Collaborative care between cancer specialists and primary care providers (PCPs) may improve the delivery of high-quality cancer care. Yet, patient perspectives about how involved the PCPs were in their breast cancer care and treatment decisions remain unknown. Patients and MethodsA weighted random sample of women newly diagnosed with breast cancer in 2013 to 2014, as reported to the SEER registries in Los Angeles, California, and Georgia, were sent a survey approximately 6 months after diagnosis (N = 2,279, 71% response rate). The distributions of patientperceived PCP quality (six questions about PCP access and awareness of values) and the following three measures of patient-reported PCP involvement were assessed: how informed the respondent felt her PCP was about her breast cancer (engagement); how often the respondent talked with her PCP (communication); and how often the respondent felt the PCP participated in treatment decisions (participation). Adjusted mean scores of patient-reported satisfaction with and deliberation about the surgical treatment decision were then compared across levels of PCP engagement, communication, and participation using multivariable linear regression. ResultsThe majority of women in this sample perceived high PCP quality (63.6%), high PCP breast cancer engagement (66.2%), and high PCP communication (69.1%). More than a third of women (35.4%) reported that their PCP participated in their treatment decisions. Higher PCP engagement was associated with higher decision satisfaction when compared with low PCP engagement (adjusted P = .003). ConclusionPatient perceptions of PCP quality and PCP involvement in breast cancer care during treatment are high for most women, and PCPs often participate in breast cancer treatment decisions. However, PCP involvement did not lead to meaningful improvements in patients' appraisals of their decision making.
Aim The COVID-19 pandemic has resulted in fewer physical microsurgical training opportunities, forcing trainees to seek virtual alternatives. As one of the largest video-sharing platforms globally, YouTube is increasingly being used to provide educational content. With additional emphasis placed on these videos, there will likely have an impact on training progression further down the line. This research aims to evaluate YouTube video content as a microsurgical training information source. Method We searched Youtube.com for videos demonstrating and teaching microsurgical techniques. Search terms included “microsurgical”, “teaching”, “anastomosis” and “flap”. All videos of neurosurgical nature were excluded. Thirty-one videos were evaluated using nine criteria and using a modified GQS score. To reduce duplication, included videos were limited to two from one source. Results Initial results show 79% of the videos were GQS Score 4/5 and therefore of good quality, despite only 38.7% featuring human procedures. 82.8% of the videos found were from medical websites, with most generated from three independent sources. The highly-scoring YouTube videos tended to have an audio voice-over or subtitles and clearly described the instruments and materials used. Conclusions The results demonstrated that high-quality videos are easily accessible on YouTube and deemed useful as educational tools. However, trainees should be aware that varied sources provide videos that range in quality; and the learning acquired may not directly correspond to learning objectives set out by governing bodies and is unlikely to be comparable to real-life observation in theatre. Overall, evidence for the current educational value of YouTube for microsurgical techniques is somewhat limited.
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