14 results on '"Backster, Anika"'
Search Results
2. Simulation for diversity, equity and inclusion in emergency medicine residency training: A qualitative study.
- Author
-
Nadir NA, Winfield A, Bentley S, Hock SM, Backster A, Bradby C, Rotoli J, Jones N, and Falk M
- Abstract
Background: The last few years have seen an increased focus on diversity, equity, and inclusion (DEI) initiatives across organizations. Simulation has been used in varying degrees for teaching about DEI topics with emergency medicine; however, there are no established best practices or guidelines on this subject. To further examine the use of simulation for DEI teachings, the DEISIM work group was created as a collaboration between the Society of Academic Emergency Medicine (SAEM) Simulation Academy and the Academy for Diversity and Inclusion in Emergency Medicine (ADIEM). This study represents their findings., Method: This qualitative study was conducted using a three-pronged approach. Initial literature search was conducted followed by a call for submission of simulation curricula. These were then followed by five focus groups. Focus groups were recorded, transcribed by a professional transcription service, and then subjected to thematic analysis., Results: Data were analyzed and organized into four broad categories including Learners, Facilitators, Organizational/Leadership, and Technical Issues. Challenges within each of these were identified, as were potential solutions. Select pertinent findings included focused faculty development, a carefully planned approach that utilized DEI content experts and the use of simulation for workplace microaggressions or discriminations., Conclusions: There appears to be a clear role for simulation in DEI teachings. Such curricula, however, should be undertaken with careful planning and input from appropriate and representative parties. More research is needed on optimizing and standardizing simulation-based DEI curricula., (© 2023 Society for Academic Emergency Medicine.)
- Published
- 2023
- Full Text
- View/download PDF
3. From inequity to access: Evidence-based institutional practices to enhance care for individuals with disabilities.
- Author
-
Rotoli J, Poffenberger C, Backster A, Sapp R, Modi P, Stehman CR, Mirus C 4th, Johnson L, Siegelman JN, and Coates WC
- Abstract
People with disabilities experience barriers to care in all facets of health care, from engaging with the provider in a clinical setting (attitudinal and communication barriers) to navigating a large institution in a complex health care environment (organizational and environmental barriers), culminating in significant health care disparities. Institutional policy, culture, and physical layout may be inadvertently fostering ableism, which can perpetuate health care inaccessibility and health disparities in the disability community. Here, we present evidence-based interventions at the provider and institutional levels to accommodate patients with hearing, vision, and intellectual disabilities. Institutional barriers can be met with strategies of universal design (i.e., accessible exam rooms and emergency alerts), maximizing electronic medical record accessibility/visibility, and institutional policy development to recognize and reduce discrimination. Barriers at the provider level can be met with dedicated training on care of patients with disabilities and implicit bias training specific to the surrounding patient demographics. Such efforts are crucial to ensuring equitable access to quality care for these patients., Competing Interests: The authors declare no conflicts of interest., (© 2023 Society for Academic Emergency Medicine.)
- Published
- 2023
- Full Text
- View/download PDF
4. Promoting Access and Equity: A Historical Perspective of Healthcare Access for People With Disabilities.
- Author
-
Rotoli JM, Backster A, Poffenberger C, and Coates WC
- Abstract
People with disabilities represent a large and often under-recognized minority population in the United States. Historically, negative healthcare provider perceptions and limited critical social determinants of health (including community living and education) have resulted in inequitable healthcare and access for this vulnerable group. Within the last 40 years, there have been some advances in legislation to improve access and support for those with disabilities. Since then, advances in accommodations have enabled better access to critical health-related resources and care. Continued forward progress and increased awareness are imperative to improve access, reduce disparities in healthcare, and combat discrimination., Competing Interests: The authorship team wrote a piece for a society newsletter that discussed a similar topic in 2021 (Society for Academic Emergency Medicine). The newsletter is distributed to the society's membership via email. It is neither peer-reviewed nor cataloged., (Copyright © 2022, Rotoli et al.)
- Published
- 2022
- Full Text
- View/download PDF
5. A Structural Competency Framework for Emergency Medicine Research: Results from a Scoping Review and Consensus Conference.
- Author
-
Zeidan A, Salhi B, Backster A, Shelton E, Valente A, Safdar B, Wong A, Porta AD, Lee S, Schneberk T, Wilson J, Westgard B, and Samuels-Kalow M
- Subjects
- Consensus, Humans, Vulnerable Populations, Emergency Medicine
- Abstract
Introduction: The application of structural competency and structural vulnerability to emergency medicine (EM) research has not been previously described despite EM researchers routinely engaging structurally vulnerable populations. The purpose of this study was to conduct a scoping review and consensus-building process to develop a structurally competent research approach and operational framework relevant to EM research., Methods: We conducted a scoping review focused on structural competency and structural vulnerability. Results of the review informed the development of a structural competency research framework that was presented throughout a multi-step consensus process culminating in the 2021 Society for Academic Emergency Medicine Consensus Conference. Feedback to the framework was incorporated throughout the conference., Results: The scoping review produced 291 articles with 123 articles relevant to EM research. All 123 articles underwent full-text review and data extraction following a standardized data extraction form. Most of the articles acknowledged or described structures that lead to inequities with a variety of methodological approaches used to operationalize structural competency and/or structural vulnerability. The framework developed aligned with components of the research process, drawing upon methodologies from studies included in the scoping review., Conclusion: The framework developed provides a starting point for EM researchers seeking to understand, acknowledge, and incorporate structural competency into EM research. By incorporating components of the framework, researchers may enhance their ability to address social, historical, political, and economic forces that lead to health inequities, reframing drivers of inequities away from individual factors and focusing on structural factors.
- Published
- 2022
- Full Text
- View/download PDF
6. Making emergency medicine accessible for all: The what, why, and how of providing accommodations for learners and physicians with disabilities.
- Author
-
Poffenberger CM, Coates WC, Backster A, and Rotoli J
- Abstract
Individuals with disabilities comprise a substantial portion of the U.S. population but make up only a small subset of medical students and health care providers. Both the Association of American Medical Colleges and the Accreditation Council for Graduate Medical Education have called for increased diversity in the physician workforce, to more closely represent the U.S. patient population and provide culturally effective care. Yet the barriers to disclosure and inclusion for individuals with disabilities in health care are significant, including attitudinal barriers such as stigma and bias, organizational barriers in policies and procedures, and environmental barriers such as resources and physical space. Lack of experience providing accommodations and a lack of knowledge of both what is legally required and what is possible also prevent programs from creating access. Realizing inclusion for individuals with disabilities in a diverse workforce requires emergency medicine programs to be proactive and deliberate in their approach to recruiting, accommodating, and retaining students, residents, and faculty with disabilities. Such efforts are likely to provide benefits that extend beyond those who receive the accommodations., Competing Interests: The authors have no potential conflicts to disclose., (© 2022 by the Society for Academic Emergency Medicine.)
- Published
- 2022
- Full Text
- View/download PDF
7. Impact of Intravenous Alteplase Door-to-Needle Times on 2-Year Mortality in Patients With Acute Ischemic Stroke.
- Author
-
Bhatt NR, Backster A, Ido MS, Nogueira RG, Bayakly R, Wright DW, and Frankel MR
- Abstract
Objective: We sought to determine whether administration of Intravenous Thrombolysis (IVT) to patients with Acute Ischemic Stroke (AIS) within 60 min from hospital arrival is associated with lower 2-year mortality. Methods: This retrospective study was conducted among patients receiving IVT in hospitals participating in the Georgia Coverdell Acute Stroke Registry (GCASR) from January 1, 2008 through June 30, 2018. Two-year mortality data was obtained by linking the 2008-2018 Georgia Discharge Data System data and the 2008-2020 Georgia death records. We analyzed the study population in two groups based on the time from hospital arrival to initiation of IVT expressed as Door to Needle time (DTN) in a dichotomized (DTN ≤ 60 vs. > 60 min) fashion. Results: The median age of patients was 68 years, 49.4% were females, and the median NIHSS was 9. DTN ≤60 min was associated with lower 30-day [odds ratio (OR), 0.62; 95% CI, 0.52-0.73; P < 0.0001], 1-year (OR, 0.71; 95% CI, 0.61-0.83; P < 0.0001) and 2-year (OR, 0.76; 95% CI, 0.65-0.88; P = 0.001) mortality as well as lower rates of sICH at 36 h (OR, 0.57; 95% CI, 0.43-0.75; P = 0.0001), higher rates of ambulation at discharge (OR, 1.38; 95% CI, 1.25-1.53; P < 0.0001) and discharge to home (OR, 1.36; 95% CI, 1.23-1.52; P < 0.0001). Conclusion: Faster DTN in patients with AIS was associated with lower 2-year mortality across all age, gender and race subgroups. These findings reinforce the need for intensifying quality improvement measures to reduce DTN in AIS patients., Competing Interests: RN reports consulting fees for advisory roles with Anaconda, Biogen, Cerenovus, Genentech, Imperative Care, Medtronic, Phenox, Prolong Pharmaceuticals, Stryker Neurovascular and stock options for advisory roles with Astrocyte, Brainomix, Cerebrotech, Ceretrieve, Corindus Vascular Robotics, Vesalio, Viz-AI, and Perfuze. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Bhatt, Backster, Ido, Nogueira, Bayakly, Wright and Frankel.)
- Published
- 2021
- Full Text
- View/download PDF
8. Recruitment of a diverse emergency medicine residency program: Creating and maintaining a culture of diversity, equity, and inclusion.
- Author
-
Lall MD, Backster A, White MH, Heron SL, and Siegelman JN
- Abstract
Competing Interests: AB reports recipient of $500 SAEM ExCITE (2018) as start‐up funds for Women in EM Promoting Wellness, Research, Diversity and Professional Development. The other authors have no potential conflicts to disclose.
- Published
- 2021
- Full Text
- View/download PDF
9. The Prevalence of Disability Health Training and Residents With Disabilities in Emergency Medicine Residency Programs.
- Author
-
Sapp RW, Sebok-Syer SS, Gisondi MA, Rotoli JM, Backster A, and McClure Poffenberger C
- Abstract
Objectives: Individuals with disabilities experience significant health care disparities due to a multitude of barriers to effective care, which include a lack of adequate physician training on this topic and negative attitudes of physicians. This results in disparities through inadequate physical examination and diagnostic testing, withholding or inferior treatment, and neglecting preventative care. While much has been published about disability education in undergraduate medical education, little is known about the current state of disability education in emergency medicine (EM) residency programs., Methods: In 2019, a total of 237 EM residency program directors (PDs) in the United States were surveyed about the actual and desired number of hours of disability health instruction, perceived barriers to disability health education, prevalence of residents and faculty with disabilities, and confidence in providing accommodations to residents with disabilities., Results: A total of 104 surveys were completed (104/237, 43.9% response rate); 43% of respondents included disability-specific content in their residency curricula for an average of 1.5 total hours annually, in contrast to average desired hours of 4.16 hours. Reported barriers to disability health education included lack of time and lack of faculty expertise. A minority of residency programs have faculty members (13.5%) or residents (26%) with disabilities. The prevalence of EM residents with disabilities was 4.02%. Programs with residents with disabilities reported more hours devoted to disability curricula (5 hours vs 1.54 hours, p = 0.017) and increased confidence in providing workplace accommodations for certain disabilities including mobility disability (p = 0.002), chronic health conditions (p = 0.022), and psychological disabilities (p = 0.018)., Conclusions: A minority of EM PDs in our study included disability health content in their residency curricula. The presence of faculty and residents with disabilities is associated with positive effects on training programs, including a greater number of hours devoted to disability health education and greater confidence in accommodating learners with disabilities. To reduce health care disparities for patients with disabilities, we recommend that a dedicated disability health curriculum be integrated into all aspects of the EM residency curriculum, including lectures, journal clubs, and simulations and include direct interaction with individuals with disabilities. We further recommend that disability be recognized as an aspect of diversity when hiring faculty and recruiting residents to EM programs, to address this training gap and to promote a diverse and inclusive learning environment., (© 2020 by the Society for Academic Emergency Medicine.)
- Published
- 2020
- Full Text
- View/download PDF
10. Emergency Medicine Resident Education on Caring for Patients With Disabilities: A Call to Action.
- Author
-
Rotoli J, Backster A, Sapp RW, Austin ZA, Francois C, Gurditta K, Mirus C 4th, and McClure Poffenberger C
- Abstract
People with disabilities constitute a marginalized population who experience significant health care disparities resulting from structural, socioeconomic, and attitudinal barriers to accessing health care. It has been reported that education on the care of marginalized groups helps to improve awareness, patient-provider rapport, and patient satisfaction. Yet, emergency medicine (EM) residency education on care for people with disabilities may be lacking. The goal of this paper is to review the current state of health care for patients with disabilities, review the current state of undergraduate and graduate medical education on the care of patients with disabilities, and provide suggestions for an improved EM residency curriculum that includes education on the care for patients with disabilities., (© 2020 by the Society for Academic Emergency Medicine.)
- Published
- 2020
- Full Text
- View/download PDF
11. A Novel Simulation to Assess Residents' Utilization of a Medical Interpreter.
- Author
-
Zdradzinski MJ, Backster A, Heron S, White M, Laubscher D, and Siegelman JN
- Subjects
- Clinical Competence, Communication Barriers, Cultural Competency, Health Services Research, Hispanic or Latino, Humans, Manikins, Patient Education as Topic methods, Professional-Patient Relations, United States, Ancillary Services, Hospital statistics & numerical data, Emergency Medicine education, Internship and Residency, Patient Simulation, Translating
- Abstract
Introduction: Physicians must be facile in working with a medical interpreter (MI) given the large population of patients with limited English proficiency., Methods: To facilitate residents' assessment of their ability to interact with non-English-speaking patients, we developed a simulation case involving one such patient. The case involved a 31-year-old Spanish-speaking postpartum female who presented with eclamptic seizures. The learner needed to request an MI to assist with obtaining the patient's medical history once her concerned family member (also Spanish speaking) arrived. The major critical actions included appropriate use of MI services, recognition of the risk for eclamptic seizures, proper evaluation and treatment, and appropriate disposition to an obstetrician. The case required a high-fidelity mannequin and simulation operator, nurse simulated participant, Spanish-speaking actor (to play the husband or family member), certified Spanish MI, and faculty evaluator., Results: We implemented this case with 60 emergency medicine residents, ranging from PGY 1 to 3. The learner was assessed by both the faculty observer and MI. Checklists for assessment and debriefing materials were provided. Two of 60 residents did not request an MI. When compared to a prior version of this case that did not include the language barrier, median scores dropped from 12 to 10 out of 24, suggesting that the language barrier created a more challenging case., Discussion: The use of MIs is an integral part of health care practice in the United States, and we present a simulation case that can assess learners' use of MIs., Competing Interests: None to report., (Copyright © 2019 Zdradzinski et al.)
- Published
- 2019
- Full Text
- View/download PDF
12. Gender differences in neurological emergencies part II: a consensus summary and research agenda on traumatic brain injury.
- Author
-
Wright DW, Espinoza TR, Merck LH, Ratcliff JJ, Backster A, and Stein DG
- Subjects
- Attitude of Health Personnel, Biomedical Research, Brain Injuries prevention & control, Consensus, Emergencies, Emergency Medicine, Female, Gender Identity, Humans, Male, Risk Factors, Sex Factors, Trauma Severity Indices, Treatment Outcome, Brain Injuries therapy, Emergency Service, Hospital organization & administration, Sex Characteristics
- Abstract
Traumatic brain injury (TBI) is a major cause of death and disability worldwide. There is strong evidence that gender and sex play an important role across the spectrum of TBI, from pathophysiology to clinical care. In May 2014, Academic Emergency Medicine held a consensus conference "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." A TBI working group was formed to explore what was known about the influence of sex and gender on TBI and to identify gaps for future research. The findings resulted in four major recommendations to guide the TBI research agenda., (© 2014 by the Society for Academic Emergency Medicine.)
- Published
- 2014
- Full Text
- View/download PDF
13. Focusing on a "serious" review of systems in the emergency department.
- Author
-
Rodriguez RM, Dean K, Backster A, Aiken L, and McClung C
- Subjects
- Adult, Female, Hospitals, Urban, Humans, Male, Middle Aged, San Francisco, Young Adult, Emergency Service, Hospital organization & administration, Medical History Taking, Physical Examination
- Abstract
We compared serious and non-serious review of systems (ROS) complaints in the Emergency Department (ED). There were 173 adults discharged from an urban county ED who were administered a 56-item ROS identical to the ED chart ROS. Blinded review of ED charts determined which ROS complaints were documented by clinicians and whether ROS complaints were addressed by ED diagnostic testing or physical examination (PE). Mean differences in proportions with 95% confidence intervals (CIs) between serious and non-serious ROS complaints were: 1) For whether patients expected ROS complaints addressed in the ED, 15.7% (95% CI 6.5-24.2); 2) For ROS complaints concomitantly noted on ED charts by providers, 9.0% (95% CI 1.7-17.6); and 3) For whether provider-noted ROS complaints were addressed by testing or PE, 21.2% (95% CI 4.2-38.3). Discharged ED patients expect more of their serious ROS complaints to be addressed. More serious ROS complaints are noted and addressed by ED providers, but most ROS complaints noted by providers are not addressed., (Copyright © 2010 Elsevier Inc. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
14. Transforming the surgical "time-out" into a comprehensive "preparatory pause".
- Author
-
Backster A, Teo A, Swift M, Polk HC Jr, and Harken AH
- Subjects
- Humans, Pilot Projects, Risk Management, Risk Reduction Behavior, Thoracic Surgery standards, Time, United States, Perioperative Care, Postoperative Complications prevention & control, Program Development, Program Evaluation, Safety Management, Thoracic Surgery methods
- Abstract
We propose expansion of the standard "time-out" into a comprehensive "preparatory pause" encompassing five well-documented perioperative risk avoidance strategies: beta-adrenergic blockade, DVT prophylaxis, preoperative antibiotics, normothermia, and euglycemia. Although all members of the surgical team acknowledge the clear benefit of these five prophylactic strategies, published national compliance even in the target patient population is a disappointingly consistent 50%. We have developed and field-tested a "preparatory pause" form that we appended to our "surgical time-out." By politely challenging our surgical team as to the inclusion of these five risk avoidance strategies in 167 consecutive patients, we increased our compliance to more than 90% for each preventive measure. We have not attempted to quantify the physical and psychological benefit of complication avoidance due to the enhanced activation of these five prophylactic strategies. Using published surgical complication prevalence data, with and without these accepted risk avoidance measures, we estimate the number of complications per 100 patients avoided. Utilizing the Medicare payment schedule for each complication, we approximate the purely financial benefit of the "preparatory pause" to be $88,640 per 100 patients, or almost $900 per patient. The now standard surgical "time-out" is designed to avoid the gratifyingly uncommon problem of "wrong patient,""wrong procedure," and "wrong site." Many surgeons negotiate an entire career without stumbling over these disastrous problems. We propose expansion of the "time-out" to include five well-documented perioperative risk avoidance strategies that many of us overlook all too often.
- Published
- 2007
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.