Using Chart-Stimulated Recall to Identify Barriers and Facilitators to Routine HIV Testing Among Pediatric Primary Care Providers

Lazar, Nellie; Rozansky, Hallie; Ely, Beth; Ford, Carol A.; Dowshen, Nadia

doi:10.1016/j.jadohealth.2019.04.005

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…The results mentioned in the review article are comparable with the present study. 11, 12 The present study shows that CBD signicantly improves all the parameters of record-keeping, clinical judgment, decision-making, management, follow-up, and reective writing. A study also reported a statistically insignicant dierence (p -value 0.087) between scores obtained between traditional assessment tools and those evaluated by CBD.…”

Section: Discussionmentioning

confidence: 59%

Role of Case-Based Discussion as Workplace-Based Assessment Tool in Urology and General Surgery

Shahzadi,

Shah,

Ali

et al. 2024

J Gandhara Med Dent Sci

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OBJECTIVES To determine the effectiveness of case-based discussion in terms of medical record-keeping, clinical reasoning, clinical judgment, and self-reflection in the management of patients. METHODOLOGY A multidisciplinary descriptive study was conducted in the Department of Urology Institute of Kidney Diseases, Hayatabad Medical Complex Peshawar, and Department of General Surgery, Hayatabad Medical Complex Peshawar, Pakistan, from January to December 2023. A total number of 20 postgraduate residents, ten from Urology and General Surgery, participated in the study with equal male and female participants. Case-based discussion (CBD) assessments focused on medical record-keeping, clinical Decision-making, clinical judgment, management, follow-up, and reflective writing. The data was collected on structured proforma and was analyzed on SPSS-25. RESULTSThe total number of study participants was 20, and 410 Case-Based Discussion sessions were conducted. This constitutes an average of 4.8 assessments per week. Most encounters were related to medical clinical decisions and management. The case-based discussion showed significant improvement on the Likert scale of the supervisor’s rating, which extended over four quarters on all major parameters of formative assessment (p 0.001). The multimodal regression test showed significant enhancement in learning parameters on case-based discussions. R2=0.172 F ration=25.141 n=410 (p=0.001). There was no significant difference in the gender of residents as well as training specialty of residents of urology and general surgery (p >0.05). CONCLUSION A case-based discussion is an effective tool for formative assessment of Urology and General Surgery postgraduate residents.

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Section: Discussionmentioning

confidence: 59%

Role of Case-Based Discussion as Workplace-Based Assessment Tool in Urology and General Surgery

Shahzadi,

Shah,

Ali

et al. 2024

J Gandhara Med Dent Sci

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“…Other barriers to HIV testing identified by pediatricians and ED providers include a lack of knowledge about recommendations and confidentiality laws, difficult interactions with parents/ caregivers, time and space constraints, concerns about breaches linked to billing, concerns about follow-up, a lack of local practice policy, and feeling that HIV testing is out of their scope of practice. 4,[10][11][12] In our small community hospital, we recognized that few adolescents presenting to our ED with symptoms suggestive of an STI who were tested for gonorrhea and chlamydia (GC/CHL) by urine nucleic acid amplification test were being screened for HIVas recommended by the CDC. In 2019, only 11% of such patients were offered or received HIV testing.…”

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confidence: 99%

“…These measures include having time alone with a provider and maintaining confidentiality of health care records, interactions, follow-up communications, and billing services. Other barriers to HIV testing identified by pediatricians and ED providers include a lack of knowledge about recommendations and confidentiality laws, difficult interactions with parents/caregivers, time and space constraints, concerns about breaches linked to billing, concerns about follow-up, a lack of local practice policy, and feeling that HIV testing is out of their scope of practice 4,10–12 …”

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confidence: 99%

Seize the Opportunity

Shakir,

Doshi,

Blakeslee

et al. 2023

Pediatr Emer Care

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Objectives Our objective was to increase human immunodeficiency virus (HIV) screening in adolescents presenting to our community pediatric emergency department with symptoms suggestive of a sexually transmitted infection (STI) and who were being tested for gonorrhea and chlamydia. Specifically, we aimed to increase the monthly average proportion of adolescents concurrently screened for HIV in this target group from 11% to 50% in 6 months. Methods We identified barriers to HIV screening, focusing on physician-related challenges and adolescents' concerns about confidentiality. We designed interventions targeting these barriers and implemented them in plan-do-study-act cycles beginning in February 2020. We educated physicians and nurses about screening recommendations, emphasized a physician-conducted private interview during which confidential contact information could be obtained, and assured confidentiality on after visit summaries by removing STI results. We also provided regular feedback to physicians on the screening rate. In addition, we implemented an electronic health record quick order set and a documentation tool. Using a statistical process control chart, we measured the average monthly proportion of adolescents in the target group who were offered HIV screening or tested for HIV before and after interventions. Results A total of 140 adolescents in the target group presented to our pediatric emergency department from February 2020 through December 2021. After plan-do-study-act cycles, the average monthly screening rate increased to 80%. Conclusions Raising physician awareness of HIV screening recommendations and the importance of conducting a private interview improved screening rates. Assuring adolescent minors of confidentiality in a private interview, removing STI results from the after visit summary, and obtaining confidential contact information were important measures to overcome confidentiality barriers.

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Screening Adolescents for Sensitive Health Topics in Primary Care: A Scoping Review

Davis

Hoskins

Phan

et al. 2022

Journal of Adolescent Health

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Using Chart-Stimulated Recall to Identify Barriers and Facilitators to Routine HIV Testing Among Pediatric Primary Care Providers

Cited by 3 publications

References 16 publications

Role of Case-Based Discussion as Workplace-Based Assessment Tool in Urology and General Surgery

Role of Case-Based Discussion as Workplace-Based Assessment Tool in Urology and General Surgery

Seize the Opportunity

Screening Adolescents for Sensitive Health Topics in Primary Care: A Scoping Review

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