Journal of evaluation in clinical practice
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Today, in the age of big data, we are more capable than ever before. But even having the world at our disposal with naught but the touch of a button, we find ourselves exceedingly vulnerable in the patient chair. With insurmountable amounts of knowledge being published and disseminated around the world, how can clinicians keep up and what can be done about it? And sitting in the patient chair, bewildered by the ever-changing landscape of medicine at the blink of an eye, how can we, as patients, ever hope to be part of the conversations revolving around our own health? In this work, we explore the present-day problems of big data in the clinical context, how failing to integrate patients can result in detrimental outcomes, and what shared decision making can do about it.
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Drawing from the philosophical work of Hans-Georg Gadamer and the perspectives of theorists Mikhail Bakhtin and Kenneth Burke, the aim of this paper is to critically reflect on the meaning of the word "shared." ⋯ Without major transformation in what, how, and with whom we teach, future clinicians may be unprepared to enact shared decision-making in a manner that does justice to the various ways of knowing.
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The aim of this paper is to present the Venus model for workforce transformation, demonstrating its research origins, theoretical foundations, and practical application for enabling individuals, teams, and services to sustain transformation in the workplace. ⋯ The paper concludes with consideration of implications for implementation of the model and its relevance for practice, policy, education, and future research as well as outlining potential limitations and conclusions.
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McHugh and Walker introduced a model of knowledge to demonstrate that EBM is a form of scientism that ignores important sources of knowledge thereby impairing the practice of medicine. We study the development of this model and explore additional applications. ⋯ Priority should be given to Upshur et al for the development of a model that has far-reaching application to medical epistemology. It is shown that all four of the types of evidence considered-qualitative/personal, qualitative/general, quantitative/general, and quantitative/personal-are required to adequately characterize epistemology in medical research and practice.
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The article looks at how, during consultations, pregnant women identified as presenting an increased risk of giving birth to a child with an impairment, and practitioners in the field of prenatal diagnosis, decide whether or not to accept the risk of a miscarriage and proceed with a diagnostic examination. ⋯ Combining frames allows protagonists to exert reflective abilities and to maintain/restore interactions. The frame analysis promotes a vision of autonomy that is sociological, relational, and processual. The frames are anchored in different structural conditions in England and France.