Journal of general internal medicine
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Randomized Controlled Trial
Harm and Medication-Type Impact Agreement with Hypothetical Deprescribing Recommendations: a Vignette-Based Experiment with Older Adults Across Four Countries.
Little is known about what factors are important to older adults when deciding whether to agree with a recommendation to deprescribe. ⋯ Older adults across four countries were accepting of deprescribing in the setting of polypharmacy. The medication type and rationale for discontinuation were important factors in the decision-making process.
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Meta Analysis
Psychological Determinants of Physician Variation in End-of-Life Treatment Intensity: A Systematic Review and Meta-Synthesis.
Physicians treating similar patients in similar care-delivery contexts vary in the intensity of life-extending care provided to their patients at the end-of-life. Physician psychological propensities are an important potential determinant of this variability, but the pertinent literature has yet to be synthesized. ⋯ Psychological propensities could influence physician judgments regarding whether and when to de-escalate life-extending treatments. Future work should examine how individual and environmental factors combine to create such propensities, and how addressing these propensities could reduce physician-attributed variation in end-of-life care intensity.
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Randomized Controlled Trial
Does a Survivorship Model of Opioid Use Disorder Improve Public Stigma or Policy Support? A General Population Randomized Experiment.
The chronic disease model of opioid use disorder (OUD) is promoted by many public health authorities, yet high levels of stigma persist along with low support for policies that would benefit people with OUD. ⋯ The survivorship model of OUD improved overall feelings compared to the chronic disease model, but we did not detect an effect of this model on other domains of public stigma or support for policies. Further refinement and testing of this novel, survivorship model of OUD could improve public opinions.
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Community teaching physicians (i.e., community preceptors) have assumed an important role in medical education. More than half of medical schools use community settings to train medical students. Whether community preceptors are well prepared for their teaching responsibilities is unknown. ⋯ Participants reported satisfaction and improvement in teaching skills after attending the program. Faculty development for community preceptors is primarily delivered through workshops and online materials, although direct observations of teaching with feedback from FD faculty and learners may be more helpful for training. Future studies need to focus on the long-term impact of FD on community preceptors' teaching skills, identity formation as medical educators, and student learning.
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Increasing numbers of faculty who are underrepresented in medicine has been a focus of academic health systems. Understanding the experiences of these faculty helps in creating environments that are inclusive and supportive, promoting faculty success. When compared with non-minoritized faculty, minoritized faculty face racism, isolation, diversity efforts disparities, clinical efforts disparities, lack of faculty development, and promotion disparities. ⋯ They may be excluded from conversations, group chats, get togethers, or other work-related or social functions. These feelings can manifest as imposter syndrome and impact work performance and decision-making. In this article, the author shares how to recognize and mitigate isolation to promote an inclusive environment for all faculty.