Declines in Religiousness Dimensions across Adolescence as Predictors of Religious Deidentification in Young Adulthood.

The present study examined whether declines in religiousness across adolescence precede religious deidentification in young adulthood. Data came from the National Study of Youth and Religion. Participants were religiously affiliated for the first three waves of the longitudinal study (N = 1144). Latent growth curve models found significant declines across adolescence in church attendance, prayer, scripture study, religious importance, and spirituality, whereas doubt was stable across time. Then, logistic regression models specified the latent intercepts and slopes as predictors of later (Wave 4) deidentification. Significant negative links were found for the intercepts and slopes on church attendance, prayer, scripture study, religious importance, and spirituality. For doubt, a significant, positive link was found for the intercept.

Exploring paediatricians' experiences with performance improvement modules and quality improvement.

OBJECTIVE: The American Board of Pediatrics' (ABP) maintenance of certification (MOC) programme seeks to continue educating paediatricians throughout their careers by encouraging lifelong learning and continued improvement. The programme includes four parts, each centring on a different aspect of medical practice. Part 4 MOC centres on quality improvement (QI). Surveys by the ABP suggest that paediatricians are dissatisfied with aspects of part 4, but their reasons are unclear. This study sought to explore factors contributing to dissatisfaction with part 4 by focusing on performance improvement modules (PIMs), a popular means of achieving part 4 credit. METHODS: The study used cross-sectional purposive sampling drawing from US physicians working in a range of practice settings: private outpatient, hospital, academic and low-income clinics. The sampling frame was divided by practice characteristics and satisfaction level, derived from a five-point Likert item asking about physician satisfaction regarding a recent PIM. In-depth interviews were conducted with 21 physicians, and the interview data were coded, categorised into themes and analysed using a framework analysis approach. RESULTS: Paediatricians expressed nuanced views of PIMs and remain globally dissatisfied with part 4, although reasons for dissatisfaction varied. Concerns with PIMs included: (1) excessive time and effort; (2) limited improvement and (3) lack of clinically relevant topics. While most agreed that QI is important, participants felt persistently dissatisfied with the mechanics of doing PIMs, especially when QI tasks fell outside of their typical work regimen. CONCLUSIONS: Paediatricians agreed that part 4, PIMs, and QI efforts in general still lack clinical relevance and need to be more easily incorporated into practice workflow. Clinicians specifically felt that PIMs must be directly integrated with physicians' practice settings in terms of topic, data quality and metrics, and must address practice differences in time and monetary resources for completing large or complex projects.