Flexner’s Words

Huecker, Martin; Danzl, D F; Shreffler, Jacob

doi:10.1007/s40670-020-00986-1

Cited by 5 publications

(8 citation statements)

References 15 publications

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“…Since the days Abraham Flexner prepared his seminal report on the future of medical education in 1910, SDM has been at the forefront of discussions. Flexner emphasized on the synergy between scientism and humanism, urging all medical schools to teach the emotional as well as the scientific [ 39 ]. More than a century later, the medical and scientific communities are still striving to strike the right balance to ensure equitable and standardized care to patients while controlling for the inevitable differences in the characteristics of the patients and their providers.…”

Section: Discussionmentioning

confidence: 99%

Patients’ and physicians’ gender and perspective on shared decision-making: A cross-sectional study from Dubai

et al. 2022

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Background Delivering patient-centered care is a declared objective of many health delivery systems globally, especially in an era of value-based health care. It entails the active engagement of the patients in healthcare decisions related to their health, also known as shared decision making (SDM). Little is known about the role of gender in shaping the perspective of patients on their opportunity for engaging in SDM in the Arabian Gulf Region. The aim of this study is to investigate the role of gender in shaping patients’ perspectives toward their opportunity for SDM in Dubai, UAE. Methods This study utilized a cross-sectional survey consisting of sociodemographic questions and the 9-item Shared Decision-Making Questionnaire (SDM-Q-9). A total of 50 physicians (25 females and 25 males), practicing at a large private healthcare delivery network in Dubai, were recruited using convenience sampling. Ten patients of every recruited physician (5 male and 5 female) were surveyed (i.e., a total of 500 patients). Statistical analysis assessed the differences in patients’ perceptions of physician SDM attitude scores by physicians’ and patients’ gender using independent t-test, ANOVA-test, and Chi-square analyses. Findings A total of 50 physicians and 500 patients (250 male patients and 250 female patients) participated in this study. The odd of patients agreement was significantly lower for male physicians, compared to their female counterparts, on the following elements of SDM: the doctor precisely explaining the advantages and disadvantages of the treatment (OR = 0.55, 95%CI: 0.34–0.88, p = 0.012); the doctor helping them understand the information (OR = 0.47, 95%CI: 0.23–0.97, p = 0.038), the doctor asking about preferred treatment option (OR = 0.52, 95%CI: 0.35–0.77, p = 0.001), and the doctor thoroughly weighting the different treatment options (OR = 0.60, 95%CI: 0.41–0.90, p = 0.013). No significant associations were observed between patients’ gender and their perception of their opportunity for SDM. Likewise, no significant associations were observed between the same or different physician-patient gender and patients’ perception of physicians’ SDM attitudes. Statistically significant associations were observed between physician-patient gender and preferred treatment option for patients (p = 0.012). Conclusion Study findings suggest that while there were no differences in patients’ perspective on SDM by the gender of patients, significant differences were observed by the gender of physicians. Female physicians, compared to their male counterparts, were more engaged in SDM, with both male and female patients. Male physician-female patient dyad received the lowest scores on SDM. This could be explained by the cultural, social, and religious sensitivities that infiltrate the physician-patient relationship in the Arab contexts. Despite the multi-cultural nature of the country, some female patients may still experience some discomfort in opening up and in discussion preferences with male physicians. For physicians, striking the right balance between assertiveness and SDM is necessary within the cultural context, especially among male providers. Offering targeted learning and development programs on the importance and practice of SDM is also necessary to ensure equitable opportunity for engagement in SDM for all patients irrespective of the gender of their provider.

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Section: Discussionmentioning

confidence: 99%

Patients’ and physicians’ gender and perspective on shared decision-making: A cross-sectional study from Dubai

et al. 2022

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“…This will allow the pathologist to search for possible adrenal tissue microscopically. The main histological features of adrenal insufficiency include 12,13 cortical atrophy, lymphoplasmacytic infiltration, and residual adrenal medulla. Inflammation is accompanied by a tendency toward fibrosis of varying degrees.…”

Section: Discussionmentioning

confidence: 99%

Death Due to Adrenal Crisis

Gitto

Stoppacher²,

Serinelli³

2021

Am J Forensic Med Pathol

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Adrenal crisis is a life-threatening manifestation of acute adrenal insufficiency. One of the most important underlying causes is Addison disease (primary adrenal insufficiency).A 42-year-old White woman with a medical history of Addison disease on chronic steroid therapy was admitted to the emergency department due to sustained episodes of cardiopulmonary arrest. Upon admission, she was hypotensive and hypoglycemic. Despite resuscitation attempts, she developed multiorgan failure and eventually died. At autopsy, no definitive adrenal gland tissue was grossly identified, but histology detected atrophy of adrenal glands with patchy chronic inflammation. Evidence of acute pneumonia was seen. The cause of death was determined to be complications of adrenal/Addisonian crisis.A review of the literature showed only a few autopsy studies regarding deaths due to adrenal crisis. Forensic pathologists should include adrenal crisis in their differential diagnosis. Adequate medical history and pertinent autopsy findings can corroborate deaths due to adrenal crisis, but exhaustive biochemical analyses are mandatory to support the diagnosis further.

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“…52 With reforms in education, caution must be taken not to jeopardize the quality of medical education and to maintain the standards defined in the Flexner Report. 53 Other trends in clinical practice, such as new advances in technology and the availability of more medical information, require a critical evaluation and restructuring of our current medical education system to provide trainees with relevant information to prepare them for their future careers. 54 AI has the potential to reshape clinical practice and should be integrated into medical education.…”

Section: Medical Education and Aimentioning

confidence: 99%

Impact of Artificial Intelligence on Medical Education in Ophthalmology

Valikodath

Cole

Ting

et al. 2021

Trans. Vis. Sci. Tech.

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Clinical care in ophthalmology is rapidly evolving as artificial intelligence (AI) algorithms are being developed. The medical community and national and federal regulatory bodies are recognizing the importance of adapting to AI. However, there is a gap in physicians' understanding of AI and its implications regarding its potential use in clinical care, and there are limited resources and established programs focused on AI and medical education in ophthalmology. Physicians are essential in the application of AI in a clinical context. An AI curriculum in ophthalmology can help provide physicians with a fund of knowledge and skills to integrate AI into their practice. In this paper, we provide general recommendations for an AI curriculum for medical students, residents, and fellows in ophthalmology.

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Flexner’s Words

Cited by 5 publications

References 15 publications

Patients’ and physicians’ gender and perspective on shared decision-making: A cross-sectional study from Dubai

Patients’ and physicians’ gender and perspective on shared decision-making: A cross-sectional study from Dubai

Death Due to Adrenal Crisis

Impact of Artificial Intelligence on Medical Education in Ophthalmology

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