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Francis JK, Rodriguez SA, Dorsey O, Blackwell JM, Balasubramanian BA, Kale N, Day P, Preston SM, Thompson EL, Pruitt SL, Tiro JA. Provider perspectives on communication and dismissal policies with HPV vaccine hesitant parents. Prev Med Rep 2021; 24:101562. [PMID: 34976628 PMCID: PMC8683895 DOI: 10.1016/j.pmedr.2021.101562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 11/16/2022] Open
Abstract
Providers (29%) experience HPV-specific vaccine hesitancy from parents. Providers feel least confident in responding to families’ religious beliefs. Some providers (25%) agree with dismissal policies for families refusing vaccines.
Parental vaccine hesitancy is a growing concern. Less is known about provider or practice characteristics that encounter HPV-specific vaccine-hesitant parents, the providers’ confidence in responding to HPV vaccine concerns, and the attitudes and use of vaccine dismissal policies (i.e., removing patients from the practice). North Texas providers completed an online survey. Dependent variables assessed: (1) percentage of HPV vaccine-hesitant parents encountered in practice defined as substantive, or high (≥11%, or among more than one out of ten adolescent patient encounters) versus low (≤10%) levels; (2) confidence in responding to 11 HPV vaccine concerns; (3) attitudes and use of vaccine dismissal policies. Chi-square and Fisher’s exact tests were conducted. Among 156 providers, 29% reported high HPV vaccine hesitancy (≥11% of patient population). Overall, providers reported being “very confident” in addressing vaccine concerns (mean: 3.37 out of 4, SD: 0.57). Mean confidence scores were significantly higher for white (vs. non-white) providers and for pediatricians (vs. family practitioners). Providers were least confident in responding to parents’ religious/personal beliefs (69%). Some providers (25%) agreed with policies that dismissed vaccine-hesitant parents after repeated counseling attempts. More providers used dismissal policies for childhood (19%) than adolescent (10%) immunizations. Provider communication training should include parental religious/personal beliefs to effectively address HPV vaccine hesitancy. Other regions should examine their HPV-specific vaccine hesitancy levels to understand how the use of dismissal policies might vary between adolescent and childhood immunizations.
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Weis HB, Weis JJ, Dorsey O, Napier RH, Wooldridge R, Sharma R, Gardner AK, Zeh HJ, AbdelFattah KR. The Relationship Between Surgeon Faculty Emotional Intelligence and Medical Student Evaluations. J Surg Educ 2021; 78:604-611. [PMID: 32900661 DOI: 10.1016/j.jsurg.2020.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/05/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE We sought to measure the emotional intelligence (EI) of surgical faculty and the relationship between faculty EI and medical student (MS) evaluations of faculty. DESIGN Faculty completed the Emotional Intelligence Appraisal. Aggregate, anonymous MS evaluations were collected from the Program Director's office. Parametric and nonparametric tests were used for analysis. SETTING This study was first performed in a single surgical division at 1 center which informed an expanded study including the entire General Surgery Department at a single academic institution. PARTICIPANTS A pilot study was conducted in 1 surgical division which was then expanded to all clinical faculty in the Department of Surgery. All clinical faculty in the Department of Surgery were eligible for enrollment. RESULTS Pilot study faculty EI scores were positively correlated with MS evaluations (r = 0.92, p < 0.001). The follow-up study enrolled 41 surgeons with a median age of 48 (inter-quartile range 12). The sample was mostly white (70.7%). Mean EI for the group was 76 (standard deviation ± 7.8). Total faculty EI scores were not significantly correlated with MS evaluations (r = 0.30, p = 0.06). CONCLUSIONS MS evaluations of surgeon faculty were not related to EI in the larger sample. However, EI did correlate to MS evaluations in 2 surgical specialties. Further exploration into the utility of EI training in surgical departments should be conducted to determine the true value of such endeavors.
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Affiliation(s)
- Holly B Weis
- Department of Surgery, University of Texas Southwestern, Dallas, Texas
| | - Joshua J Weis
- Department of Surgery, University of Texas Southwestern, Dallas, Texas
| | - Olivia Dorsey
- Department of Population and Data Science, University of Texas Southwestern, Dallas, Texas
| | - Rebecca H Napier
- Department of Surgery, University of Texas Southwestern, Dallas, Texas
| | - Rachel Wooldridge
- Department of Surgery, University of Texas Southwestern, Dallas, Texas
| | - Rohit Sharma
- Department of Surgery, University of Texas Southwestern, Dallas, Texas
| | - Aimee K Gardner
- Department of Health Professions, Surgery, Baylor College of Medicine, Houston, Texas
| | - Herbert J Zeh
- Department of Surgery, University of Texas Southwestern, Dallas, Texas
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Gerber DE, Hamann HA, Dorsey O, Ahn C, Phillips JL, Santini NO, Browning T, Ochoa CD, Adesina J, Natchimuthu VS, Steen E, Majeed H, Gonugunta A, Lee SJC. Clinician Variation in Ordering and Completion of Low-Dose Computed Tomography for Lung Cancer Screening in a Safety-Net Medical System. Clin Lung Cancer 2020; 22:e612-e620. [PMID: 33478912 DOI: 10.1016/j.cllc.2020.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 11/19/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Less than 5% of eligible individuals in the United States undergo lung cancer screening. Variation in clinicians' participation in lung cancer screening has not been determined. PATIENTS AND METHODS We studied medical providers who ordered ≥ 1 low-dose computed tomography (LDCT) for lung cancer screening from February 2017 through February 2019 in an integrated safety-net healthcare system. We analyzed associations between provider characteristics and LDCT orders and completion using chi-square, Fisher exact, and Student t tests, as well as ANOVA and multinomial logistic regression. RESULTS Among an estimated 194 adult primary care physicians, 144 (74%) ordered at least 1 LDCT, as did 39 specialists. These 183 medical providers ordered 1594 LDCT (median, 4; interquartile range, 2-9). In univariate and multivariate models, family practice providers (P < .001) and providers aged ≥ 50 years (P = .03) ordered more LDCT than did other clinicians. Across providers, the median proportion of ordered LDCT that were completed was 67%. The total or preceding number of LDCT ordered by a clinician was not associated with the likelihood of LDCT completion. CONCLUSION In an integrated safety-net healthcare system, most adult primary care providers order LDCT. The number of LDCT ordered varies widely among clinicians, and a substantial proportion of ordered LDCT are not completed.
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Affiliation(s)
- David E Gerber
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX; Division of Hematology-Oncology, UT Southwestern Medical Center, Dallas, TX; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX.
| | - Heidi A Hamann
- Departments of Psychology and Family and Community Medicine, University of Arizona, Tucson, AZ
| | - Olivia Dorsey
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX
| | - Chul Ahn
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX
| | - Jessica L Phillips
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX
| | - Noel O Santini
- Parkland Health and Hospital System, Dallas, TX; Division of General Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Travis Browning
- Parkland Health and Hospital System, Dallas, TX; Department of Radiology, UT Southwestern Medical Center, Dallas, TX
| | - Cristhiaan D Ochoa
- Parkland Health and Hospital System, Dallas, TX; Division of Pulmonary and Critical Care Medicine, UT Southwestern Medical Center, Dallas, TX
| | | | | | - Eric Steen
- Parkland Health and Hospital System, Dallas, TX; Division of General Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Harris Majeed
- School of Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Amrit Gonugunta
- School of Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Simon J Craddock Lee
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX
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Weis HB, Pickett ML, Weis JJ, Dorsey O, Bailey LW, Gardner AK, Napier R, AbdelFattah KR. Faculty Emotional Intelligence Matters for Resident Education. J Surg Educ 2020; 77:1132-1137. [PMID: 32522560 DOI: 10.1016/j.jsurg.2020.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This study aimed to determine the emotional intelligence (EI) of surgical faculty and evaluate its relationship with resident evaluations of faculty behaviors. DESIGN This study retrospectively collected faculty EI scores as well as general surgery resident evaluations of faculty. Parametric and nonparametric tests were used for statistical analysis. SETTING The study was conducted at the University of Texas Southwestern in the Department of Surgery in Dallas, Texas. This is an academic, tertiary care center. PARTICIPANTS Surgical faculty members at a single institution in 2018 completed the Emotional Intelligence Appraisal, a 28-item, electronic assessment with possible scores ranging from zero to 100. Aggregate, anonymous resident evaluations of faculty members were collected from the program director's office. Faculty with fewer than 8 resident evaluations were excluded. RESULTS In total, 59 faculty members participated (89%). The sample was mostly white (69.2%), male (63.5%), with an average of 47 ± 10 years of age, 12.2 ± 10 years in practice, and 44 ± 24 evaluations per faculty member. The group's mean EI score was 76 ± 7.7. Faculty EI scores were found to have a moderate, positive correlation with resident rotational evaluations of faculty (r(51) = 0.52, p < 0.001). Faculty EI scores did not significantly correlate with resident evaluations of faculty intraoperative behaviors. CONCLUSIONS The results of this study suggest that a majority of our faculty are competent with regard to EI. Furthermore, faculty EI is an important factor in the clinical learning environment and correlates with resident rotational evaluations of teaching behaviors.
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Affiliation(s)
- Holly B Weis
- Department of Surgery, University of Texas Southwestern, Dallas, Texas
| | | | - Joshua J Weis
- Department of Surgery, University of Texas Southwestern, Dallas, Texas
| | - Olivia Dorsey
- Department of Population and Data Science, University of Texas Southwestern, Dallas, Texas
| | - Lisa W Bailey
- Department of Surgery, University of Texas Southwestern, Dallas, Texas
| | - Aimee K Gardner
- Department of Health Professions, Surgery, Baylor College of Medicine, Houston, Texas
| | - Rebecca Napier
- Department of Surgery, University of Texas Southwestern, Dallas, Texas
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Gerber DE, Hamann HA, Chavez C, Dorsey O, Santini NO, Browning T, Ochoa CD, Adesina J, Natchimuthu VS, Steen E, Zhu H, Lee SJC. Tracking the Nonenrolled: Lung Cancer Screening Patterns Among Individuals not Accrued to a Clinical Trial. Clin Lung Cancer 2020; 21:326-332. [PMID: 32184050 DOI: 10.1016/j.cllc.2020.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/24/2020] [Accepted: 02/13/2020] [Indexed: 01/31/2023]
Abstract
INTRODUCTION For lung cancer screening, the available data are often derived from patients enrolled prospectively in clinical trials. We, therefore, investigated lung cancer screening patterns among individuals eligible for, but not enrolled in, a screening trial. PATIENTS AND METHODS From February 2017 through February 2019, we enrolled subjects in a trial examining telephone-based navigation during low-dose computed tomography (LDCT) for lung cancer screening. We identified patients for whom LDCT was ordered and who were approached, but not enrolled, in the trial. We categorized nonenrollment as the patient had declined or could not be reached. We compared the characteristics and LDCT completion rates among these groups and the enrolled population using the 2-sample t test and χ2 test. RESULTS Of 900 individuals approached for participation (mean age, 62 years; 45% women, 53% black), 447 were enrolled in the screening clinical trial. No significant demographic differences were found between the enrolled and nonenrolled cohorts. Of the 453 individuals not enrolled, 251 (55%) had declined participation and 202 (45%) could not be reached, despite up to 6 attempts. LDCT completion was significantly associated with enrollment status: 81% of enrolled individuals, 73% of individuals who declined participation, and 49% of those who could not be reached (P < .001). CONCLUSIONS In the present single-center study, demographic factors did not predict for participation in a lung cancer screening trial. Lung cancer screening adherence rates were substantially lower for those not enrolled in a screening trial, especially for those who could not be contacted. These findings may inform the broader implementation of screening programs.
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Affiliation(s)
- David E Gerber
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX; Division of Hematology-Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX; Division of Hematology-Oncology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX.
| | - Heidi A Hamann
- Department of Psychology, University of Arizona, Tucson, AZ; Department of Family and Community Medicine, University of Arizona, Tucson, AZ
| | - Claudia Chavez
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - Olivia Dorsey
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Travis Browning
- Parkland Health and Hospital System, Dallas, TX; Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Cristhiaan D Ochoa
- Parkland Health and Hospital System, Dallas, TX; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | | | | | - Eric Steen
- Parkland Health and Hospital System, Dallas, TX; Division of General Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Hong Zhu
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX; Division of Hematology-Oncology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX
| | - Simon J Craddock Lee
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX; Division of Hematology-Oncology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX
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