Using business/law negotiation techniques in response to a ‘difficult’ family

Effective communication between clinicians, patients, and families at end of life is associated with better clinical outcomes. A large body of literature describes the key skills needed for effective communication. We believe that clinicians could also benefit from communication skills more commonly associated with business or law negotiations. We will demonstrate via analogy (i.e. buying a house) how four key business/law negotiation techniques – 1. Determine your Reservation and Aspiration Value; 2. Separate People from their Positions; 3. Separate Positions from Interests; and 4. Logrolling of Interests – can be applied to a difficult family meeting in a home hospice patient.     

Relation between active mediation,exposure to Daniel Tiger’s Neighborhood,and US preschoolers’ social and emotional development

This study explored the relationship between active mediation, exposure to Daniel Tiger’s Neighborhood, and key indicators of preschoolers’ social and emotional development. One hundred and twenty-seven children aged 2–6 either watched or did not watch 10 episodes of Daniel Tiger’s Neighborhood over a two-week period. Results revealed that preschoolers who watched the program exhibited higher levels of empathy, self-efficacy, and emotion recognition when their regular TV-watching experiences are frequently accompanied by active mediation. This was especially true for younger preschoolers and preschoolers from low-income families. Implications for policy-makers, parents, producers of prosocial programming, and educators are discussed.     

What makes a biostatistician?

Biostatisticians play an important role in medical research. They are co-responsible for an appropriate and efficient study design, they are involved in monitoring the study conduct, they plan and perform the data analysis, and they are involved in interpreting and publishing the results. However, how are the biostatisticians prepared for their tasks and responsibilities? Graduate programs in biostatistics are being offered, but some practicing biostatisticians completed their studies in a mathematical or epidemiological program, or obtained their degree in subject-specific fields (such as medicine or biology). Therefore, the expertise and the competencies can vary widely between the individual biostatisticians, also depending on the application field. In this article, focusing on European and US practices, we discuss the required professional expertise for the main areas of applications in the medical field as well as the necessary soft skill competencies of a biostatistician.     

Development of a Simulation-Based Mastery Learning Curriculum for Breaking Bad News

Introduction

Physician communication impacts patient outcomes. However, communication skills, especially around difficult conversations, remain suboptimal, and there is no clear way to determine the validity of entrustment decisions. The aims of this study were to 1) describe the development of a simulation-based mastery learning (SBML) curriculum for breaking bad news (BBN) conversation skills and 2) set a defensible minimum passing standard (MPS) to ensure uniform skill acquisition among learners.

Normative values of the motor competence assessment (MCA) from 3 to 23 years of age

ObjectivesGrowing evidence of the importance of motor competence for developing a healthy lifestyle has been established in the last decade. Nonetheless, no single instrument or observation tool have been able to fully measure this construct, particularly because most were built for the diagnosis of children in risk for motor impairment; are limited to a few years of the developmental span; lack objectivity in the assessment protocols; or do not include the locomotor, stability, and manipulative components. This led to the difficulty of comparing researches, and longitudinally follow children into adulthood. Recently, a novel proposal to assess motor competence was presented - the Motor Competence Assessment (MCA) - and this study aims to present the MCA normative data from 3-to-23 years.Design and methodsTwo thousand and eighty-seven participants (1102 boys) between 3 and 23 years of age were evaluated in the MCA (standing long jump, 10 m shuttle run, throwing velocity, kicking velocity, lateral jumps, shifting platforms). Results for each test were introduced in the LMS Chartmaker 2.3. The best model for test and sex was used, resulting in normative curves and percentile values.ResultsFinal norms showed a good fit to the instrument developmental expectations, allowing to differentiate and classify performances along the age interval.ConclusionsThe MCA age- and sex- normative values allow to assess motor competence from childhood to early adulthood. Future directions will include obtaining a total MCA score and the normative scores for the MCA components (stability, locomotion, object control), and to expand the norms to adulthood and old age.     

Patient readiness for return to home: Discord between expectations and reality

This study examined the interface between acute hospital care and return to home in relation to elderly patients' perceived ability and preparedness to cope at home. Seventy-six (n = 76) elderly patients aged 60 years and over were randomly recruited from a large Queensland hospital and interviewed prior to discharge about their perceived health, functional status and their ‘readiness’ to cope at home. They were followed up at home 7–10 days post-discharge. Comparisons were made between a number of measures at discharge and post-discharge. Although the majority of patients indicated that they would cope very well upon discharge, a large number of patients reported experiencing considerable difficulty with activities of daily living, particularly instrumental activities of daily living prior to and especially after discharge. The self-reported health status of patients similarly deteriorated between discharge and follow-up. Despite a large number of patients experiencing functional limitations, few were referred to hospital or community-based therapy services. Some policy implications are explored.     

Cancer support groups – are they effective?

Cancer causes significatlt emotional distress to a considerable majority of patients. Many of these patients typically receive little formal psychological intervention. Support groups, however, have provided one forum from which patients can attempt to gain help and can use to overcome some psychological trauma that accompanies the cancer hagnosis, subsequent treatment and relapse. This article reviews past studies of professionally run cancer support groups as opposed to psychological intervention groups. These studies are considered in light of the proposed benefits and the methodological limitations frequently inherent in such studies.     

Learning to Observe Relationships and Coping

Milieu relationships provide the critical background presence to staff's attempts to motivate, regulate, and teach patients how to cope with stress. Forging a connection with hospitalized children and adolescents demands attention to how they respond to adults and engage with staff around milieu expectations. Assessment guides that deal with these issues are presented. Important aspects of children's relatedness are presented in the context of their working models of adults and the influence of these representations on their response to staff. Coping skills are explained with particular emphasis on behavioral coping strategies. Tied to the assessment process are interventions that emphasize staff's role in helping patients manage strong affects and avoid the use of nonproductive behavior regulation strategies.