Health professions school applicant experiences of discrimination during interviews.

BACKGROUND: Bias pervades every aspect of healthcare including admissions, perpetuating the lack of diversity in the healthcare workforce. Admissions interviews may be a time when applicants to health profession education programs experience discrimination. METHODS: Between January and June 2021 we invited US and Canadian applicants to health profession education programs to complete a survey including the Everyday Discrimination Scale, adapted to ascertain experiences of discrimination during admissions interviews. We used chi-square tests and multivariable logistic regression to determine associations between identity factors and positive responses. RESULTS: Of 1115 respondents, 281 (25.2%) reported discrimination in the interview process. Individuals with lower socioeconomic status (OR: 1.78, 95% CI [1.26, 2.52], p = 0.001) and non-native English speakers (OR: 1.76, 95% CI [1.08, 2.87], p = 0.02) were significantly more likely to experience discrimination. Half of those experiencing discrimination (139, or 49.6%) did nothing in response, though 44 (15.7%) reported the incident anonymously and 10 (3.6%) reported directly to the institution where it happened. CONCLUSIONS: Reports of discrimination are common among HPE applicants. Reforms at the interviewer- (e.g. avoiding questions about family planning) and institution-level (e.g. presenting institutional efforts to promote health equity) are needed to decrease the incidence and mitigate the impact of such events.

Investigation and analysis on an outbreak of norovirus infection in a health school in Guangdong Province, China.

Our objective was to describe the epidemiological features of an outbreak of norovirus infection in a health school in Guangdong province, China, to identify the cause of such a large scale outbreak of norovirus among older students, to simulate the transmission dynamics, and to evaluate the effect of intervention measures of GII.17 [P17] genotype norovirus infection. We identified all cases during the outbreak. Descriptive epidemiological, analytical epidemiological and hygiene survey methods were used to described the outbreak epidemic course and identify the cause of the outbreak of norovirus infection. We also used dynamical model to simulate the transmission dynamics of norovirus infection and evaluate the effect of intervention measures. Norovirus genotyping was assigned to the newly obtained strains, with a maximum likelihood phylogenetic analysis conducted. There were 360 cases of 42 classes in five grades with a 12.99% attack rate. Proportionally, more students were in contact with sick students and vomit in the suspected case group than the control group (χ2 = 5.535, P = 0.019 and χ2 = 5.549, P = 0.019, respectively). The basic reproduction number was 8.32 before and 0.49 after the intervention. Dynamical modeling showed that if the isolation rate was higher or case isolation began earlier, the total attack rate would decrease. Molecular characterization identified the GII.17 [P17] genotype in all stains obtained from the health school, which were clustered with high support in the phylogenetic tree. This was an outbreak of norovirus infection caused by contact transmission. The main reasons for the spread of the epidemic were the later control time, irregular treatment of vomit and no case isolation. The transmission dynamics of contact transmission was high, more efficient control measures should be employed.

Association between the pattern of mobile phone use and sleep quality in Northeast China college students.

OBJECTIVES: Currently, mobile penetration is high amongst college students. The aims of this study were to investigate the characteristics of mobile phone use and to explore the influence of mobile phone use characteristics on sleep quality amongst college students. METHODS: From December 2016 to January 2017, we collected mobile phone use characteristics and sleep quality data using the Pittsburgh Sleep Quality Index (PSQI) and standardised questionnaires that were answered by 4500 medical university students in Liaoning Province (actual response rate of 94%, n = 4234 college students). This study used the SPSS 21.0 software to establish the database and perform the statistical analysis. RESULTS: One hundred percent of the college students had mobile phones and used mobile phones for entertainment (91%), work (51%), obtaining information (61%), and other purposes (23%). Additionally, there was a statistically significant difference in the PSQI score between students who held the phone at a distance of more than 10 cm from their eyes and those who held it a distance of less than 10 cm (P = 0.002). Multiple logistic regression analysis showed that the risk of poor sleep quality was 1.21-1.53 times higher for those who spent more than 5 h a day using their phones and 1.41-1.59 times higher for those who used their phones for more than half an hour before going to bed when the lights were off. CONCLUSIONS: Daily cumulative mobile phone use and use with the lights off before sleep are associated with poorer sleep quality.

Reflections on a Physician Assistant Entrance Exam: Does the Profession Need One?

ABSTRACT: Standardized entrance exams are used in many health professions as one way to objectively measure knowledge and facilitate comparisons across student groups. The physician assistant (PA) profession has historically not employed a profession-specific entrance exam, and the idea was never seriously explored until the Physician Assistant College Admissions Test was developed recently by a commercial assessment publisher, with field testing in some volunteer programs in 2018 and the exam's first administration in May of 2020. The 2020 Physician Assistant Education Association Presidents Commission chose to investigate the issues raised by a consensus-derived, PA-specific entrance exam to stimulate more informed discussion on the efficacy of such an exam. While it may have the potential to enhance efficiency in PA admissions and reduce variability in admissions requirements, a PA entrance exam would also likely introduce new challenges, including increased costs, impact on the diversity of the applicant pool, and incongruence with an increasingly holistic admissions process. The biggest barrier would likely be the lack of current consensus on the knowledge, skills, and attributes that matriculants need to be successful in the program and in clinical practice. Development of a consensus-derived PA entrance exam would be a complex, expensive, and time-consuming endeavor, requiring considerable attention to technical issues of psychometric quality, process transparency, and legal defensibility. Changes being made to health professions admissions practices due to the COVID-19 pandemic, including the dropping of test scores as a requirement by some institutions, may make some of the issues raised in this paper more timely than ever.

COVID-19: ensuring safe clinical teaching at university optometry schools.

The COVID-19 pandemic has been spreading across the globe for several months. The nature of the virus (SARS-CoV-2) with easy person-to-person transmissions and the severe clinical course observed in some people necessitated unprecedented modifications of everyday social interactions. These included the temporary suspension of considerable elements of clinical teaching at optometry schools worldwide. This article describes the challenges optometry schools were facing in early to mid 2020. The paper highlights the experiences of six universities in five countries on four continents. Strategies to minimise the risk of virus transmission, to ensure safe clinical optometric teaching and how to overcome the challenges presented by COVID-19 are described. An outlook on opportunities to further improve optometric education is provided.

Ten principles for data sharing and commercialization.

Digital medical records have enabled us to employ clinical data in many new and innovative ways. However, these advances have brought with them a complex set of demands for healthcare institutions regarding data sharing with topics such as data ownership, the loss of privacy, and the protection of the intellectual property. The lack of clear guidance from government entities often creates conflicting messages about data policy, leaving institutions to develop guidelines themselves. Through discussions with multiple stakeholders at various institutions, we have generated a set of guidelines with 10 key principles to guide the responsible and appropriate use and sharing of clinical data for the purposes of care and discovery. Industry, universities, and healthcare institutions can build upon these guidelines toward creating a responsible, ethical, and practical response to data sharing.

Willingness to perform induced abortion and associated factors among graduating midwifery, medical, nursing, and public health officer students of University of Gondar, Northwest Ethiopia: institution based cross sectional study.

BACKGROUND: In developing countries, abortion is often unsafe and a significant cause of maternal morbidity and mortality accounting for about 8% (4.7-13.2%) of maternal mortality worldwide. Internationally, safe abortion services are recognized as reducing maternal mortality, and liberalized abortion laws are associated with reduced mortality resulting from unsafe abortion procedures. However, health care providers have moral, social and gender-based reservations that affects their willingness towards providing induced abortion services. The purpose of this study was to assess willingness to perform induced abortion and associated factors among graduating Midwifery, Medical, Nursing, and Public health officer students of University of Gondar. METHODS: Institution based cross sectional study was conducted from March 29 to May 30, 2019. All graduating students available during data collection period were considered as study population. Stratified simple random sampling technique was used to select 424 study participants. Pre tested, semi- structured, self-administered questionnaire was used to collect data. Data analysis was done using SPSS version 20. Ethical clearance was obtained from School of midwifery under the delegation of institutional review board of university of Gondar. RESULTS: Two hundred ninety students out of 424 students were willing to perform induced abortion for indications supported by Ethiopian abortion law, making a proportion of 68.4% (95%Cl: 64.2, 72.9). Sex (Being male (AOR = 4.89, 95%CI: 3.02, 7.89)), religion (being orthodox than protestant (AOR = 10.41, 95%CI: 3.02, 21.57)), being Muslim than protestant (AOR = 5.73, 95%CI: 1.37, 15.92)) and having once or less a week religious attendance (AOR = 2.00, 95% CI: 1.20, 3.34) were factors associated with willingness towards performing induced abortion. CONCLUSIONS: According to this study willingness of students towards providing induced abortion services was good. However female students, protestant followers and those students with more than once a week religious attendance should be encouraged to support women's access to induced abortion services by referring them to other health care professionals willing to provide induced abortion services.

COVID-19 Planning Among Radiologic Science Programs: Response Mitigation Activities.

PURPOSE: To examine radiologic science programs' mitigation activities and educators' experiences related to coronavirus disease 2019 (COVID-19) response planning. METHODS: Using a mixed-methods approach, educators in magnetic resonance, medical dosimetry, radiation therapy, and radiography programs were surveyed to capture their experiences and mitigation strategies related to COVID-19 response planning. Quantitative data were summarized using descriptive statistics and percentages. Thematic analyses were performed on the qualitative responses. RESULTS: A total of 274 educators responded. Educators reported being somewhat comfortable with modifying clinical experiences (79, 28.8%), moderately comfortable with adjusting assessment procedures (112, 40.9%), and extremely comfortable with changing delivery of didactic content (115, 42%). Incidentally, 220 (80.3%) educators thought adjusting to a new course delivery approach (eg, face-to-face to online format) was the greatest challenge for faculty during the pandemic. Notably, half of the educators in this study questioned the quality of online (remote) learning. Specific to program policies, educators indicated that access restrictions to campus buildings (263, 96%) and removal of students from clinical sites (254, 92.7%) were implemented during the pandemic. DISCUSSION: Educators self-reported a moderate to strong comfort level with curricular modification. The area of modification that yielded the most uncertainty arose from alterations of clinical experiences. Thematic analyses revealed concerns related to personal protective equipment procurement and clinical sites prohibiting students from completing rotations. However, educators created innovative alternatives to enhance clinical education by providing simulations, case study analyses, and virtual tours of facilities during the pandemic. Securing educational technology resources, such as lockdown browser software, and working with institutional instructional designers might provide some resolution to educators' concerns regarding the quality of online (remote) learning. CONCLUSION: Archiving radiologic science programs' COVID-19 response efforts is important. The compilation of mitigation strategies will inform and guide programs on contingency planning for future pandemic and emergent conditions.

Assessment of Climate-Health Curricula at International Health Professions Schools.

Importance: Researchers have published surveys on health professionals' perceptions of the possible association between climate change and health (climate-health) and assessed climate-health or planetary health curricula in medical schools. However, curricula on climate-health are still lacking and gaps in knowledge persist. Objective: To understand the state of climate-health curricula among health professions institutions internationally. Design, Setting, and Participants: A survey of 160 institutional members of the Global Consortium on Climate and Health Education, which includes international health professions schools and programs, was conducted from August 3, 2017, to March 1, 2018. The survey, hosted by Columbia University Mailman School of Public Health, used an online survey tool for data collection. Main Outcomes and Measures: The survey assessed climate-health curricular offerings across health professions institutions internationally, including existing climate-health educational offerings, method of teaching climate-health education, whether institutions are considering adding climate-health education, whether institutions received a positive response to adding climate-health curricula and/or encountered challenges in adding curricula, and opportunities to advance climate-health education. Results: Overall response rate to the survey was 53%, with 84 of 160 institutional responses collected; 59 of the responses (70%) were from schools/programs of public health, health sciences, or health professions; 15 (18%) were from medicine; 9 (11%) were from nursing; and 1 (1%) was from another type of health profession institution. Among respondents, 53 (63%) institutions offer climate-health education, most commonly as part of a required core course (41 [76%]). Sixty-one of 82 respondents (74%) reported that climate-health offerings are under discussion to add, 42 of 59 respondents (71%) encountered some challenges trying to institute the curriculum, and most respondents have received a positive response to adding content, mainly from students (39 of 58 [67%]), faculty (35 of 58 [60%]), and administration (23 of 58 [40%]). Conclusions and Relevance: Current climate-health educational offerings appear to vary considerably among health professions institutions. Students, faculty, and administration are important groups to engage when instituting curricula, and awareness, support, and resources may be able to assist in this effort.

Perceived Barriers and Challenges of Leadership Positions in Schools and Colleges of Health Professions in Higher Education: A Survey of Faculty at ASAHP Institutions.

AIMS: Faculty recruitment into leadership positions is increasingly more difficult. The purpose of this research study was to explore the perceived barriers and challenges to leadership positions in schools of allied health professions from a faculty perspective. METHODS: This study utilized an exploratory, survey design with convenience sampling. The survey was electronically disseminated to academic representatives within the 115 ASAHP member institutions. Survey questions included basic demographic and faculty information and addressed perceptions of barriers and challenges related to leadership positions. RESULTS: Responses were collected from 310 individuals, of whom 268 who completed the entire survey. Of these, 125 identified themselves as "full-time faculty within the institution and no prior administrative/leadership experience." Respondents were primarily female, white, non-Hispanic, with 10 or fewer years of faculty experience. The top five perceived barriers included: time demands, concerns about increased workload, lack of experience, family obligations, and lack of mentoring. The top five perceived challenges included: time management/workload demands, budgeting, faculty personnel issues, resource constraints, and fundraising. CONCLUSION: Institutions should consider position announcements that reflect behaviors and characteristics versus rank and faculty line, provide education on daily responsibilities, and implement intentional mentoring and professional development in the area of leadership positions.

A Primer on the Military Health System's Approach to Medical Research and Development.

The Military Health System (MHS) has a medical research program aimed at a wide range of health-, disease-, and injury-related topic areas that works with civilian academic institutions and the biomedical industry to accomplish its goals. There are many opportunities for civilian academic institutions and the biomedical industry to engage with this program, but its unique features are important to understand to optimize the chances for successful partnerships. Unlike the National Institutes of Health, which uses an "investigator-initiated" approach, the Department of Defense (DoD) aligns its funding with specific needs, also referred to as requirements; thus, DoD research is often described as "requirements-driven" research. At the highest level, requirements are aligned with the National Security Strategy and National Defense Strategy, though requirements documents list specific areas in medicine with unmet needs. Military labs and the Uniformed Services University of the Health Sciences, which can also receive DoD appropriations to conduct medical research, serve as hubs that interface with civilian academic institutions and the biomedical industry and organize and track the overall progress of DoD investments. As a mechanism to propel findings from "bench to bedside," the military budgets funds for the various phases of research and development for a given topic area. Research programs are most effective when they are integrated into the MHS learning health system, which allows MHS clinical communities to inform and track research investments and evaluate the utility of research products in real clinical practice settings. This Perspective provides introductory information and a basic framework for those interested in performing DoD-funded medical research or collaborating with researchers in military labs. It is hoped that as academic institutions and the biomedical industry look to increase efficiency in medical research, they will find ways to engage with DoD research opportunities and consider elements of the military's approach useful.

Examination Innovation: Transforming the National Board of Examiners in Optometry's Clinical Skills Examination.

SIGNIFICANCE: The National Board of Examiners in Optometry recognizes the need for innovation and is creating a multidimensional clinical examination to parallel advancements within optometry. As optometry evolves, so must the assessments which form the path to optometric licensure. The current performance-based Part III, Clinical Skills Examination, is undergoing a transformation to best assess the diversity of knowledge, skills, and abilities needed to practice contemporary optometry. The objectives for the new clinical examination include increasing clinical authenticity, prioritizing the most essential and relevant skills, and emphasizing patient-centered care. This initiative is evidence based and consistent with best practices within the larger assessment community.

Strength in Differences? The Importance of Diversity to Students When Choosing a Physician Assistant Program.

PURPOSE: Physician assistant (PA) programs are the linchpin of endeavors to increase the diversity of the PA profession. Key to this role is understanding whether students from various backgrounds value certain program attributes differently. The current study investigated whether PA students' demographic characteristics were associated with their likelihood of having considered program diversity, and the importance they placed on program diversity when selecting a program to attend. METHODS: In 2017, 3882 recently matriculated PA students provided key demographic information (ie, gender, race, and ethnicity) and indicated whether they had considered student body and faculty diversity when choosing PA programs to attend. Those who had considered a factor then reported how important it was to them for their program to have that attribute. The current study investigated whether students' demographic characteristics were associated with their likelihood of considering PA program diversity and their subsequent ratings of the importance of program diversity. RESULTS: Female, Asian, and underrepresented racial and ethnic minority students, compared with male and non-Hispanic white students, were significantly more likely to consider program diversity when choosing PA programs to attend and rated program diversity as being more important. CONCLUSIONS: Program diversity is a greater concern for female and racial and ethnic minority students when selecting PA programs to attend. Less diverse programs could potentially increase their appeal to minority students by highlighting opportunities to connect with communities of color outside of the PA program and by prioritizing the recruitment of minority faculty.