Introduction: Telemedicine is a growing practice with minimal training in US medical schools. Telemedicine OSCE (TeleOSCE) simulations allow students to practice this type of patient interaction in a standardized way. Methods: The Insomnia-Rural TeleOSCE was implemented as part of a required clinical clerkship for students in their second, third, or fourth year of medical school. This case addressed a patient with depression in a medically underserved area. Students performed it as a formative experience and received immediate feedback. They then completed a survey to evaluate the experience. Results: Students (n = 287) rated the quality of the experience 7.59 out of 10. Comments showed that 61 learners thought the TeleOSCE was a positive experience, 35 wanted more teaching about telemedicine, 28 improved their understanding of barriers to care, 25 expressed concern over minimal other training, 23 found the TeleOSCE important and challenging, 16 appreciated the differences between in-person and remote visits, and 15 wanted fewer distractions. Eight students worried about how they would be judged, five learned from the technical limitations, five requested more time, five were skeptical of the utility, and five saw telemedicine as triage. Discussion: The TeleOSCE allows learners to gain exposure to telemedicine in a safe simulated teaching environment and assesses learner competencies. The TeleOSCE also improves students' understanding of barriers to care and the utility of telemedicine. It logistically allows faculty to directly assess distance students on their clinical reasoning and patient communication skills.
This article examines the views of low‐wage mothers about how they are stereotyped when they need work flexibility to care for children. From a decade of qualitative and participative research with low‐income/working class mothers (n = 300) and employers (n = 50) of entry‐level workers, a discourse of “personal irresponsibility” emerged rather than one about work/family conflict. Drawn from interviews and interpretive focus groups, mothers describe being unable to find or buy stable care for children, thus facing trouble at work. While some employers expressed sympathy, others echoed “welfare mother” schema and dismissed low‐wage mothers’ conflicts caring for children as the fault of irresponsible reproducers. Implications for a cross‐class work/family movement are discussed.
Poor mothers have long-standing habits of hiding their lives in response to punitive authorities and stigma. We identify practices of hiding daily life, and we describe participatory research approaches for and ethical concerns in learning more about poor women's critical insights and survival strategies.
This article analyzes a decade of qualitative research to identify and explore an overlooked survival strategy used in low‐income families: children's family labor. Defined as physical duties, caregiving, and household management responsibilities, children’s—most often girls’—family labor is posited as a critical source of support where low wages and absent adult caregivers leave children to take over essential, complex, and time‐consuming family demands. We argue that there are lost opportunities when children are detoured from childhood to do family labor and that an intergenerational transfer of poverty is associated with those losses.
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