Understanding physician well-being may help prevent physician burnout, improve the quality of care they provide to their patients, reduce medical errors, and improve patient satisfaction. Using the biopsychosocial-spiritual theory as the conceptual framework, this quantitative study examined the relationship between: (a) physician well-being and patient satisfaction, (b) physician gender and physician well-being, (c) primary care providers' and specialists' well-being, (d) patient satisfaction based on physician specialty, and (e) the duration of practice and physician well-being. All of the 87 employed physicians in a Florida regional hospital were invited to respond to a physician well-being questionnaire; a response rate of 58.4% was achieved. Patient satisfaction information was obtained through archived data of 4,500 patient surveys. Data were analyzed utilizing linear regression to examine the relationship between patient satisfaction and duration of physicians' practice, with the dependent variable, physician well-being. Two logistic regression analyses were utilized to examine (a) differences between physician well-being, gender, and specialty; and (b) differences between patient satisfaction and physician specialty. There were no significant relationships evident; however, it was speculated that the nonsignificance may be due to the small available sample of physicians. Future research on physician well-being may use the current findings to refine the conceptual framework and increase the understanding of how physician well-being can prevent physician burnout, improve the quality of care they provide to their patients, reduce medical errors, and improve patient satisfaction. Future research in this area will have the potential to increase the quality of patient care that will address positive social change.

The purpose of this qualitative dissertation study was to examine the lived experience and meaning making of challenges, benefits, satisfaction, and professional sustainability for the advanced practice provider in the burn surgery specialty service. The problem addressed was the knowledge gap resulting from a lack of literature describing aspects of the advanced practice provider role in the burn specialty. An interpretive phenomenological analysis, informed by the philosophy of Dr. Martin Heidegger, was undertaken. Participants were solicited from the American Burn Association Advanced Practice Provider (APP) special interest group site. The results provided a thick description of the lived experience of the Burn APP offering, illuminating commonalities and distinctions to promote role gratification and fulfillment leading to professional success and prolonged engagement. Keywords: advanced practice provider, nurse practitioner, physician assistant, interpretive phenomenology, hermeneutics.

Patient dissatisfaction with the physician/patient relationship and medical care is well documented in both the lay press and the medical literature. This problem appears to stem from communication between physician and patient and is drawing increased attention from the communication discipline. Research conducted in interpersonal communication satisfaction theory provides a basis for this study of patient satisfaction with physician/patient communication and its relationship to the perceived quality of medical care. This paper reports two sets of interviews with a total of 108 respondents on the topic of physician/patient communication which resulted in the identification of nine salient issues which appeared to contribute strongly to patient communication satisfaction. These issues are explained in terms of three areas of communication theory: control, empathy and confirmation.

In 2016, Gray and Jones adapted the narrative policy framework (NPF) to a qualitative context. In this research, I build from their resulting Qualitative NPF (Q-NPF) method to analyze 300 randomly selected Canadian media articles published between 2007-2017 on the topic of Medical Assistance In Dying (MAID). I begin by explaining how the concrete procedures of MAID are distinct from other end-of-life practices, and introduce the terminology that will be used throughout this research. I then introduce historic and academic literature relevant to the form and content of the contemporary media narratives to be analyzed, especially drawing theoretically from Rose’s (2013) discussion of biomedical personhood discourses and Butler’s theory of unevenly distributed precarity. I then explain the methodology of qualitative narrative policy analysis (Q-NPF), and apply it to Canada’s MAID debate by dividing the policy positions into what I call the Freedom, Protection, and Fence-sitting narrative policy camps. The Freedom camp advocated for MAID legalization; the Protection camp advocated against MAID legalization; and the Fence-sitting camp avoided advocating either for or against baseline legalization of MAID, instead weighing in only on peripheral issues. I discuss the qualitative differences of narrative content specific to these three camps, highlighting the most prominent narrative trends (by frequency of publication) and discussing the ways in which these findings either accord with or contradict the expectations of the literature review. Finally, I update the reader on Canadian legislative developments since 2017 and identify how the data of 2007-2017 anticipated these developments, demonstrating the salience and predictive power of Q-NPF. I conclude by proposing new directions for potential investigation. / Graduate / 2022-12-13

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IntroductionOver the last decades a positive shift in attitudes towards legalisation of assisted dying (AD) (AD including euthanasia (EUT) and physician-assisted suicide (PAS)) have occurred in western Europe. Physicians are generally more negative than the general public toward legalisation. Medical students’ attitudes, as future practitioners, are important to assess when addressing this ethically complex issue.AimThe aim was to explore the attitudes among medical students at Örebro university, Sweden regarding assisted dying and their stance on the legalisation of assisted dying and to evaluate if religious beliefs, current term of study, gender, and a shift of legal framing would affect medical students´ attitudes.MethodsA cross-sectional online-based anonymous survey containing eight different patient scenarios was distributed to all medical students enlisted at Örebro university Sweden (n=657). Association between demographics and positive attitudes towards AD was tested using logistic regression, and McNemar for difference of proportion in attitudes between various scenario framings.ResultsThirty five percent (n=229) of the medical students responded with completed questionnaires. Sixty percent of the respondents believed PAS for terminally ill patients should be legalized in Sweden. Shifting of legal framing resulted in statistically significant differences of position in all eight scenarios (p<0.05). Strong religious beliefs were associated with decreased likelihood for positive attitudes towards AD in scenario 1-6 (p<0.05).ConclusionsMost respondents in this study believed PAS should be legalised. Held attitudes toward AD were affected by religious beliefs and legal framework. Additional studies to further explore medical students´ attitudes are deemed necessary.

abstract: More underrepresented minority (URM) healthcare professionals are needed to improve health equity. Although holistic review in admissions has the potential to increase URM participation in health professions, recent data suggest that its impact varies substantially. The purpose of the dissertation research described here was to identify interventions to increase diversity among healthcare professionals and explore holistic review use in physician assistant (PA) program admissions to advance understanding of effective practices. PA programs were selected as an important prototype for exploratory studies since the extent of holistic review use in PA programs was unknown; at the same time, URM representation among PA students has decreased over the last 15 years. A critical review of the literature revealed that various holistic review practices have been used by several health professions programs to successfully increase URM enrollment and that organizational culture may be a factor that promotes success. Following this, 2017 Physician Assistant Education Association survey data were analyzed to assess the frequency of holistic review in PA programs and examine its association with URM matriculation. Results from 221 of the 223 PA programs accredited at the time showed that 77.5% used holistic review, and its use modestly correlated with proportion of first-year students identified as ethnic minorities (rs = .20, p < .01). Of particular interest, some programs using holistic review had substantially higher proportions of URM students than others. This finding laid the foundation for a qualitative multiple case study to explore the role of organizational culture as a hypothesized antecedent to effective holistic admissions processes. Survey study responses were used to select two PA program ‘cases’ that met criteria consistent with a proposed conceptual framework linking organizational culture that values diversity (or ‘diversity culture’) to holistic admissions associated with high URM enrollment. Directed content analysis of data revealed that diversity culture appears to be a strong driver of practices that support enrolling diverse classes of students. Overall, this mixed methods program of research advances understanding of holistic review, its utility, and the influence of organizational culture. The research generated important insights with ramifications for current practice and future studies within PA and across health professions programs. / Dissertation/Thesis / Doctoral Dissertation Nursing and Healthcare Innovation 2019