Practising just medicine in an unjust world.
Ontology highlight
ABSTRACT:
SUBMITTER: Bhutta Z
PROVIDER: S-EPMC261643 | biostudies-literature | 2003 Nov
REPOSITORIES: biostudies-literature
Publications
Practising just medicine in an unjust world.
BMJ (Clinical research ed.) 20031101 7422
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Project description:ObjectiveThis systematic review examines the medical, psychological and educational literature for training in practising leadership of a team leader in emergencies. The objectives of this paper are (1) describe how literature addresses operational training in practising leadership for the emergency medical team-leader (2) enhance understanding of leadership training in the medical environment.BackgroundWorldwide, medical supervisors find it difficult to get students to rise to the occasion as leaders of emergency teams. It appears that many residents feel unprepared to adopt the role as a leader in emergencies.MethodA systematic review was conducted (May-December 2016) in accordance with the PRISMA 2009 Checklist. A literature search was conducted against a set of inclusion criteria. Databases searched included PubMed, Psycinfo (via Ovid), and ERIC.Results27 articles covering the period 1986-2016 were analysed. Four sources of data were identified: Intervention studies practising leadership, intervention studies on simulation and leadership assessment, observation studies assessing leadership, interview/survey studies about the need for leadership training. No workable training in practising leadership in emergencies for doctors was found. The majority of the research projects focused on various different types of taxonomies.ConclusionsNo consistent and workable leadership training for the emergency medical teamleader was identified. One study for paramedics succeeded in training empowering leadership skills. For many years multiple taxonomies and leadership assessment tools have been developed but failed to come to terms with workable leadership training. The literature describes lack of leadership as highly detrimental to performance during a critical, clinical situation.
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Project description:IntroductionThe incidents of violence against doctors, leading to grievous injury and even death, seem to be on an increasing trend in recent years. There is a paucity of studies on workplace violence against doctors and its effect, in India. The present study was conducted to assess workplace violence faced by doctors, its effect on the psycho-social wellbeing of the treating doctor and, subsequently, on patient management.MethodsThe present nationwide cross-sectional study was conducted from November 2019 -April 2020. The sample size was calculated assuming the prevalence of workplace violence as 50%, with 20% non-response. Doctors, working in private and/or public set-up, with ≥1 year clinical experience, were included. A pre-tested study tool- Google form-was sent to study participants via social media platforms. The Microsoft Excel spreadsheet was downloaded from google drive and data was analysed using STATA-12 statistical software.ResultsA total of 617 responses were received from doctors all over India; out of which 477 (77.3%) doctors had ever faced workplace violence. "Actual or perceived non-improvement or deterioration of patient's condition" (40.0%), followed by "perception of wrong treatment given" (37.3%) were the main causes of workplace violence; and the family members/relatives were the major perpetrators (82.2%). More than half of the participants reported "loss of self-esteem", "feeling of shame" and "stress/depression/anxiety/ideas of persecution" after the incident. Management by surgical interventions (p-value<0.001) and handling of emergency/complicated cases (p-value<0.001) decreased significantly with an increase in severity of workplace violence; while the suggestion of investigations and referrals increased (p-value<0.001).ConclusionsWorkplace violence has a significant effect on the psycho-social well-being of doctors, as well as on patient management; which may escalate discontent and distrust among the general public, thereby increasing incidents of workplace violence-in a self-propagating vicious cycle.
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Project description:ObjectiveThe purpose of this study was to determine the impact of a 1-day evidence-based medicine (EBM) workshop on physician attitudes and behaviours around teaching and practicing EBM.DesignA mixed methods study using a before/after cohort.SettingA medical school delivering continuing professional development to 1250 clinical faculty over a large geographic area in Canada.Participants105 physician clinical faculty members.InterventionA 1-day workshop presented at 11 different sites over an 18-month period focusing on EBM skills for teaching and clinical practice.Outcome measures(1) A quantitative survey administered immediately before and after the workshop, and 3-6 months later, to assess the hypothesis that comfort with teaching and practising EBM can be improved.(2) A qualitative survey of the expectations for, and impact of the workshop on, participant behaviours and attitudes using a combination of pre, post and 3 to 6-month follow-up questionnaires, and telephone interviews completed 10-14 months after the workshop.ResultsPhysician comfort with their EBM clinical skills improved on average by 0.93 points on a 5-point Likert scale, and comfort with EBM teaching skills by 0.97 points (p values 0.001). Most of this improvement was sustained 3-6 months later. Three to fourteen months after the workshop, half of responding participants reported that they were using the Population Intervention Comparator Outcome (PICO) methodology of question framing for teaching, clinical practice or both.ConclusionsComfort in teaching and practicing EBM can be improved by a 1-day workshop, with most of this improvement sustained 3-6 months later. PICO question framing can be learnt at a 1-day workshop, and is associated with a self-reported change in clinical and teaching practice 3-14 months later. This represents both level 2 (attitudes) and level 3 (behaviours) change using the Kirkpatrick model of evaluation.
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Project description:The purpose of this article is to assess the justness or unjustness of the securitization of Covid-19 in the Greek case. To do so, the Just Securitization Theory, is used as articulated by Rita Floyd to examine the following research question: Was there a just initiation and just conduct in the case of the securitization of Covid-19 in Greece? To answer this question, the methodology employed is a mix of methods proposed by Rita Floyd, such as the recourse to natural sciences to establish the actuality of the threat in combination with discourse analysis in political and scientific actors' speech acts and qualitative analysis of legal policy documents. In total, 85 statements and legal documents were examined for the period 26/02/2020 to 15/06/2020 which is considered to be the first "phase" of the pandemic. Overall, the analysis shows that the securitization of the Covid-19 pandemic in Greece was just. More specifically, there was indeed an existential threat, the securitizing actors were sincere in their intentions to securitize Covid-19, whereas the good gained from this securitization (physical survival and protection of public health) was greater than the harm inflicted (suspension of liberties). In addition, the results show that the securitization of Covid-19 in Greece did not cause more insecurity than it aimed to solve and that the overall response from the Greek Government was proportionate to the threat and respectful of the human rights of the people secured by the threat.
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