Biomedical subjects

Donald Brady

Publications and source records attributed to Donald Brady.

3 recordsLinked to original sources

PubMed2006

Personal growth and its correlates during residency training.

OBJECTIVES: To explore the characteristics of and factors associated with personal growth during residency training. METHODS: In 2003, 359 house officers on 7 internal medicine residency training programmes in the USA were surveyed about their training experiences and issues related to their personal growth. Factor analysis and internal reliability testing were used to develop a 'personal growth scale'. Logistic regression models were then used to identify independent associations between individual variables and 'high' versus 'low' personal growth scores. RESULTS: A total of 281 house officers (80%) responded. The personal growth scale had a Cronbach's alpha of 0.81. Factors that were independently associated with achieving high amounts of personal growth during residency training included: agreeing that reflection is important during residency training (odds ratio [OR] 2.9, 95% confidence interval [CI] 1.1-7.4); being male (OR 2.6, 95% CI 1.4-4.5); being non-white (OR 2.2, 95% CI 1.3-3.9); having a strong desire to develop personally and professionally (OR 2.2, 95% CI 1.1-4.1), and feeling highly supported by one's programme director (OR 2.1, 95% CI 1.2-3.9). Independent predictors of scoring below the median on the personal growth scale included feeling emotionally isolated at work (OR 0.4, 95% CI 0.2-0.7) and noting that negative or disappointing experiences had been powerful (OR 0.4, 95% CI 0.2-0.9). CONCLUSIONS: Disparate amounts of personal growth occur among trainees during residency training. Residency programmes interested in promoting personal growth among their trainees may wish to focus on modifiable factors that are associated with personal growth, such as fostering supportive relationships and encouraging reflection.

Adult↗

PubMed2003

Building the case for cultural competence.

Cultural competence in the provision of health care is a very important area of investigation and is receiving recognition at multiple levels. Minority groups constitute a significant and growing percentage of our population. However, there has been no commensurate increase in the number of minority physicians. There is a tremendous need for medical professional schools and health care organizations to implement formal cultural competence training for current and future health professionals. In this article, we present the findings of an extensive literature review that describes how several factors have brought the need for cultural competence to the forefront. These factors include a greater appreciation for the impact of culture on health, changes in U.S. demographics, increased awareness in health care disparities, and modifications in legislative and accreditation mandates.

Cultural Characteristics↗

PubMed2002

Iterative method for learning skills as an efficient outpatient teacher.

BACKGROUND: We sought to identity the choices and the methods used by ambulatory teachers in a qualitative study, using teacher-intern-patient role plays to improve ambulatory teaching. METHODS: We used repeated performances of a scripted role play; during each iteration, field notes were taken by the authors. Insights garnered at each iteration were incorporated into the next version of the role play. After 9 iterations, no further insights into outpatient teaching were forthcoming, and our observations were included into a qualitative study. RESULTS: The sequence of steps and major choices to be made in an outpatient teaching encounter were delineated. The goals of the initial opening phase were defined as setting a learning climate, gathering information about the case, and assessing the learner's level of knowledge. Alternatives posed for setting up the second phase of the interaction with the patient included the choice of being a role model or being a "coach." Three-way conversations between patient, learner, and teacher were described in this phase of the encounter. In the final or summary phase of the encounter, we described the choices between giving a "general rule" for learning, and/or exploring higher-level issues, such as patient-doctor communication skills, medical ethics, or feedback for the learner. CONCLUSIONS: The sequence of steps involved in an outpatient teaching encounter, were defined, and the major choices to be made in the encounter were described.

Ambulatory Care↗