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The beginning of the COVID-19 pandemic required research institution administrators and researchers to make rapid and unprecedented decisions about whether research should continue and in what form. In the fall of 2020, we conducted a national survey of 930 federally-funded principal investigators (Pis) who continued in-person research during the early months of the COVID-19 pandemic. We investigated researcher perceptions of what shaped their choices about conducting in-person essential research and managing personnel during this time. Several quantitative survey questions asked about PI perceptions of institutional policies serving as barriers and facilitators to decision making, and these responses to qualitative questions were coded when they made reference to the role of administration in their decisions. Using this subset of data, we analyzed how administrative decisions at the institutional level affected downstream experiences of researchers. By jointly interpreting the quantitative and qualitative data, we identified 10 concrete lessons that can inform administrator decision making and best practices in preparation and response to crisis shutdowns of research if and when they happen in the future. Keywords: Crisis planning, best practices, COVID-19, research shut-down, stakeholder feedback, resilience, Introduction In response to shortages in the workplace and the persistent changes in scientific funding and its workforce, national authorities and research organizations have endorsed inter-professional work and task substitutions. [...]

This article demonstrates how instructors of professionalism and ethics training programs can integrate a professional decision-making tool in training curricula. This tool can help trainees understand how to apply professional decision-making strategies to address the threats posed by a variety of psychological and environmental factors when they are faced with complex professional and ethical situations. We begin by highlighting key decision-making frameworks and discussing factors that may undermine the use of professional decision-making strategies. Then, drawing upon findings from past research, we present the "SMART" professional decision-making framework: seeking help, managing emotions, anticipating consequences, recognizing rules and context, and testing assumptions and motives. Next, we present a vignette that poses a complex ethical and professional challenge and illustrate how each professional decision-making strategy could or should be used by characters in the case. To conclude, we review a series of educational practices and pedagogical tools intended to help trainers facilitate trainee learning, retention, and application of "SMART" decision-making strategies.

Background: There are notable differences in how adult patients with traumatic brachial plexus injuries (BPI) are evaluated and treated. Purpose: To better understand existing philosophies, we used the Delphi method to measure and foster consensus on routine use of electrodiagnostic testing, ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) myelograms prior to surgery. Panelists were 10 peripheral nerve surgeons board certified in their respective specialties at 5 academic medical centers in the United States. Methods: We presented 2 cases (1 complete/pan-BPI and 1 upper trunk BPI) to panelists and asked how often they would order the following preoperative diagnostic tests: electrodiagnostic studies; ultrasound of the brachial plexus; MRI of the brachial plexus; CT myelogram. Our Delphi process included an initial survey with videoconference discussion after the first round. A second survey/videoconference round was conducted to further probe the items that did not reach consensus during the first round. Results: Among the 10 surgeons, there was consensus that prior to brachial plexus surgery electrodiagnostic studies and MRI should be routinely ordered and ultrasound of the brachial plexus should not be routinely ordered. The group did not reach consensus on whether CT myelogram should or should not be routinely ordered. Conclusions: Based on our panel's discussion, future work should focus on comparing the accuracy of CT myelogram and MRI for evaluation of cervical nerve root presence and viability. [ABSTRACT FROM AUTHOR]

Serious and continuing research noncompliance and integrity violations undermine the quality of research and trust in science. When researchers engage in these behaviors, institutional officials (IOs) often develop corrective action plans. Ideally, such plans address the root causes so noncompliance or research integrity violations discontinue. The aim of this study was to identify what IOs perceive as causes and action plan activities typically prescribed. We conducted semi-structured in-depth interviews with 47 IOs at research institutions across the U.S. including: institutional review board and institutional animal care and use committee chairs and directors, chief research officers, research compliance and integrity officers, and institutional conflicts of interest chairs and directors. The most common root causes identified were: 1) lack of knowledge or training, 2) failure to provide research team supervision, and 3) researcher attitudes toward compliance. The most common action plan activities include: 1) retraining in compliance or research integrity, 2) follow-up and hands-on involvement with the researcher, and 3) mandated oversight or mentoring. Because the most commonly identified action plan activities fail to adequately address the majority of root causes, our findings suggest a need for IOs to rethink existing approaches to action plan development to more effectively target root causes. [ABSTRACT FROM AUTHOR]

Objectives Study Design Methods Results Conclusions Patient engagement is critical for the effective development and use of artificial intelligence (AI)‐enabled tools in learning health systems (LHSs). We adapted a previously validated measure from pediatrics to assess adults' openness and concerns about the use of AI in their healthcare.Cross‐sectional survey.We adapted the 33‐item “Attitudes toward Artificial Intelligence in Healthcare for Parents” measure for administration to adults in the general US population (AAIH‐A), recruiting participants through Amazon's Mechanical Turk (MTurk) crowdsourcing platform. AAIH‐A assesses openness to AI‐driven technologies and includes 7 subscales assessing participants' openness and concerns about these technologies. The openness scale includes examples of AI‐driven tools for diagnosis, prediction, treatment selection, and medical guidance. Concern subscales assessed privacy, social justice, quality, human element of care, cost, shared decision‐making, and convenience. We co‐administered previously validated measures hypothesized to correlate with openness. We conducted a confirmatory factor analysis and assessed reliability and construct validity. We performed exploratory multivariable regression models to identify predictors of openness.A total of 379 participants completed the survey. Confirmatory factor analysis confirmed the seven dimensions of the concerns, and the scales had internal consistency reliability, and correlated as hypothesized with existing measures of trust and faith in technology. Multivariable models indicated that trust in technology and concerns about quality and convenience were significantly associated with openness.The AAIH‐A is a brief measure that can be used to assess adults' perspectives about AI‐driven technologies in healthcare and LHSs. The use of AAIH‐A can inform future development and implementation of AI‐enabled tools for patient care in the LHS context that engage patients as key stakeholders. [ABSTRACT FROM AUTHOR]

Background: Web-based patient portals are tools that could support adolescents in managing their health and developing autonomy. However, informatics administrators must navigate competing interests when developing portal access policies for adolescents and their parents. Objective: We aimed to assess the perspectives of informatics administrators on guiding principles for the development of web-based health care portal access policies in adolescent health care. Methods: We interviewed informatics administrators from US hospitals with ≥50 dedicated pediatric beds. We performed a thematic analysis of guiding principles for developing and implementing adolescent portal access policies. Results: We interviewed 65 informatics leaders who represented 63 pediatric hospitals, 58 health care systems, 29 states, and 14,379 pediatric hospital beds. Participants described 9 guiding principles related to three overarching themes: (1) balancing confidentiality and other care needs, (2) balancing simplicity and granularity, and (3) collaborating and advocating. Participants described the central importance of prioritizing the health and safety of the adolescent while also complying with state and federal laws. However, there were differing beliefs about how to prioritize health and safety and what role parents should play in supporting the adolescent's health care. Participants also identified areas where clinicians and institutions can advocate for adolescents, especially with electronic health record vendors and legislators. Conclusions: Informatics administrators provided guiding principles for adolescent portal access policies that aimed to balance the competing needs of adolescent confidentiality and the usefulness of the portal. Portal access policies must prioritize the adolescent's health and safety while complying with state and federal laws. However, institutions must determine how to best enact these principles. Institutions and clinicians should strive for consensus on principles to strengthen advocacy efforts with institutional leadership, electronic health record vendors, and lawmakers. [ABSTRACT FROM AUTHOR]