Motivations of assessment item writers in medical programs: a qualitative study
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SUBMITTER: Karthikeyan S
PROVIDER: S-EPMC7523313 | biostudies-literature | 2020 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe prevalence of depression is high and has been stable despite increased treatment, research, and dissemination. People encounter barriers to seeking traditional mental health services, which could be mitigated by using web-based prevention methods.ObjectiveThis study aims to understand what people at high risk for depression perceive as effective aspects of web-based mental health programs and what motivates people at high risk for depression to use web-based mental health programs.MethodsWe conducted an inductive content analysis using telephone interview data from 77 participants at high risk for depression who were recruited from 2 randomized controlled trials (RCTs). Participants from the first RCT were working men who had been randomly assigned to 1 of the following 3 groups: control group, who had access to general depression information from a website called BroMatters; intervention group 1, who had access to the BroMatters website along with the associated BroHealth web-based mental health program; and intervention group 2, who had access to the BroMatters website, the BroHealth web-based mental health program, and telephone sessions with a life coach. Participants from the second RCT were men and women who had been assigned to the intervention group, who received access to the HardHat web-based mental health program, or the control group, who only received access to the HardHat web-based mental health program following completion of the RCT. Participants for this inductive content analysis study were recruited from the intervention groups in both RCTs. Two groups of participants (n=41 and n=20) were recruited from the BroHealth RCT, and a third group comprised 16 participants that were recruited from the HardHat RCT.ResultsWe generated four categories regarding the perceived effectiveness of web-based programs and five categories related to what motivates the use of web-based programs. Participants identified awareness, program medium and functionality, program content, and coaches as categories related to the effectiveness of the programs. Categories of motivators to use web-based programs included providing reminders or incentives, promotion of the programs, providing appropriate medium and functionality, appropriate content, and perceived need. The final category related to motivators reflects perceptions of participants who were either unsure about what motivates them or believed that there is no way to motivate use.ConclusionsConflicting evidence was obtained regarding the perceived effectiveness of aspects of the content and functionality of web-based programs. In general, web-based mental health programs were perceived to help increase mental health awareness, especially when it includes live access to a coach. However, the results also revealed that it is difficult to motivate people to begin using web-based mental health programs. Strategies that may motivate the use of such programs include perceived personal need, effective promotion, providing incentives and reminders, and improving functionality.
| S-EPMC7428897 | biostudies-literature
Project description:Improved health, wellbeing and quality of life are associated with older adults living well at home. Enabling older adults to remain at home requires organisations to consider different workforce models to support these initiatives. Volunteers are often used by organisations providing such services. However, given the changing nature of the volunteer industry, volunteer recruitment and retention practices must be better understood. This study sought to understand individuals' motivations to volunteer in aged care home support. Eighteen volunteers were recruited from not-for-profit aged support organisations in Perth, Western Australia. Semi-structured interviews were conducted, and five themes were thematically interpreted: What's Important to Me?, Learning and Growth, Somewhere to Belong, Meet Me in the Middle, and Not Just a Number. Fulfilling volunteers' desires for interest, social connection, self-growth, recognition, and support appeared conducive to positive volunteering experiences. These findings may suggest avenues to capture and retain volunteers in aged care home support.
| S-EPMC7197773 | biostudies-literature
Project description:ObjectivesImproving medical students' wellbeing and empowerment through curricular activities is a topic of interest worldwide. Mindfulness-based interventions (MBIs) are increasingly implemented in medical education often as part of elective courses. To better understand training outcomes and adjust curriculum to students' needs, we will explore why will medical students participate in meditation-based education?MethodsWe analyzed 29 transcripts from the first session of an 8-week MBSR program offered to medical students in French. Transcripts were coded and analyzed using a qualitative content thematic analysis and the constant comparison method.ResultsAnalyses resulted in three themes describing students' motivation: (1) Medical education and the physician's role, i.e. improving interpersonal skills, acquiring skills oriented toward a more integrative medicine, being more productive in a highly competitive context. (2) Caring for my health i.e. aiming at stress reduction, emotion regulation, and improving self-compassion. (3) A quest for meaning, i.e. optimizing meaning of care, and meaning of life.ConclusionThe results highlight the congruence between the perceived motivations and the evidence on the effect of mindfulness on self-care, the development of humanistic medical skills, and the meaning of care. Some findings raise the issue of the limits of using mindfulness to enhance one's productivity. Notably, participants articulated the need for self-care as in mindfulness training, with the ability to care for others.
| S-EPMC10199565 | biostudies-literature
Project description:BackgroundLow-dose computed tomography (LDCT) of the chest for lung cancer screening of heavy smokers was given a 'B' rating by the U.S. Preventive Services Task Force (USPSTF) in 2013, and gained widespread insurance coverage in the U.S. in 2015. Lung cancer screening has since had low uptake. However, for those that do choose to screen, little is known about patient motivations for completing screening in real-world practice.ObjectiveTo explore the motivations for screening-eligible patients to screen for lung cancer.MethodsSemi-structured qualitative interviews were conducted with 20 LDCT screen-completed men and women who were members of an integrated mixed-model healthcare system in Washington State. From June to September 2015, participants were recruited and individual interviews performed about motivations to screen for lung cancer. Audio-recorded interviews were transcribed and analyzed using inductive content analysis by three investigators.ResultsFour primary themes emerged as motivations for completing LDCT lung cancer screening: 1) trust in the referring clinician; 2) early-detection benefit; 3) low or limited harm perception; and 4) friends or family with advanced cancer.ConclusionParticipants in our study were primarily motivated to screen for lung cancer based on perceived benefit of early-detection, absence of safety concerns, and personal relationships. Our findings provide new insights about patient motivations to screen, and can potentially be used to improve lung cancer screening uptake and shared decision-making processes.
| S-EPMC6033377 | biostudies-literature
Project description:ObjectivesIt has been shown that assessment strongly affects students' performance. A deeper insight needs to be gained into the interplay of assessment and learning. The aim of the current study was to develop a model to explain the educational impact of assessments on students' learning, before, during and after the test.DesignThis study used semistructured interviews, focus group discussions and observation and collection of field notes. A qualitative methodology using the grounded theory data analysis approach was then used to generate an explanation of the process of how assessment impacts students' learning.SettingSchool of Medicine, Tehran University of Medical Sciences.ParticipantsParticipants were medical students and teachers with first-hand experience or expertise in assessment as well as their willingness to participate in the study. Fifteen people (eight medical students, seven faculty members) were interviewed. One focus group discussion (with five students) was held.ResultsThe extracted concepts from our study were classified into four main categories. These categories include elements of the assessment programme which affect learning, the mechanism through which they exert their effects, contextual factors and the impact they have on learning. These elements and their interplay occur within an environment with its antecedent characteristics.ConclusionsThis study suggested a model for understanding the elements of the assessment which, within the context, affect learning, the mechanisms through which they impart their effects and the final outcomes obtained.
| S-EPMC6677973 | biostudies-literature
Project description:BackgroundHomeopathy is widely used, and many European physicians practice homeopathy in addition to conventional medicine. Adverse effects in homeopathy are not expected by homeopaths due to the negligible quantities of active substances in a remedy. However, we questioned if homeopathic aggravation, which is described as a temporary worsening of existing symptoms following a correct homeopathic remedy, should be regarded as adverse effects or ruled out as desirable events of the treatment. In order to improve knowledge in an unexplored area of patient safety, we explored how medical homeopath discriminate between homeopathic aggravations and adverse effects, and how they assessed patient safety in medical practice.MethodA qualitative approach was employed using focus group interviews. Two interviews with seven medical homeopaths were performed in Oslo, Norway. The participants practiced homeopathy besides conventional medicine. Qualitative content analysis was used to analyze the text data. The codes were defined before and during the data analysis.ResultsAccording to the medical homeopaths, a feeling of well-being may be a criterion to distinguish homeopathic aggravations from adverse effects. There was disagreement among the participants whether or not homeopathic treatment produced adverse effects. However, they agreed when an incorrect remedy was administrated, it may create a disruption or suppressive reaction in the patient. This was not perceived as adverse effects but a possibility to prescribe a new remedy as new symptoms emerge. This study revealed several advantages for the patients as the medical homeopaths looked for dangerous symptoms which may enhance safety. The patient was given time and space, which enabled the practitioner to see the complete picture. A more comprehensive toolkit gave the medical homeopaths a feeling of professionalism.ConclusionThis explorative study investigated how Medical Homeopaths understood and assessed risk in their clinical practice. A feeling of well-being emerging soon after taking the remedy was the most important criterion for discriminating between Homeopathic Aggravations and Adverse Effects in clinical practice. The Medical Homeopaths used the view of both professions and always looked for red flag situations in the consultation room. They combined knowledge from two treatment systems which may have advantages for the patient. These tentative results deserve further research efforts to improve patient safety among users of homeopathy. For further research we find it important to improve and develop concepts that are unique to homeopathy in order to validate and modernize this medical practice.
| S-EPMC3488491 | biostudies-literature
Project description:Response process validation is a crucial source of test validity. The expected cognitive load scale was created based on the reflection of the mental effort by which borderline students solve an item defined by experts. The stem length affects the students' extraneous cognitive load. The purposes of this study were to develop an exam for medical students and corroborate the response process validity by analyzing the correlation between the expected cognitive load, stem length, and the difficulty. This was a correlational study. Five medical teachers as the experts and 183 third-year medical students were enrolled from the Faculty of Medicine, Prince of Songkla University, Thailand. The instruments used were a medical physiology exam and a three-level expected cognitive load evaluation form judged by medical teachers. Data were analyzed using an explanatory item response model. The test consists of 20 items and 21 possible scores. The median score was 8, with a quartile deviation of 1.5. Nine items had long stems (more than two lines). Sixteen items were judged as high (level 2 or 3) expected cognitive load. When adding the expected cognitive load in a Rasch model, the expected cognitive load significantly correlated with item difficulty. In the Rasch model that included both the expected cognitive load and stem length, a long stem had a greater effect on item difficulty than low expected cognitive load. However, the Rasch model showed the best fit. The long stem had a stronger correlation with test difficulty than expected cognitive load, which indirectly implied response process validity. We suggest incorporating stem length and expected cognitive load to create an appropriate distribution of the difficulty of the entire test.
| S-EPMC9737731 | biostudies-literature
Project description:The 100,000 Genomes Project is a hybrid clinical and research project in which patients and parents are offered genome sequencing for cancer and rare and inherited disease diagnosis; all participants receive their main findings and contribute their data for research, and are offered optional secondary findings. Our aim was to explore participating parents' attitudes towards and understanding of genome sequencing in this hybrid context. We conducted in-depth telephone interviews with 20 parents of children with rare diseases participating in the 100,000 Genomes Project. Parents were positive about contributing to research, although some had needed reassurance about data protections. Although most felt positive about secondary findings, some could not recall or misunderstood key aspects. Some were also concerned about potential emotional impact of results and a few raised concerns about life insurance implications, and the impact of future legal changes. Participants were generally positive about consent appointments, but several raised concerns about 'information overload' because of deciding about secondary findings at the same time as about the main diagnostic genome sequencing and data contribution. Additional information resources, particularly online tools, were highlighted as potentially useful ways of supporting the consent process. We conclude that parents offered genome sequencing as part of a national hybrid clinical and research project report many positive attitudes and experiences, but also concerns and misunderstandings. Further research is needed on how best to support informed consent, particularly about secondary findings. Additional resources such as online tools might usefully support future genome sequencing consent processes.
| S-EPMC7316711 | biostudies-literature
Project description:BackgroundNutrition information-seeking behavior is highly prevalent even though it can be challenging to find reliable nutrition information in the current media landscape. Previous quantitative research has identified which population segments use which sources, yet little is known about motivations underpinning nutrition information-seeking behavior. Understanding motivations for seeking nutrition information can increase the efficacy of future nutrition education efforts. The present study aims to identify motivations for nutrition information-seeking behavior among Belgian adults.MethodsIn-depth qualitative interviews were conducted with 20 adults (n women = 15, n men = 4, n other = 1). Audio-recorded interviews were transcribed verbatim and analyzed in NVivo 12 using inductive thematic analysis. The coding process involved open and axial coding combined with constant comparison to identify themes.ResultsThe interviews revealed a diverse spectrum of motivations for nutrition information-seeking behavior. Five categories of motivations centered on health management, cognitive needs, affective needs, social integrative needs, and personal identity. Participants indicated seeking nutrition information to regain a sense of control over their health and it also helped them express their autonomy. Additionally, participants sought nutrition information out of curiosity or out of a long-standing interest. Nutrition information-seeking was also used as a form of emotion regulation with participants actively engaging in seeking behavior to pursue enjoyment, diversion, confirmation, inspiration, and even relaxation. Furthermore, nutrition information-seeking enabled participants to meet social integrative needs by helping them connect to others, gather social support, help others, and sometimes convince others. Lastly, participants indicated a need for nutrition information to express or defend their identity.ConclusionsOur results indicate that beneath the surface of a more apparent need for nutrition information lies a range of motivations demonstrating that nutrition information serves more complex needs than simply information needs. To improve the efficacy of future nutrition education efforts, communication strategies must be tailored to a diverse range of motivations.
| S-EPMC9792929 | biostudies-literature
Project description:ImportanceMistreatment of medical students is pervasive and has negative effects on performance, well-being, and patient care.ObjectiveTo document the published programmatic and curricular attempts to decrease the incidence of mistreatment.Data sourcesPubMed, Scopus, ERIC, the Cochrane Library, PsycINFO, and MedEdPORTAL were searched. Comprehensive searches were run on "mistreatment" and "abuse of medical trainees" on all peer-reviewed publications until November 1, 2017.Study selectionCitations were reviewed for descriptions of programs to decrease the incidence of mistreatment in a medical school or hospital with program evaluation data. A mistreatment program was defined as an educational effort to reduce the abuse, mistreatment, harassment, or discrimination of trainees. Studies of the incidence of mistreatment without description of a program, references to a mistreatment program without outcome data, or a program that has never been implemented were excluded.Data extraction and synthesisAuthors independently reviewed all retrieved citations. Articles that any author found to meet inclusion criteria were included in a full-text review. The data extraction form was developed based on the guidelines for Best Evidence in Medical Education. An assessment of the study quality was conducted using a conceptual framework of 6 elements essential to the reporting of experimental studies in medical education.Main outcomes and measuresA descriptive review of the interventions and outcomes is presented along with an analysis of the methodological quality of the studies. A separate review of the MedEdPORTAL mistreatment curricula was conducted.ResultsOf 3347 citations identified, 10 studies met inclusion criteria. Of the programs included in the 10 studies, all were implemented in academic medical centers. Seven programs were in the United States, 1 in Canada, 1 in the United Kingdom, and 1 in Australia. The most common format was a combination of lectures, workshops, and seminars over a variable time period. Overall, quality of included studies was low and only 1 study included a conceptual framework. Outcomes were most often limited to participant survey data. The program outcome evaluations consisted primarily of surveys and reports of mistreatment. All of the included studies evaluated participant satisfaction, which was mostly qualitative. Seven studies also included the frequency of mistreatment reports; either surveys to assess perception of the frequency of mistreatment or the frequency of reports via official reporting channels. Five mistreatment program curricula from MedEdPORTAL were also identified; of these, only 2 presented outcome data.Conclusions and relevanceThere are very few published programs attempting to address mistreatment of medical trainees. This review identifies a gap in the literature and provides advice for reporting on mistreatment programs.
| S-EPMC6324298 | biostudies-literature