Approximately 23% of Americans over age 12 have some level of hearing loss.1 Emergency departments can reduce healthcare barriers for deaf and hard-of-hearing (DHoH) patients through improved patient-physician communication. DHoH students, once they become physicians, may provide one mechanism for reducing existing healthcare disparities and communication barriers for DHoH patients, and may be more adept with patients facing other communication barriers. A renewed interest in disability access and a commitment to social justice has increased efforts toward the inclusion of individuals with disabilities in medical education and training. Despite this increased interest and a growing number of DHoH students entering medical education, DHoH students continue to be dissuaded from specialty careers such as emergency medicine (EM) over concerns regarding effective communication and ability. Given the academic medicine communities’ commitment to diversity, a recounting of the successful inclusion of DHoH students in EM can benefit medical education and practice.In this account, the authors reflect on the successful experiences of a visiting DHoH medical student in an academic EM rotation at a Level I trauma hospital that serves a diverse population, and they identify the potential challenges for DHoH students in an EM setting, offer solutions including reasonable accommodations, and provide commentary on the legal requirements for providing full and equal access for DHoH students. We secured permission from the student to share the contents of this article prior to publication.

Key Points Question Could transparent masks help to overcome communication barriers associated with widespread mask use among the general population, general health care workers, and health care workers who are deaf or hard of hearing in the United States? Findings In this survey study of 1000 members of the general public, 123 general health care workers, and 45 health care workers who are deaf or hard of hearing, participants perceived mask wearing as potentially impairing communication. Respondents reported an improved ability to read emotion with transparent mask use, and transparent masks were generally accepted across all 3 populations surveyed. Meaning These findings suggest that transparent masks have the potential to overcome barriers in communication brought on by universal mask wearing during the COVID-19 pandemic.

Patients with COPD are required to take long-term treatments to treat their chronic disease and avoid further complications. However, lack of adherence is very common and represents major barriers to treatment efficiency. Measuring patient acceptance of their medication should help to better understand and predict patients' medication-taking behavior. Objectives: The objectives of this study are to evaluate the level of acceptance to medication in patients with COPD in real life; to identify issues and to define priorities for action. MethOds: This is an observational, crosssectional study conducted in Europe using Carenity Online Community. Adult COPD patients were invited to complete an online questionnaire including a validated patient reported outcome measure: the 25-item ACCEptance by the Patients of their Treatment (ACCEPT©). It includes one general acceptance dimension (Acceptance/ General) and five multi-item treatment-attribute specific dimensions: Acceptance/ Medication Inconvenience, Acceptance/Long-term Treatment, Acceptance/Regimen Constraints, Acceptance/Side Effects, Acceptance/Effectiveness, scored from 0-100 (lowest to highest acceptance). Patients were categorized according to their main treatment class: adrenergics, inhalants; other drugs for obstructive airway diseases, inhalants; other COPD treatment. Results: 117 patients with COPD were included. Mean Acceptance/General score was of 56.27 ± 33.95. Significant differences (p < 0.05) were found between groups defined by treatment class on Acceptance/ General and Acceptance/Effectiveness. Pearson correlations showed Acceptance/ General to be highly correlated with Acceptance/ Effectiveness (R = 0.64). Having side effects and their unpleasantness were the main reported issues. cOnclusiOns: Treatment acceptance is not satisfactory in COPD. Patients' treatment acceptance is primarily driven by its effectiveness and limitations for COPD. These findings give indications about patients' priorities and unmet needs for COPD.

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