The Role of Mentoring in Recruiting and Retaining Minority Physician Assistant Faculty.

INTRODUCTION: The physician assistant profession (PA) is experiencing a proliferation of PA programs nationally, creating a demand for PA faculty to educate and train future PA clinicians. Current data show that the number of minority PA educators is insufficient to train a diverse PA workforce. Previous studies have explored the high turnover rate of minority PA faculty, their retention, and attrition. Guided by the social-ecological model (SEM), the purpose of this phenomenological study was to explore the lived experiences of Black and Hispanic minority PA faculty in PA education to gain further insights about the specific role that mentoring has played in their recruitment and retention. METHODS: Qualitative data were collected from a purposive sample of 6 minority PA faculty using semi-structured telephone interviews. RESULTS: This study's findings identified specific SEM constructs-specifically individual, interpersonal, and institutional levels of mentoring-that may influence minority PA faculty recruitment and retention efforts. The participants in this study identified several recruitment and retention factors, including formal and informal mentoring, support, and guidance. Challenges related to lack of pedagogical training and lack of administrative support for meaningful professional development were reportedly overcome by the assistance of colleagues within and outside of their programs. DISCUSSION: The findings of this study provide insights necessary to inform professional practice initiatives among PA program leaders and institutional leadership to engage in dialogue and coordinate efforts involving the implementation of effective professional development and mentoring structures.

Technologists' Experience Providing Patient Education in a Pediatric Setting.

PURPOSE: To understand the challenges faced by radiologic technologists working in a pediatric setting when addressing patients' and caregivers' concerns about ionizing radiation exposure during imaging examinations and to determine how technologists' can increase their confidence when providing this information. METHODS: Qualitative data were collected from 7 pediatric radiologic technologists working at a large pediatric teaching hospital. Semistructured interviews were recorded, transcribed, and analyzed using MAXQDA software (VERBI Software). RESULTS: Radiologic technologists' confidence declined when patients and caregivers requested detailed and specific radiation dose information. The most common concerns expressed by patients and caregivers were shielding, radiation dose, and the long-term effects of radiation exposure. In addition, the radiologic technologists reported that continuing education and patient education pamphlets could help improve their confidence when discussing radiation doses and risks with patients. DISCUSSION: The pediatric radiologic technologists in this study reported challenges of providing radiation dose and risk information to patients and caregivers, especially when detailed or complex information was requested. Radiologic technologists might be apprehensive to provide detailed information to caregivers and patients because pediatric patients vary in size and the dose given. Furthermore, radiologic technologists might be concerned that patients will worry unnecessarily and potentially refuse imaging examinations. Patient and caregiver concerns identified in this study might be elevated because the patients are children. CONCLUSION: There is a critical need to equip radiologic technologists with the tools necessary to enhance their self-efficacy in addressing pediatric patients' and their caregivers' concerns related to the use of ionizing radiation for medical imaging procedures.

Medical students' perceptions of understanding skills needed in treating cardiac patients through simulation-based encounters in a clinical skills curriculum.

CONTEXT: Simulation-based education can enhance medical students' understanding of clinical concepts as they learn the key elements needed to treat patients with various medical conditions. The integration of simulation programs into medical school curricula increases students' exposure to this type of learning. OBJECTIVES: To determine the effectiveness of simulation activities on medical students' perceptions of understanding cardiac rhythm identification and the pharmacology skills necessary to manage a stable patient with cardiac arrhythmia. METHODS: A retrospective secondary data analysis was conducted utilizing a quasi-experimental one-group pretest/posttest study of a convenience sample of 159 second-year medical students in the southeastern United States during the 2017-2018 academic year. Because this was a one-group pretest/posttest study, only second-year medical students whose data could be matched were included. A 5-point Likert scale, previously developed as part of the clinical skills course, was utilized to collect ordinal understanding of cardiac rhythm identification and the pharmacologic management of a stable patient with cardiac arrhythmia. The intervention was an 18-min simulated patient encounter involving a high-fidelity mannequin (SimMan 3G or Essential) with supraventricular tachycardia. RESULTS: Of the 159 students, the number of students who reported a good perception of understanding of cardiac rhythm identification presimulation activity increased from 44.0% (70) to 52.2% (83) postsimulation activity. The number who reported a good perception of understanding of the pharmacologic management of a stable patient with cardiac arrhythmia presimulation increased from 37.7% (60) to 49.1% (78) postsimulation. A Wilcoxon signed-rank test model was fitted to examine improvements in perceptions of understanding of cardiac rhythm identification and the pharmacologic management of cardiac arrhythmia. The results suggested that participation in simulation activities elicited a statistically significant improvement in the students' perceptions of understanding of cardiac rhythm identification and the pharmacologic management of cardiac arrhythmia (p=0.000). CONCLUSIONS: As medical education continues to evolve, simulation-based education may be helpful in enhancing medical students' understanding of cardiac rhythm identification and the pharmacology skills necessary to manage a stable patient with cardiac arrhythmia.

Predictors of Obesity Among Nigerian Immigrants in the United States.

Obesity is a highly prevalent cardiovascular disease risk factor globally and in African-descent populations. A cross-sectional study of obesity among a Nigerian immigrant sample population in the United States was conducted. Data was obtained through a web-based survey. Spearman's correlation and logistic regression were used to determine sociodemographic and behavioral determinants of obesity. The results showed no significant relationship between obesity and education, socioeconomic status, length of stay, and level of physical activity. However, we identified a significant association between weekly consumption of alcohol and all obesity (OR 1.78, 95 % CI 1.091, 2.919), and moderate/morbid obesity (OR 2.46, 95 % CI 1.213, 4.999), and between gender and moderate/morbid obesity-men were less likely (OR .030, 95 % CI .001, .733) to be obese. These findings provide strong evidence to inform targeted screening for excessive alcohol consumption along with other primary prevention strategies that may reduce the prevalence of obesity among the Nigerian immigrant population.

Length of Residence in the United States is Associated With a Higher Prevalence of Cardiometabolic Risk Factors in Immigrants: A Contemporary Analysis of the National Health Interview Survey.

BACKGROUND: Cardiometabolic risk (CMR) factors including hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia are high among United States ethnic minorities, and the immigrant population continues to burgeon. METHODS AND RESULTS: Hypothesizing that acculturation (length of residence) would be associated with a higher prevalence of CMR factors, the authors analyzed data on 54, 984 US immigrants in the 2010-2014 National Health Interview Surveys. The main predictor was length of residence. The outcomes were hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia. The authors used multivariable logistic regression to examine the association between length of US residence and these CMR factors.The mean (SE) age of the patients was 43 (0.12) years and half were women. Participants residing in the United States for ≥10 years were more likely to have health insurance than those with <10 years of residence (70% versus 54%, P<0.001). After adjusting for region of birth, poverty income ratio, age, and sex, immigrants residing in the United States for ≥10 years were more likely to be overweight/obese (odds ratio [OR], 1.19; 95% CI, 1.10-1.29), diabetic (OR, 1.43; 95% CI, 1.17-1.73), and hypertensive (OR, 1.18; 95% CI, 1.05-1.32) than those residing in the United States for <10 years. CONCLUSIONS: In an ethnically diverse sample of US immigrants, acculturation was associated with CMR factors. Culturally tailored public health strategies should be developed in US immigrant populations to reduce CMR.

The Afro-Cardiac Study: Cardiovascular Disease Risk and Acculturation in West African Immigrants in the United States: Rationale and Study Design.

Cardiovascular disease (CVD) remains the leading cause of death in the United States (US). African-descent populations bear a disproportionate burden of CVD risk factors. With the increase in the number of West African immigrants (WAIs) to the US over the past decades, it is imperative to specifically study this new and substantial subset of the African-descent population and how acculturation impacts their CVD risk. The Afro-Cardiac study, a community-based cross-sectional study of adult WAIs in the Baltimore-Washington metropolis. Guided by the PRECEDE-PROCEED model, we used a modification of the World Health Organization Steps survey to collect data on demographics, socioeconomic status, migration-related factors and behaviors. We obtained physical, biochemical, acculturation measurements as well as a socio-demographic and health history. Our study provides critical data on the CVD risk of WAIs. The framework used is valuable for future epidemiological studies addressing CVD risk and acculturation among immigrants.