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BackgroundBack pain, the most common type of pain reported by older adults, is often undertreated for reasons that are poorly understood, especially in minority populations. The objective of this study was to understand older adults’ beliefs and perspectives regarding care-seeking for restricting back pain (back pain that restricts activity).MethodsWe used data from a diverse sample of 93 older adults (median age 83) who reported restricting back pain during the past 3 months. A semi-structured discussion guide was used in 23 individual interviews and 16 focus groups to prompt participants to share experiences, beliefs, and attitudes about managing restricting back pain. Transcripts were analyzed in an iterative process to develop thematic categories.ResultsThree themes for why older adults may not seek care for restricting back pain were identified: (1) beliefs about the age-related inevitability of restricting back pain, (2) negative attitudes toward medication and/or surgery, and (3) perceived importance of restricting back pain relative to other comorbidities. No new themes emerged in the more diverse focus groups.ConclusionsIllness perceptions (including pain-related beliefs), and interactions with providers may influence older adults’ willingness to seek care for restricting back pain. These results highlight opportunities to improve the care for older adults with restricting back pain.

This paper examines how physicians determine the quality and quantity of time to devote to each patient, and how these decisions are taught to physicians-in-training as part of the 'hidden curriculum' in medical education. The notion of moral economy is used to analyze how judgments of patient worth come to guide and influence interactions among physicians and physicians-in-training and patients, and how these interactions impact medical care. However, this paper also questions the notion of the hidden curriculum as a static or reified concept. Instead, the paper uses participant narratives to show how physicians-in-training are not simply passive recipients of the hidden curriculum but also actively resist judging patients based on perceptions of worth, even as they learn to operate within a moral economy of care.

Our exploratory analysis reveals that providers engaging hesitant parents and addressing their concerns can lead to same-day HPV vaccination. Data reveal that even parents making assertive statements are amenable to influence by providers. Our findings reveal an important missed opportunity when providers simply acquiesce to parental hesitation.

Background Although the inclusion of arts in medical school curricula has garnered attention, little is known about the effect of arts-based interventions on the behaviors, attitudes, and technical skills of students. The Art of Observation is an optional elective at the University of Texas Southwestern Medical Center (UTSW) in collaboration with educators from the Dallas Museum of Art (DMA). We utilized a qualitative approach to describe in-depth how engaging with art influences the development of medical students’ observation skills and empathy. Methods We analyzed evaluations from 65 medical students who completed the course between 2015 and 2017. Evaluations contained open-ended questions that asked students to reflect upon their experiences and describe their perceptions, thoughts, and feelings after guided museum visits. We used grounded theory to generate a thematic codebook, then employed axial coding to discover thematic relationships. Results We report three main findings and several subthemes: (1) Enhanced observation skills: by engaging with art and completing relevant activities, students developed the ability to synthesize a compelling narrative in addition to learning technical skills; (2) Improved physician socialization: students reported enhanced self-awareness, increased tolerance of ambiguity, and development of a humanistic view of medicine, key components of physician socialization; and (3) Reduction in burnout symptoms: students reported an enhanced sense of well-being after each session, which mitigates the process of burnout. Conclusions Fine arts can be used to teach technical skills, stimulate personal reflection, and prevent burnout. A meaningful engagement with the arts can play an important role in developing physicians who are observant, empathetic, and more well-rounded. Electronic supplementary material The online version of this article (10.1186/s12909-019-1671-2) contains supplementary material, which is available to authorized users.