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Lewis BE, Naik AR. A scoping review to identify and organize literature trends of bias research within medical student and resident education. BMC MEDICAL EDUCATION 2023; 23:919. [PMID: 38053172 DOI: 10.1186/s12909-023-04829-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/01/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Physician bias refers to the unconscious negative perceptions that physicians have of patients or their conditions. Medical schools and residency programs often incorporate training to reduce biases among their trainees. In order to assess trends and organize available literature, we conducted a scoping review with a goal to categorize different biases that are studied within medical student (MS), resident (Res) and mixed populations (MS and Res). We also characterized these studies based on their research goal as either documenting evidence of bias (EOB), bias intervention (BI) or both. These findings will provide data which can be used to identify gaps and inform future work across these criteria. METHODS Online databases (PubMed, PsycINFO, WebofScience) were searched for articles published between 1980 and 2021. All references were imported into Covidence for independent screening against inclusion criteria. Conflicts were resolved by deliberation. Studies were sorted by goal: 'evidence of bias' and/or 'bias intervention', and by population (MS or Res or mixed) andinto descriptive categories of bias. RESULTS Of the initial 806 unique papers identified, a total of 139 articles fit the inclusion criteria for data extraction. The included studies were sorted into 11 categories of bias and showed that bias against race/ethnicity, specific diseases/conditions, and weight were the most researched topics. Of the studies included, there was a higher ratio of EOB:BI studies at the MS level. While at the Res level, a lower ratio of EOB:BI was found. CONCLUSIONS This study will be of interest to institutions, program directors and medical educators who wish to specifically address a category of bias and identify where there is a dearth of research. This study also underscores the need to introduce bias interventions at the MS level.
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Affiliation(s)
- Brianne E Lewis
- Department of Foundational Sciences, Central Michigan University College of Medicine, Mt. Pleasant, MI, 48859, USA
| | - Akshata R Naik
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI, 48309, USA.
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Moonen G, Perrier L, Meiyappan S, Akhtar S, Crampton N. COVID-19 pandemic partnership between medical students and isolated elders improves student understanding of older adults' lived experience. BMC Geriatr 2022; 22:636. [PMID: 35918634 PMCID: PMC9344259 DOI: 10.1186/s12877-022-03312-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 06/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence supports loneliness and social isolation as a strong risk factor for poor mental and physical health outcomes for older adults. The COVID-19 pandemic necessitated older adults isolate themselves for a prolonged duration. The Faculty of Medicine at the University of Toronto established the Student-Senior Isolation Prevention Partnership (SSIPP), a volunteer program involving telephone calls between medical students and older adults. METHODS A mixed methods pre-post study design included collecting quantitative data from older adults using the UCLA Loneliness Scale and the Warwick-Edinburgh Mental Well-being Scale. The study included 29 medical students and 47 older adults. The medical students filled out a questionnaire on self-perceived knowledge of social isolation, perception of seniors, attitudes towards seniors, and likelihood to engage in specialties focusing on older adults. Interviews were conducted with both the older adults and the medical students to understand each groups' experiences and perspectives with taking part in the SSIPP program. RESULTS Participation in the program resulted in significant changes for medical students in areas such as increasing their likelihood to engage in care for older adults (p < .001), improving their knowledge of social isolation for seniors (p < .001), and the value of addressing social isolation in older adults (p < .001). The interviews conducted with the medical students support these findings and provide insight into contributing factors. Loneliness and mental well-being scales did not show significant changes for older adults however, our interviews revealed they considered the program to be valuable. CONCLUSIONS Our results showed that after the communication outreach program, medical students' perceptions were positively influenced towards older adults and they were more likely to pursue a career concentrated on older adults. The qualitative analysis revealed older adults valued the program. Timing and consistency of calls were factors identified by this group as having practical importance.
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Affiliation(s)
- Gray Moonen
- Bridgepoint Active Care, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada. .,Sinai Health Systems, Toronto, Canada. .,Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Laure Perrier
- Toronto Western Family Health Team, University Health Network, Toronto, Canada
| | | | - Sabrina Akhtar
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.,Toronto Western Family Health Team, University Health Network, Toronto, Canada
| | - Noah Crampton
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.,Toronto Western Family Health Team, University Health Network, Toronto, Canada
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Mendez A, Lopez M, Rodriguez-Quintanilla K, Carrion B. Ageist No More: Interprofessional Training for Undergraduate Healthcare Students. Geriatrics (Basel) 2022; 7:geriatrics7010017. [PMID: 35200522 PMCID: PMC8872434 DOI: 10.3390/geriatrics7010017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/23/2022] [Accepted: 02/02/2022] [Indexed: 01/27/2023] Open
Abstract
Ageism seeps deep into our society, whether in law, policies, or healthcare practices it segregates individuals based on their age. The aim of this work was to evaluate the impact of an educational strategy in ageist attitudes against older adults in healthcare undergraduate students. A five-week intervention: Healthy environments and self-care for the older adults was implemented. To assess the impact of this strategy in ageist attitudes in participants, a simulated consultation with an older adult was conducted. Participants’ perspectives on the experience were collected using an online survey. One hundred and thirty-eight undergraduate students from health programs were included. They highlighted growth in the understanding of the normal aging process and the prejudices that surround aging. During the role-play activity, participants identified communication, empathy, and professionalism as the abilities developed with this strategy and the need to show empathy and avoid prejudice against older adults in their clinical interactions. Educational interventions are a great tool to promote cultural changes, diminish prejudices and misconceptions of ageism in future healthcare professionals.
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Even-Zohar A, Shtanger V, Israeli A, Averbuch E, Segal G, Mayan H, Steinlauf S, Galper A, Zimlichman E. The Association between Health and Culture: The Perspective of Older Adult Hospital In-Patients in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126496. [PMID: 34208609 PMCID: PMC8296490 DOI: 10.3390/ijerph18126496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/10/2021] [Accepted: 06/13/2021] [Indexed: 11/16/2022]
Abstract
People from different cultures are often hospitalized while the staff treating them do not have sufficient knowledge about the attitudes and feelings of the patients regarding culture and health. To fill this gap, the aim of this study was to examine the perspective of Israeli older adult hospital in-patients regarding the association between health and culture and to understand the meaning of the participants’ experiences with regards to the medical staff’s attitude towards them. This study was carried out using qualitative methodology that followed the interpretive interactionism approach. The research participants were 493 (mean age 70.81, S.D.: 15.88) in-patients at internal care departments at a hospital in Israel who answered an open-ended question included in the questionnaire as part of a wide study held during 2017 to 2018. Two main themes were found: (1) a humane attitude of respect and the right to privacy and (2) beliefs, values, and traditional medicine that are passed down through generations. The findings highlighted the issue of the patients’ cultural heritage and ageist attitudes they ascribed to the professional staff. This study provided recommendations for training the in-patient hospital workforce on the topic of cultural competence, beginning from the stage of diagnosis through treatment and to discharge from the hospital, in order to improve the service.
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Affiliation(s)
- Ahuva Even-Zohar
- Faculty of Social Sciences, School of Social Work, Ariel University, Ariel 40700, Israel
- Correspondence:
| | - Varda Shtanger
- Quality Assurance Department Patient Report Outcome Measures, Sheba Medical Center, Tel Ha Shomer 52620, Israel;
| | - Anat Israeli
- Internal Nursing Wing, Sheba Medical Center, Tel Ha Shomer 52620, Israel;
| | - Emma Averbuch
- Reduction of Health Inequalities Unit in the Administration for Strategic and Economic Planning at the Israeli Ministry of Health, Jerusalem 9101002, Israel;
| | - Gad Segal
- Internal Medicine, Sheba Medical Center, Tel Ha Shomer 52620, Israel; (G.S.); (H.M.); (S.S.)
| | - Haim Mayan
- Internal Medicine, Sheba Medical Center, Tel Ha Shomer 52620, Israel; (G.S.); (H.M.); (S.S.)
| | - Shmuel Steinlauf
- Internal Medicine, Sheba Medical Center, Tel Ha Shomer 52620, Israel; (G.S.); (H.M.); (S.S.)
| | - Alex Galper
- Quality Assurance Department Patient Report Outcome Measures, Tele-Health Project, Sheba Medical Center, Tel Ha Shomer 52620, Israel;
| | - Eyal Zimlichman
- Innovative and Quality Assurance Department, Sheba Medical Center, Tel Ha Shomer 52620, Israel;
- Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Punchik B, Tkacheva O, Runikhina N, Sharashkina N, Ostapenko V, Samson T, Freud T, Press Y. Ageism Among Physicians and Nurses in Russia. Rejuvenation Res 2021; 24:297-301. [PMID: 33715384 DOI: 10.1089/rej.2020.2376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The phenomenon of ageism has been studied extensively in the Western world, but there is only a small number of studies among medical staff in Russia. The aim of this study was to assess the prevalence of ageism and to identify variables that can explain ageism in a sample of physicians and nurses in Russia. This is a prospective cross-sectional study of physicians and nurses who participated in a training course in the years 2016-2018 in Russia. Data collected before the start of training included the Fraboni scale of ageism (FSA) questionnaire, and sociodemographic characteristics including age, gender, profession, professional seniority, place of work, and number of older adults treated by the study participant over the past half year. In total, 903 physicians and nurses participated in the study. The mean FSA score was 2.75 ± 0.49, which indicates a moderate degree of ageism. There was a trend to higher scores among nurses compared with physicians (2.78 ± 0.50 vs. 2.76 ± 0.48, p < 0.465). There was a weak, but statistically significant, correlation between ageism and age (r = 0.157, p < 0.0001), professional seniority (r = 0.098, p < 0.003), and the number of older adult patients treated by the participant over the prior half year (r = 0.075, p < 0.025). There were no differences in other characteristics including gender, profession, work setting, or serving as main caregiver for a family member and the magnitude of ageism. The phenomenon of ageism exists among physicians and nurses in Russia. Older participants with greater professional seniority and a larger number of older patients had stronger ageism attitudes.
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Affiliation(s)
- Boris Punchik
- Home Care Unit, Clalit Health Services, Beer-Sheva, Israel.,Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Unit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Olga Tkacheva
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia
| | - Nadezda Runikhina
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia.,Laboratory of Ambulatory Geriatrics, Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia
| | - Natalya Sharashkina
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia.,Laboratory of General Gerontology and Neuro-Gerontology, Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia
| | - Valentina Ostapenko
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia.,Department of Geriatrics, Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Tali Samson
- Unit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Pain and Palliative Care Unit, Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tami Freud
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yan Press
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Unit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Geriatrics, Soroka University Medical Center, Beer-Sheva, Israel.,Center for Multidisciplinary Research in Aging, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Gomez-Moreno C, Verduzco-Aguirre H, Soto-Perez-de-Celis E. Geriatric oncology in Mexico. Ecancermedicalscience 2020; 14:1102. [PMID: 33082852 PMCID: PMC7532031 DOI: 10.3332/ecancer.2020.1102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Indexed: 11/06/2022] Open
Abstract
Mexico is an upper-middle income country located in North America, with an increasing life expectancy and a growing population of older adults. Due to population ageing and lifestyle changes, the number of cancer cases amongst older individuals is expected to increase in the upcoming decades, representing a challenge to the healthcare system. The challenges for implementing geriatric oncology care in Mexico include a fragmented healthcare system, as well as the lack of geriatric training amongst healthcare professionals. In this mini-review, we present an overview of the epidemiology of cancer amongst older adults in Mexico, the Mexican healthcare system and ongoing initiatives for the development of geriatric oncology programmes in the country. In addition, we highlight the priorities for future developments in the field of cancer and ageing in Mexico, with a focus on the various stakeholders involved.
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Affiliation(s)
- Carolina Gomez-Moreno
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, 14080, Mexico
| | - Haydeé Verduzco-Aguirre
- Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, 14080, Mexico
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, 14080, Mexico
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Fan JY, Zhao HM, Liu YT, Kong LL, Mao J, Li J. Psychometric properties of a Chinese version of the Fraboni scale of ageism: evidence from medical students sample. BMC MEDICAL EDUCATION 2020; 20:197. [PMID: 32552703 PMCID: PMC7302149 DOI: 10.1186/s12909-020-02111-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The increasing of older adults has led to enormous demand for medical care. However, as a group with unique needs and characteristics, older adults are often discriminated against in the medical field. In this paper, we aimed to translate the Fraboni Scale of Ageism (FSA) into Chinese and examine its construct validity, content validity, and reliability in Chinese mainland medical students. In order to evaluate the prevalence of ageism in Chinese medical students and prompt medical college to adopt necessary teaching methods to mitigate ageism in medical students. METHODS By Brislin's translation guidelines, FSA was translated to Chinese. The convenient sampling method was used to select samples for this survey, including 1,974 students from two medical schools in central and north China. Construct validity was verified by the exploratory and confirmatory factor analysis. The content validity index (CVI) was used to assess content validity. The Cronbach's alpha coefficients and intraclass correlation coefficient (ICC) were used to estimate reliability. RESULTS The alpha coefficients for FSA (Chinese version) was 0.81 and ICC was 0.87. The CVI was 0.93. Three factors were identified by exploratory factor analysis explaining 34.84% of the total variance and a three-factor model was confirmed to fit by confirmatory factor analysis. CONCLUSIONS FSA (Chinese version) is a reliable and valid scale for measuring discrimination degree against older adults in Chinese medical students.
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Affiliation(s)
- Jun-Yao Fan
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Qiaokou District, Wuhan, 430030, Hubei Province, China
| | - Hui-Min Zhao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Qiaokou District, Wuhan, 430030, Hubei Province, China
| | - Yue-Ting Liu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Qiaokou District, Wuhan, 430030, Hubei Province, China
| | - Ling-Lin Kong
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Qiaokou District, Wuhan, 430030, Hubei Province, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Qiaokou District, Wuhan, 430030, Hubei Province, China
| | - Jie Li
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Qiaokou District, Wuhan, 430030, Hubei Province, China.
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Leon Rodriguez E, Rivera Franco MM. Unmet need for hematopoietic stem cell transplantation in older adults in developing countries: Experience from a Latin American referral center. J Geriatr Oncol 2019; 11:131-133. [PMID: 31281089 DOI: 10.1016/j.jgo.2019.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/20/2019] [Accepted: 06/22/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Eucario Leon Rodriguez
- Stem Cell Transplantation Program, Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Belisario Dominguez Seccion XVI, Tlalpan, Mexico City 14080, Mexico.
| | - Monica M Rivera Franco
- Stem Cell Transplantation Program, Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Belisario Dominguez Seccion XVI, Tlalpan, Mexico City 14080, Mexico
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