Emergency Care Handover (ECHO study) across care boundaries : the need for joint decision making and consideration of psychosocial history

Background: Inadequate handover in emergency care is a threat to patient safety. Handover across care boundaries poses particular problems due to different professional, organisational and cultural backgrounds. While there have been many suggestions for standardisation of handover content, relatively little is known about the verbal behaviours that shape handover conversations. This paper explores both what is communicated (content) and how this is communicated (verbal behaviours) during different types of handover conversations across care boundaries in emergency care. Methods: Three types of interorganisational (ambulance service to emergency department (ED) in ‘resuscitation’ and ‘majors’ areas) and interdepartmental handover conversations (referrals to acute medicine) were audio recorded in three National Health Service EDs. Handover conversations were segmented into utterances. Frequency counts for content and language forms were derived for each type of handover using Discourse Analysis. Verbal behaviours were identified using Conversation Analysis. Results: 203 handover conversations were analysed. Handover conversations involving ambulance services were predominantly descriptive (60%–65% of utterances), unidirectional and focused on patient presentation (75%–80%). Referrals entailed more collaborative talk focused on the decision to admit and immediate care needs. Across all types of handover, only 1.5%–5% of handover conversation content related to the patient's social and psychological needs. Conclusions: Handover may entail both descriptive talk aimed at information transfer and collaborative talk aimed at joint decision-making. Standardisation of handover needs to accommodate collaborative aspects and should incorporate communication of information relevant to the patient's social and psychological needs to establish appropriate care arrangements at the earliest opportunity

2019 Diversity, Equity, and Student Success Conference Association of American Colleges & Universities

Instructor Objectives: Identify students’ diversity and inclusion needs and how they integrate with learning and student success. Develop pedagogical skills to better convey diversity and inclusion throughout a course. Anticipate and effectively manage instructional dynamics regarding sensitive topics when teaching health communication (e.g. health disparities related to race, socioeconomic status). Recognize and effectively manage instructional dynamics regarding sensitive topics when teaching organizational communication (e.g., multicultural workplaces, intercultural team interactions, discrimination)

Os Estados Unidos como um caldeirão cultural: a universalidade dos direitos humanos

The universality of human rights means ensuring equal human rights to each individual regardless of any differences (race, sex, gender, religion, etc.). The United States has struggled with actively supporting the universality of human rights since its inception. The U.S. is a country built by immigrants and continues to be a destination for opportunity. However, balancing the different cultures from Asia to Europe to Africa has proved to be an increasingly difficult task for the U.S. The country has moved from one extreme (assimilation) to another (cultural relativity) while trying to be a true “melting pot” of cultures. This essay analyzes the costs and benefits of each of these solutions through a historical lens while also examining less extreme options for ensuring the universality of human rights such as promoting differences and ensuring equality.La universalidad de los derechos humanos implica garantizar la igualdad de derechos humanos a cada individuo, independientemente de las diferencias (raza, sexo, género, religión, etc.). Estados Unidos es un país construido por inmigrantes y sigue siendo un destino de oportunidades, y desde su creación, ha luchado por defender activamente la universalidad de los derechos humanos. Sin embargo, equilibrar las diferentes culturas provenientes de Asia, Europa y África ha resultado ser una tarea cada vez más difícil. El país ha pasado de un extremo (asimilacionismo) a otro (relativismo cultural) mientras intentaba ser un verdadero "crisol" de culturas. Este ensayo analiza los costos y beneficios de cada una de estas soluciones a través de una perspectiva histórica, a la vez que examina opciones menos extremas para garantizar la universalidad de los derechos humanos, como promover las diferencias y garantizar la igualdad.Universalidade dos direitos humanos significa garantir direitos humanos iguais a todos os indivíduos, independentemente das diferenças (raça, sexo, gênero, religião, etc.). Os Estados Unidos são um país construído por imigrantes e continua sendo um destino de oportunidades, e desde sua criação, tem lutado para defender ativamente a universalidade dos direitos humanos. Entretanto, o equilíbrio das diferentes culturas da Ásia, Europa e África provou ser uma tarefa cada vez mais difícil. O país passou de um extremo (assimilação) para outro (relativismo cultural) enquanto tentava ser um verdadeiro "caldeirão de culturas". Este ensaio analisa os custos e benefícios de cada uma dessas soluções através de uma perspectiva histórica, enquanto examina opções menos extremas para garantir a universalidade dos direitos humanos, como a promoção das diferenças e a garantia da igualdade.&nbsp

Os Estados Unidos como um caldeirão cultural: a universalidade dos direitos humanos

The universality of human rights means ensuring equal human rights to each individual regardless of any differences (race, sex, gender, religion, etc.). The United States has struggled with actively supporting the universality of human rights since its inception. The U.S. is a country built by immigrants and continues to be a destination for opportunity. However, balancing the different cultures from Asia to Europe to Africa has proved to be an increasingly difficult task for the U.S. The country has moved from one extreme (assimilation) to another (cultural relativity) while trying to be a true “melting pot” of cultures. This essay analyzes the costs and benefits of each of these solutions through a historical lens while also examining less extreme options for ensuring the universality of human rights such as promoting differences and ensuring equality.La universalidad de los derechos humanos implica garantizar la igualdad de derechos humanos a cada individuo, independientemente de las diferencias (raza, sexo, género, religión, etc.). Estados Unidos es un país construido por inmigrantes y sigue siendo un destino de oportunidades, y desde su creación, ha luchado por defender activamente la universalidad de los derechos humanos. Sin embargo, equilibrar las diferentes culturas provenientes de Asia, Europa y África ha resultado ser una tarea cada vez más difícil. El país ha pasado de un extremo (asimilacionismo) a otro (relativismo cultural) mientras intentaba ser un verdadero "crisol" de culturas. Este ensayo analiza los costos y beneficios de cada una de estas soluciones a través de una perspectiva histórica, a la vez que examina opciones menos extremas para garantizar la universalidad de los derechos humanos, como promover las diferencias y garantizar la igualdad.Universalidade dos direitos humanos significa garantir direitos humanos iguais a todos os indivíduos, independentemente das diferenças (raça, sexo, gênero, religião, etc.). Os Estados Unidos são um país construído por imigrantes e continua sendo um destino de oportunidades, e desde sua criação, tem lutado para defender ativamente a universalidade dos direitos humanos. Entretanto, o equilíbrio das diferentes culturas da Ásia, Europa e África provou ser uma tarefa cada vez mais difícil. O país passou de um extremo (assimilação) para outro (relativismo cultural) enquanto tentava ser um verdadeiro "caldeirão de culturas". Este ensaio analisa os custos e benefícios de cada uma dessas soluções através de uma perspectiva histórica, enquanto examina opções menos extremas para garantir a universalidade dos direitos humanos, como a promoção das diferenças e a garantia da igualdade.&nbsp

Notes

Notes by John M. Anderton, B. M. Apker, J. V. Wilcox, Leonard Boykin, Jr., John J. Broderick, Jr., Thomas F. Broden, Robert F. Burns, John E. Cosgrove, James K. Sugnet, and James D. Sullivan

Contributors to the May Issue/Notes

Notes by John M. Anderton, Robert F. Burns, B. M. Apker, Thomas F. Broden, James A. Cassidy, John E. Cosgrove, and Robert S. Olivier

Contributors to the May Issue/Notes

Notes by John M. Anderton, Robert F. Burns, B. M. Apker, Thomas F. Broden, James A. Cassidy, John E. Cosgrove, and Robert S. Olivier

Family physicians\u27 professional identity formation: a study protocol to explore impression management processes in institutional academic contexts.

BACKGROUND: Despite significant differences in terms of medical training and health care context, the phenomenon of medical students\u27 declining interest in family medicine has been well documented in North America and in many other developed countries as well. As part of a research program on family physicians\u27 professional identity formation initiated in 2007, the purpose of the present investigation is to examine in-depth how family physicians construct their professional image in academic contexts; in other words, this study will allow us to identify and understand the processes whereby family physicians with an academic appointment seek to control the ideas others form about them as a professional group, i.e. impression management. METHODS/DESIGN: The methodology consists of a multiple case study embedded in the perspective of institutional theory. Four international cases from Canada, France, Ireland and Spain will be conducted; the \u22case\u22 is the medical school. Four levels of analysis will be considered: individual family physicians, interpersonal relationships, family physician professional group, and organization (medical school). Individual interviews and focus groups with academic family physicians will constitute the main technique for data generation, which will be complemented with a variety of documentary sources. Discourse techniques, more particularly rhetorical analysis, will be used to analyze the data gathered. Within- and cross-case analysis will then be performed. DISCUSSION: This empirical study is strongly grounded in theory and will contribute to the scant body of literature on family physicians\u27 professional identity formation processes in medical schools. Findings will potentially have important implications for the practice of family medicine, medical education and health and educational policies