Impact of Pharmacist Education on Incoming Medical Residents

Introduction: The graduating medical student transitioning to the role of a first-year medical resident is expected to know the proper medications and dosages for routine patient conditions. Pharmacists on an interdisciplinary health care team can be effective teachers of medical residents. Given the small amount of pharmacy-based education included in medical school curricula, it is important that medical residents have a basic foundation of pharmacotherapeutic knowledge. The purpose of this study was to assess the effectiveness of a pharmacist-led education session in improving medical resident pharmacotherapy knowledge. Methods: During orientation in 2016 to 2019, first-year medical residents completed an 8-item pre-test assessing their choices of medications and dosages on 8 patient conditions. A post-test assessing these same items was taken after a 50-minute lecture from a pharmacist experienced in resident education. First-year medical residents at a separate institution within the university system completed the pre-test only. Results: Overall, 243 medical residents received the lecture and took both tests and 170 medical residents at the other institution completed the pre-test only (100% response rate). Using descriptive statistics, the 2 groups of medical residents were comparable in age, gender, and scores on the pre-test. Medical residents receiving the lecture showed an average 32% point change improvement in performance on the post-test. The pharmacist-led lecture consistently received the highest ratings (4.7 ± 0.5 out of 5) from residents of all the orientation topics presented. Conclusions: A pharmacist-led education session increased the pharmacotherapy knowledge of first-year medical residents at their resident orientation. Medical residents value reinforcement of basic pharmacotherapy knowledge to start their training.

Interdisciplinary Health Care Evaluation Instruments: A Review of Psychometric Evidence

Teamwork among health care professionals has been found to improve patient outcomes and reduce burnout. Surveys from individual team members are often used to measure the effectiveness of teamwork performance, as they provide an efficient way to capture various constructs of teamwork. This allows evaluators to better understand team functioning, areas of strength, and to identify potential areas for improvement. However, the majority of published surveys are yet to be validated. We conducted a review of psychometric evidence to identify instruments frequently used in practice and identified in the literature. The databases searched included MEDLINE, EMBASE, CINAHL, and PsycINFO. After excluding duplicates and irrelevant articles, 15 articles met the inclusion criteria for full assessment. Seven surveys were validated and most frequently identified in the literature. This review aims to facilitate the selection of instruments that are most appropriate for research and clinical practice. More research is required to develop surveys that better reflect the current reality of teamwork in our evolving health system, including a greater consideration for patient as team members. Additionally, more research is needed to encompass an increasing development of team assessment tools.

Navigating the Hierarchy: Communicating Power Relationships in Collaborative Health Care Groups

Interdisciplinary health care groups increasingly face issues related to power and authority in the patient care process. Many of these issues stem from a tension between the historically entrenched hierarchy in health care organizations and the growing pressure of collaborative models of care that require a flattening of this hierarchy, greater mutual respect among disciplines, and more willingness to share power. This project used the framework of text and conversation to explore how groups negotiate this tension through communication. Findings suggest how some groups navigate texts that reinforce the hierarchy alongside texts that challenge it, creating a delicate balance of power that supports collaboration without threatening the position of those at the top of the hierarchy. Other groups primarily use texts that reinforce the hierarchy without consistently using texts that challenge it, which seems to make collaboration more difficult. These findings challenge the idea that equal balance should always be the goal of power sharing in collaborative interdisciplinary groups and offer a more nuanced understanding of how everyday group communication creates and recreates power relationships that impact collaborative care.

Ready to Respond: A Survey of Interdisciplinary Health-Care Students and Administrators on Disaster Management Competencies

ABSTRACTBackground:A sense of competency and confidence in disaster management is linked to response willingness and efficacy. This study assessed current health-care student disaster competency curricula and resultant confidence.Methods:A survey was sent to students and administrators in nurse practitioner (NP), master of public health (MPH), and medical/osteopathic schools (MD/DO), assessing curriculum coverage of 15 disaster management competencies (1-4, total 15-60), and confidence in performing 15 related behaviors (1-7, total 15-105). One-way analysis of variance with Tukey’s post-hoc and Mann-Whitney U-tests were used to examine group differences.Results:A total of 729 students and 72 administrators completed the survey. Low coverage of all topics was reported by both students and administrators (mean 24.4; SD 9.6). Among students, NP students (21.66 ± 8.56) scored significantly lower than MD/DO (23.32 ± 8.19; P < 0.001) and MPH students (26.58 ± 9.06; P < 0.001) on curriculum coverage. Both administrators and students expressed low confidence in competence, with students significantly lower (P < 0.001). NP students scored higher (63.12 ± 20.69; P < 0.001) than both MPH (54.85 ± 17.82) and MD/DO (51.17 ± 19.71; P < 0.001) students.Conclusions:Health-care students report low coverage of topics considered to be necessary disaster response competencies, as well as their confidence to execute functions. This may negatively impact willingness and ability of these professionals to respond effectively in a disaster.

PODOLOGICAL ASPECTS OF FOOT CARE IN SOCIAL CARE CENTERS

Investigate the necessity for therapeutic foot care and the involvement of a podologist in an interdisciplinary health care team in social care institutions in Latvia.So far, no study has been conducted on the need for therapeutic pediatric care for Social Care Center (SCC) clients in Latvia; it is known that in individual SCC’s where some podologists work part-time, another podologist is invited in specific cases, or clients are taken to a podologist at a medical institution.The study was conducted in 15 Latvian Social Care Centers (SCC), surveying 750 customer feet. People who, for various reasons, are no longer capable of foot care, is a highly necessary specialist who will do it professionally and according the needs of each client, so the involvement of a podologist in the SCC team's work is essential. The foot healing provided by the podologist would help prevent diabetes, cardiovascular, musculoskeletal etc. complications caused by the disease; those clients whose age (range of motion, vision problems, etc.) no longer allows them to care for their feet.Methods: Qualitative and Quantitative Research Method. Research tool – foot examination protocol.

“I’m Trying To Be the Safety Net”: Family Protection of Patients With Moderate-To-Severe TBI During the Hospital Stay

Research has shown that during hospital stay, family caregivers of patients with traumatic brain injury (TBI) perceive that their role is to protect the patient; however, research on this topic is limited. The purpose of this article is to describe family caregivers’ experience of protecting patients with TBI during the hospital stay. Grounded theory was used to conduct 24 interviews with 16 family caregivers. Findings showed family caregivers worked to protect the patient’s physical and emotional safety, using the following strategies: (a) influencing the selection of staff, (b) breaking the patient’s bad habits, (c) anticipating how to orchestrate the home environment; (d) connecting on an emotional level, (e) managing visitors, and (f) connecting on an emtoional level. The findings have practice implications for educating interdisciplinary health care providers about the experience of family caregivers and for developing an adversarial alliance between health care providers and family caregivers during the hospital stay to improve support provided to them.