Can online patient reviews be used to assess oncologist competency? RateMD as a cancer care evaluation tool.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18656-e18656
Author(s):  
Nina Morena ◽  
Nicholas Zelt ◽  
Diana Nguyen ◽  
Carrie A. Rentschler ◽  
Devon Greyson ◽  
...  
Keyword(s):  
Cancer Care ◽  
Interpersonal Skills ◽  
Descriptive Analysis ◽  
Healthcare Delivery ◽  
Assessment Tools ◽  
Care Providers ◽  
Evaluation Tool ◽  
Care Experience ◽  
Standard Assessment ◽  
Written Examination

e18656 Background: Medical oncology (MEDONC) requires a combination of skills in collaboration, communication, and professionalism, ultimately delivering technical and clinical knowledge in practice. Standard assessment tools (e.g. written examination, OSCE) are not effective in evaluating competencies beyond technical skills and fail to define the cancer care experience holistically. This explorative, descriptive study aims to identify the potential of unstructured, unsolicited, open access online patient reviews (OPRs) as a tool to assess physician competency. Methods: University-affiliated MEDONCs in Ontario (Canada) were selected. All OPRs were identified on RateMD using every name permutation; physician names and institutional affiliations were removed from comments. A descriptive analysis of the cohort was completed. The CanMEDS Framework, defining physician standards, was used with its hierarchy of roles, concepts, and competencies. Two reviewers, a communication studies researcher and a healthcare professional, independently assessed comments and identified common themes. Competency-level assessments were evaluated using kappa with linear weights. Results: 473 OPRs were identified for 49 MEDONCs (71% male, 29% female). Of these, 23% were written by care providers. Competencies defining roles of Medical Expert, Communicator, and Professional were most prevalent (64%, 38%, and 27% respectively). Agreement levels were high in all roles (wK = 0.71 - 1.00). Themes identified were similar in positive and negative evaluations. Most commonly discussed positive themes were knowledge translation and compassionate interpersonal skills. Most common negative themes centered on lack of humility, compassion, and communication skills. 38% of comments were marked helpful, indicating engagement with other OPRs as a key characteristic of rating tools. In addition to the physician in question, 21% of OPRs reported on healthcare delivery by staff. Conclusions: OPRs emphasize experiential competencies related to interpersonal skills and suggest an alternative format to evaluating such aspects of MEDONC competencies.[Table: see text]

scholarly journals Cognitive Assessment Tools Recommended in Geriatric Oncology Guidelines: A Rapid Review

2021 ◽  
Vol 28 (5) ◽  
pp. 3987-4003
Author(s):  
Gina Tuch ◽  
Wee Kheng Soo ◽  
Ki-Yung Luo ◽  
Kinglsey Frearson ◽  
Ek Leone Oh ◽  
...  
Keyword(s):  
Cancer Care ◽  
Cognitive Assessment ◽  
Assessment Tool ◽  
Geriatric Oncology ◽  
Assessment Tools ◽  
Rapid Review ◽  
Clinical Settings ◽  
Care Experience ◽  
Clock Drawing Test ◽  
Cancer Guidelines

Cognitive assessment is a cornerstone of geriatric care. Cognitive impairment has the potential to significantly impact multiple phases of a person’s cancer care experience. Accurately identifying this vulnerability is a challenge for many cancer care clinicians, thus the use of validated cognitive assessment tools are recommended. As international cancer guidelines for older adults recommend Geriatric Assessment (GA) which includes an evaluation of cognition, clinicians need to be familiar with the overall interpretation of the commonly used cognitive assessment tools. This rapid review investigated the cognitive assessment tools that were most frequently recommended by Geriatric Oncology guidelines: Blessed Orientation-Memory-Concentration test (BOMC), Clock Drawing Test (CDT), Mini-Cog, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Short Portable Mental Status Questionnaire (SPMSQ). A detailed appraisal of the strengths and limitations of each tool was conducted, with a focus on practical aspects of implementing cognitive assessment tools into real-world clinical settings. Finally, recommendations on choosing an assessment tool and the additional considerations beyond screening are discussed.

scholarly journals Measuring Health Care Experiences that Matter to Indigenous People in Australia with Cancer: Identifying Critical Gaps in Existing Tools

2020 ◽  
Author(s):  
Monica Green ◽  
Joan Cunningham ◽  
Kate Anderson ◽  
Kalinda Griffiths ◽  
Gail Garvey
Keyword(s):  
Health Care ◽  
Indigenous People ◽  
Patient Experience ◽  
Health Care Providers ◽  
Cancer Care ◽  
World View ◽  
Cultural Safety ◽  
Care Providers ◽  
Care Experience ◽  
Critical Aspects

Abstract Background: The measurement of patients’ experiences of healthcare is increasingly used as an indicator of the quality of care. There are concerns that many mechanisms used to collect patient experience data produce large amounts of superficial data, while missing deeper, more nuanced information that is meaningful to the patient, and that insufficient attention is paid to whether the information is used to make a difference to health care. This is particularly so for Indigenous people in Australia, whose health care experience is impacted by the context of colonisation and discordance between Indigenous understandings of health and the biomedical health system. The aim of this study was to assess the extent to which existing patient experience measures currently in use in Australia collect information about the most critical aspects of cancer care, as identified by Indigenous people affected by cancer and their health care providers in previous research. Methods: A two-stage process was used to examine the adequacy of existing patient experience measures for Indigenous people in Australia: (1) relevant tools and measures were identified and assessed, and four measures were selected as suitable comparators; (2) the comparators were examined in detail and mapped against the topics identified in our earlier research as important to Indigenous people affected by cancer. Gaps in topic coverage in the comparators were identified. Results: No comparators completely captured the critical aspects of cancer care identified by Indigenous people with cancer and their health care providers. The number of topics ‘partially’ captured by the four comparators ranged from 4 to 7 out of 9. While most topics were at least partially covered, the lack of questions around culture and cultural safety was notable. Conclusions: Existing patient experience measurement tools are likely to miss some key aspects of Indigenous peoples’ experiences of cancer care in Australia. Failure to adequately assess experiences of care related to cultural safety may compromise efforts to improve health outcomes. Addressing the gaps requires the development of experience measures that are strengths-based, reflect an Indigenous world view and measure aspects of experience that are relevant to Indigenous people.

scholarly journals Correction to: Survivorship Care Plan Implementation in US Cancer Programs: a National Survey of Cancer Care Providers

2018 ◽  
Vol 34 (3) ◽  
pp. 623-623 ◽  
Author(s):  
Sarah A. Birken ◽  
Sarah Raskin ◽  
Yuqing Zhang ◽  
Gema Lane ◽  
Alexandra Zizzi ◽  
...  
Keyword(s):  
National Survey ◽  
Cancer Care ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Care Providers ◽  
Plan Implementation

Ways that nurse practitioner students self-explain during diagnostic reasoning

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Leah Burt ◽  
Susan Corbridge ◽  
Colleen Corte ◽  
Laurie Quinn ◽  
Lorna Finnegan ◽  
...  
Keyword(s):  
Problem Solving ◽  
Health Care Providers ◽  
Nurse Practitioner ◽  
Descriptive Analysis ◽  
Diagnostic Errors ◽  
Diagnostic Reasoning ◽  
Knowledge Structures ◽  
Future Research ◽  
Biological Knowledge ◽  
Care Providers

Abstract Objectives An important step in mitigating the burden of diagnostic errors is strengthening diagnostic reasoning among health care providers. A promising way forward is through self-explanation, the purposeful technique of generating self-directed explanations to process novel information while problem-solving. Self-explanation actively improves knowledge structures within learners’ memories, facilitating problem-solving accuracy and acquisition of knowledge. When students self-explain, they make sense of information in a variety of unique ways, ranging from simple restatements to multidimensional thoughts. Successful problem-solvers frequently use specific, high-quality self-explanation types. The unique types of self-explanation present among nurse practitioner (NP) student diagnosticians have yet to be explored. This study explores the question: How do NP students self-explain during diagnostic reasoning? Methods Thirty-seven Family NP students enrolled in the Doctor of Nursing Practice program at a large, Midwestern U.S. university diagnosed three written case studies while self-explaining. Dual methodology content analyses facilitated both deductive and qualitative descriptive analysis. Results Categories emerged describing the unique ways that NP student diagnosticians self-explain. Nine categories of inference self-explanations included clinical and biological foci. Eight categories of non-inference self-explanations monitored students’ understanding of clinical data and reflect shallow information processing. Conclusions Findings extend the understanding of self-explanation use during diagnostic reasoning by affording a glimpse into fine-grained knowledge structures of NP students. NP students apply both clinical and biological knowledge, actively improving immature knowledge structures. Future research should examine relationships between categories of self-explanation and markers of diagnostic success, a step in developing prompted self-explanation learning interventions.

scholarly journals An Investigation of the Effect of Attachment on Distress among Partners of Patients with Ovarian Cancer and Their Relationship with the Cancer Care Providers

2021 ◽  
Vol 28 (4) ◽  
pp. 2950-2960
Author(s):  
Danielle Petricone-Westwood ◽  
Jacqueline Galica ◽  
Sarah Hales ◽  
Elisa Stragapede ◽  
Sophie Lebel
Keyword(s):  
Ovarian Cancer ◽  
Postsecondary Education ◽  
Social Relations ◽  
Cancer Care ◽  
Attachment Anxiety ◽  
Depression And Anxiety ◽  
Care Providers ◽  
Attachment Avoidance ◽  
Attachment Insecurity ◽  
Cross Sectional

Caregivers of patients with ovarian cancer experience distress related to caregiving difficulties within cancer care. Attachment insecurity is a well-known protector of distress, particularly as it relates to support from others. Using multivariate analyses, this study sought to determine the contribution of attachment insecurity and experiences with cancer care on symptoms of depression and anxiety, and investigated whether attachment insecurity moderated the relationship between caregiving experiences and distress. Multiple hierarchical regression analyses were conducted as part of a larger cross-sectional questionnaire study of distress among partners of patients with ovarian cancer. Participants (n = 82) were predominantly male, white, had household incomes over $100,000 and postsecondary education. Caregiving experiences explained 56% of the variance in depression, and 28% of the variance in anxiety. Specifically, lack of time for social relations as a result of caregiving significantly predicted depression and anxiety. Attachment anxiety correlated with both depression and anxiety, but attachment avoidance did not. Neither attachment anxiety nor attachment avoidance significantly contributed to distress variance, and neither moderated any of the relationships between caregiving experiences and distress outcomes. This study highlights the importance for cancer care to recognize the effect of caregiving responsibilities upon caregivers’ mental health, regardless of vulnerability to distress.

Opportunities and challenges for telemedicine oncology: Perspectives from the frontline (Preprint)

2021 ◽  
Author(s):  
Kea Turner ◽  
Margarita Bobonis Babilonia ◽  
Cristina Naso ◽  
Oliver Nguyen ◽  
Brian D. Gonzalez ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Cancer Care ◽  
Healthcare Workers ◽  
Healthcare Delivery ◽  
Implementation Strategies ◽  
Structured Interviews ◽  
Biometric Data ◽  
Quality Costs ◽  
Workflow Integration ◽  
The Impact

BACKGROUND Rapid implementation of telemedicine for cancer care during COVID-19 required innovative and adaptive solutions among healthcare workers. OBJECTIVE The objective of this qualitative study was to explore healthcare workers’ experiences with telemedicine implementation during COVID-19. METHODS We conducted semi-structured interviews with 40 oncology healthcare workers who implemented telemedicine during COVID-19. The interviews were recorded, transcribed verbatim, and analyzed for themes using Dedoose software (Version 4.12). RESULTS Approximately half of participants were physicians (55%) and one quarter of participants were APPs (25%). Other participants included social workers (n=3), psychologists (n=2), dieticians (n=2), and a pharmacist. Five key themes were identified: 1) establishing and maintaining patient-provider relationships, 2) coordinating care with other providers and informal caregivers, 3) adapting in-person assessments for telemedicine, 4) developing workflows and allocating resources, and 5) future recommendations. Participants described innovative strategies for implementing telemedicine, such as coordinating inter-disciplinary visits with multiple providers. Healthcare workers discussed key challenges, such as workflow integration, lack of physical exam and biometric data, and overcoming the digital divide. Participants recommended policy advocacy to support telemedicine (e.g., medical licensure policies) and monitoring how telemedicine affects patient outcomes and healthcare delivery. CONCLUSIONS To support the growth of telemedicine, implementation strategies are needed to ensure providers and patients have the tools necessary to effectively engage in telemedicine. At the same time, cancer care organizations will need to engage in advocacy to ensure policies are supportive of oncology telemedicine and develop systems to monitor the impact of telemedicine on patient outcomes, healthcare quality, costs, and equity. CLINICALTRIAL N/A

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