Decision influences and aftermath: parents, stillbirth and autopsy.

BACKGROUND: Stillbirth, among the most distressing experiences an adult may face, is also a time when parents must decide whether an autopsy or other post-mortem examinations will be performed on their infant. Autopsies can reveal information that might help explain stillbirth, yet little is known about how people make this difficult decision. OBJECTIVES: This study examines the influences on decisions about autopsy after stillbirth among Australian parents. DESIGN: The study involved secondary analysis of transcripts of three focus groups using qualitative content analysis. PARTICIPANTS AND SETTING: Seventeen parents of 14 stillborn babies participated in consultations around the revision of a perinatal mortality audit guideline. RESULTS: Parents shared the decision making. Four decision drivers were identified: parents' preparedness or readiness to make decisions; parental responsibility; concern for possible consequences of an autopsy and the role of health professionals. Each decision driver involved reasons both for and against autopsy. Two decision aftermath were also present: some parents who agreed to an autopsy were dissatisfied with the way the autopsy results were given to them and some parents who did not have an autopsy for their infant expressed some form of regret or uncertainty about the choice they made. CONCLUSIONS: To make decisions about autopsy after stillbirth, parents need factual information about autopsy procedures, recognition that there might be fear of blame, an environment of trust, and health services and professionals prepared and skilled for difficult conversations.

The Role of Psychological Safety in Enhancing Medical Students' Engagement in Online Synchronous Learning.

Background: The COVID-19 pandemic instigated a global change in the delivery of undergraduate medical education, with an eminent shift from in-person to online teaching. The virtual methods that were utilised to a limited extent previously have now become the mainstay in education. The concept of psychological safety has been studied previously within medical education, but not in the distance learning context. The aim of the study was to explore students' experiences of online learning and to gain an understanding of the factors affecting psychological safety and its subsequent impact on their learning. Methods: A qualitative, social constructivist approach was adopted in this research. Data collection involved semi-structured interviews with 15 medical students from the University of Dundee. There was a representation from each year group on the undergraduate medical course. Data was transcribed verbatim and analysed thematically. Results: Five key themes were identified as motivation for learning, engagement with learning, fear of judgement, group learning and adjustment to online learning. Each of these comprised of interlinked subthemes related to peer and tutor interactions. Conclusions: Drawing on students' experiences, the paper presents the significant interplay of group interactions and tutor attributes operating in the virtual synchronous learning environment. The relevance of psychological safety in student learning and experience, and strategies to foster it in online classrooms are discussed in the context of existing literature and proposed future developments.

Parents experiences of having an infant with early onset group B streptococcus infection.

OBJECTIVES: The study explores parents lived experience of having an infant with early onset group B streptococcus (GBS). DESIGN: The study adopts a qualitative approach and a phenomenological framework with written autobiographical accounts as the method of data collection. METHODS: Twenty-seven parents wrote first-hand accounts of their experience of having an infant with early onset GBS. Participants documented their experiences in their own way, reporting their thoughts and feelings, experiences, and events that were meaningful to them. RESULTS: Four themes were developed from data analysis: 'bonding'; 'grief'; 'communication and information provision'; and 'future family'. CONCLUSIONS: The study findings demonstrate the complexity of emotions within parent's experiences and highlight grief and loss as a core component of these experiences. Medical intervention, while acknowledged as being vital and in many cases lifesaving, was viewed as a disruption to early bonding experiences resulting in sadness and guilt. Variation in information provision, communication about this infection, and feeling that their infant's illness and/or death were preventable added to the sense of loss. Breakdowns in interpersonal communications with partners and family were commonly described and experiences of early onset GBS had implications for decision-making around future pregnancies.

Historically black college and university (HBCU) COVID-19 return-to-campus policies and prevention measures-Fall 2021.

Objectives: Examine publicly accessible HBCU COVID-19 policies and associations with community COVID-19 infection and vaccination rates, and utilization of a dashboard. Participants: Excluding unaccredited or closed programs (n = 5) and those without COVID-19 information on website (n= 18), 76 HBCUs were included. Methods: Data on vaccine requirements, masking, and other policies were collected. Student enrollment and demographics and community infection and vaccination rates were obtained from websites. Results: Between August 15 and September 6, 2021, 36% of HBCU websites indicated vaccination requirements for students, with differences by private (57%) and public (17%). Masking requirements were more prevalent in HBCUs in areas with >50% community vaccination coverage vs those with <25%. Private institutions were more likely than public to require faculty/staff testing (34% vs 19%). HBCUs in areas with low/moderate COVID-19 rates were twice as likely to require vaccinations than HBCUs with higher rates. Conclusions: Easily accessible COVID-19 policies may help guide community prevention measures.