Within Medical 2008 (x64) Keygen Download
Alke Stilwell
Conclusions: Very few RCTs in the field have measures of participation in decision making and at least one health outcome. Moreover, extant studies exhibit little consistency in measurement of these variables, and results are mixed. There is a great need for well-designed, reproducible research on clinically relevant outcomes of patient participation in medical decisions.
Objective: To explore student experiences relating to racism, microaggressions and implicit bias within healthcare communication and medical education in the wake of the Black Lives Matter movement METHODS: Students and faculty from different racial/ethnic backgrounds, medical schools, countries, and levels of training shared their perspectives with a multi-disciplinary, international audience at the 2020 International Conference on Communication in Healthcare (ICCH).
Results: We highlight experiences shared at the symposium and demonstrate how the student voice can help shape the medical school curriculum. 3 main themes are discussed: 1) Institutional bias and racism, 2) Racial discrimination during medical training and 3) Recommendations for curricula change.
Conclusion: Racism influences many aspects of student experiences and often appears in covert and institutional forms. These shared experiences reflect a common problem faced by ethnic minority medical students.
Context: Emotion in medical education rests between the idealised and the invisible, sitting uneasily at the intersection between objective fact and subjective values. Examining the different ways in which emotion is theorised within medical education is important for a number of reasons. Most significant is the possibility that ideas about emotion can inform a broader understanding of issues related to competency and professionalism.
Objectives: The current paper provides an overview of three prevailing discourses of emotion in medical education and the ways in which they activate particular professional expectations about emotion in practice.
Methods: A Foucauldian critical discourse analysis of the medical education literature was carried out. Keywords, phrases and metaphors related to emotion were examined for their effects in shaping medical socialisation processes.
Discussion: Despite the increasing recognition over the last two decades of emotion as 'socially constructed', the view of emotion as individualised is deeply embedded in our language and conceptual frameworks. The discourses that inform our emotion talk and practice as teachers and health care professionals are important to consider for the effects they have on competence and professional identity, as well as on practitioner and patient well-being. Expanded knowledge of how emotion is 'put to work' within medical education can make visible the invisible and unexamined emotion schemas that serve to reproduce problematic professional behaviours. For this discussion, three main discourses of emotion will be identified: a physiological discourse in which emotion is described as located inside the individual as bodily states which are universally experienced; emotion as a form of competence related to skills and abilities, and a socio-cultural discourse which calls on conceptions from the humanities and social sciences and directs our attention to emotion's function in social exchanges and its role as a social, political and cultural mediator.
The data produced by the scientific community impacts on academia, clinicians, and the general public; therefore, the scientific community and other regulatory bodies have been focussing on ethical codes of conduct. Despite the measures taken by several research councils, unethical research, publishing and/or reviewing behaviours still take place. This exploratory study considers some of the current unethical practices and the reasons behind them and explores the ways to discourage these within research and other professional disciplinary bodies. These interviews/discussions with PhD students, technicians, and academics/principal investigators (PIs) (N=110) were conducted mostly in European higher education institutions including UK, Italy, Ireland, Portugal, Czech Republic and Netherlands.
This qualitative exploratory study was based on informal mini-interviews conducted through collegiate discussions with technicians, PhD scholars, and fellow academics (N=110) within medical and biomedical sciences mainly in European higher education institutions including UK, Italy, Ireland, Portugal, Czech Republic and Netherlands (only 5 PhD students). PhD students (n=75), technicians (mostly in the UK; n=25) and academics/principal investigators (PIs; n=10), around Europe, have taken part in this qualitative narrative exploration study. These mini-interviews were carried out in accordance with local ethical guidance and processes. The discussions or conversations were not voice recorded; nor the details of interviewees taken to maintain anonymity. The data was captured (in long-hand) by summarising their views on following three questions (see below).
This study has identified some less reported (not well-known) unethical behaviours or misconduct. These findings from technician/PhD scholars and academics/PIs are summarised in Tables 1 and 2. The study initially aimed to identify any previously unreported unethical research conducts, however, the data shows that many previously identified misconduct are still common amongst researchers. Since the interviews were not audio recorded (to reassure anonymity), the participants were openly reported the unethical practices within their laboratories (or elsewhere). This may cast doubts on the accuracy of data interpretation. To minimise this, we have captured the summary of the conversation in long-hand.
This exploratory study (and previously reported large scale studies) showed QRP is still a problem in science and medical research. So what are the way forward to stop these types of misconduct? Whilst it is important to set up confirmed criteria for individual research conduct, it is also important to set up institutional policies. These policies should aim at promoting academic/research integrity, with paramount attention on the training of young researchers about research integrity. The focus should be on young researchers attaining rigorous learning/application of the best methodological and professional standards in their research. In fact, the Singapore statement on research integrity (www7 n.d.), not only highlights the importance of individual researchers maintaining integrity in their research, but also insists the roles of institutions creating/sustaining research integrity via educational programmes with continuous monitoring (Cosentino and Picozzi 2013). Considering the findings from this study, it would also be appropriate to suggest an international regulatory body to regularly monitor these practices involving all stakeholders including governments.
We, do agree this is a small-scale pilot study and due to the way it was conducted, we are unable to carry out a full thematic analysis. This was mainly because the participants were extremely reluctant to offer information to formulate researcher characteristics. Also, the study data in many cases conforms to the previously reported fact, that QRP and research misconduct is still a problem within science and medicine. Yet, this study has attempted to narrate the previously unreported justifications given by the interviewees. In addition, we were able to highlight that these activities are becoming regular occurrence (those nick-named behaviours). We also provided some directives on how academic pressures are inflicted upon early career researchers. We also provided some recommendations in regard to the training ECRs.
The study has highlighted the negative influence on supervisory/peer pressures and/or inappropriate training may be main causes for these misconducts, highlighting the importance on devising and implementing a universal research code of conduct. Although this was an exploratory investigation, the data presented herein have pointed out that unethical practices can still be widespread within biomedical field. It highlighted the fact that despite the proactive/reflective measures taken by the research governance organisations, these practices are still going on in different countries within Europe. As the study being explorative, we had the flexibility to adapt and evolve our questions in reflection to the responses. This would help us to carry out a detailed systematic research in this topic involving international audience/researchers.
To summarise, this small-scale interview-based narrative study has highlighted that QRP and research misconduct is still a problem within science and medicine. Although they may be influenced by institutional and career-related pressures, these practices seriously undermine ethical standards, and question the validity of data that are being reported. The findings also suggest that both methodological and publication-related malpractices continue, despite being widely reported. The measures taken by journal editors and other regulatory bodies such as WAME and ICMJE may not be efficient to curtail these practices. Therefore, it would be important to take steps in providing a universal research code of conduct. Without a globalised approach with clear punitive measures for offenders, research misconduct and QRP not only affect reliability, reproducibility, and integrity of research, but also hinder the public trustworthiness for medical research. This study has also highlighted the importance of carrying out large-scale studies to obtain a clear picture about misconduct undermining research ethics culture.
Caregivers noted that music brought up a lot of emotion during the sessions, which often manifested as tearfulness, verbal reflections in conversation, and verbal sharing of experiences. Many caregivers commented that the music elicited emotion in a surprisingly immediate way, as they would often begin to cry shortly after the music began. Through follow-up interviews, caregivers shared that the music therapy created opportunities for their own reflections on personal narratives, including past experiences such as pivotal life moments with their loved one or current experiences of anticipatory grief. The wife of Participant #4 shared that she reflected on their marriage and life together while listening to the songs within the music therapy session, many of which played an important role throughout their relationship.
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