academic emergency medicine program were solicited as simulation research volunteers. Other than stating that the research involved adverse outcomes, no identifying information was given. Seven volunteers participated in a simulation involving a forced error (nurse confederate gave an incorrect medication dose). Based on the initial simulation, one physician completed a simulated deposition in a teaching conference six weeks later conducted by a licensed attorney with malpractice experience. The audience, consisting of residents, attendings, and students, watched a recording of the patient care, witnessed the deposition, and evaluated the experience using a 13 question survey with five-point Likert scales. Outcome:, Participants felt that, overall, the training program was a useful educational tool (average Likert score of 4.63) that would change aspects of their practice (3.31). Participants stated that they would be more careful in their documentation (3.88), review high risk situations with staff (4.00), and monitor more carefully for errors (3.95). Overall, there was a degree of increased fear of the litigation process (3.95), but participants felt they would improve the risk profile of their practices (3.70). Conclusion:, A novel approach to medical education was successful in changing attitudes and provided an expanded educational experience for participants. Layered simulation can be successfully incorporated into educational programs for numerous issues including medical malpractice. [source] Methamphetamine-related Emergency Department Utilization and CostACADEMIC EMERGENCY MEDICINE, Issue 1 2008Robert G. Hendrickson MD Abstract Objective:, To quantify the frequency, cost, and characteristics associated with emergency department (ED) visits that are related to methamphetamine use. Methods:, This was a prospective observational study. The authors performed a training program for ED clinicians on the acute and chronic effects of methamphetamine and the signs of methamphetamine abuse. A standardized two question survey was administered to clinicians concerning the relationship between the ED visit and the patient's methamphetamine use. The survey was embedded in the patient tracking system and was required for all ED patients before disposition. Survey results were merged with administrative data on demographics, diagnosis, disposition, and charges. Univariate analyses were used to determine patient characteristics associated with methamphetamine-related ED visits. Results:, The authors examined 15,038 ED visits over a 20-week period from February 2006 to June 2006. There were a total of 353 methamphetamine-related visits, for an average of 17.65 visits per week (2.4% of all visits). Hospital charges for methamphetamine-related ED visits averaged $133,181 per week, for an estimated total of $6.9 M in annual charges. Methamphetamine-related ED patients were more likely to be male (odds ratio [OR] 1.6, 95% confidence interval [CI] = 1.30 to 2.01), white (OR 1.8, 95% CI = 1.38 to 2.29), and uninsured (OR 3.2, 95% CI = 2.21 to 4.69). The top four medical conditions associated with methamphetamine-related visits were mental health (18.7%), trauma (18.4%), skin infections (11.1%), and dental diagnoses (9.6%). Conclusions:, Methamphetamine abuse accounts for a modest but substantial proportion of ED utilization and hospital cost. Methamphetamine-related ED visits are most commonly related to mental illness, trauma, skin, and dental-related problems. [source] | ||||||||||