Assessing Professionalism in Medicine - A Scoping Review of Assessment Tools from 1990 to 2018.

BACKGROUND: Medical professionalism enhances doctor-patient relationships and advances patient-centric care. However, despite its pivotal role, the concept of medical professionalism remains diversely understood, taught and thus poorly assessed with Singapore lacking a linguistically sensitive, context specific and culturally appropriate assessment tool. A scoping review of assessments of professionalism in medicine was thus carried out to better guide its understanding. METHODS: Arksey and O'Malley's (2005) approach to scoping reviews was used to identify appropriate publications featured in four databases published between 1 January 1990 and 31 December 2018. Seven members of the research team employed thematic analysis to evaluate the selected articles. RESULTS: 3799 abstracts were identified, 138 full-text articles reviewed and 74 studies included. The two themes identified were the context-specific nature of assessments and competency-based stages in medical professionalism. CONCLUSIONS: Prevailing assessments of professionalism in medicine must contend with differences in setting, context and levels of professional development as these explicate variances found in existing assessment criteria and approaches. However, acknowledging the significance of context-specific competency-based stages in medical professionalism will allow the forwarding of guiding principles to aid the design of a culturally-sensitive and practical approach to assessing professionalism.

Enhancing Mentoring in Palliative Care: An Evidence Based Mentoring Framework.

BACKGROUND: Growing concerns over ethical issues in mentoring in medicine and surgery have hindered efforts to reinitiate mentoring for Palliative Care (PC) physicians following the easing of COVID-19 restrictions. Ranging from the misappropriation of mentee's work to bullying, ethical issues in mentoring are attributed to poor understanding and structuring of mentoring programs, underlining the need for a consistent approach to mentoring practices. METHODS: Given diverse practices across different settings and the employ of various methodologies, a novel approach to narrative reviews (NR)s is proposed to summarize, interpret, and critique prevailing data on novice mentoring. To overcome prevailing concerns surrounding the reproducibility and transparency of narrative reviews, the Systematic Evidenced Based Approach (SEBA) adopts a structured approach to searching and summarizing the included articles and employed concurrent content and thematic analysis that was overseen by a team of experts. RESULTS: A total of 18 915 abstracts were reviewed, 62 full text articles evaluated and 41 articles included. Ten themes/categories were ascertained identified including Nature; Stakeholders; Relationship; Approach; Environment; Benefits; Barriers; Assessments; Theories and Definitions. CONCLUSION: By compiling and scrutinizing prevailing practice it is possible to appreciate the notion of the mentoring ecosystem which sees each mentee, mentor, and host organization brings with them their own microenvironment that contains their respective goals, abilities, and contextual considerations. Built around competency based mentoring stages, it is possible to advance a flexible yet consistent novice mentoring framework.

Feeding-Related Knowledge, Attitudes, and Practices among Grandparents in Singapore.

Childhood obesity is a growing concern worldwide. Though multifactorial, the family environment exerts significant influence on children's eating habits. Grandparents are increasingly involved as caregivers and they can significantly influence their grandchildren's eating habits. Yet, literature on this topic is lacking. This exploratory sequential mixed methods study (qualitative interview and interviewer-administered questionnaire) aims to understand grandparents' knowledge, attitudes, and practices on the feeding of their grandchildren in Singapore. A total of 11 interview participants and 396 questionnaire respondents with at least one grandchild, aged 12 years and below were included. Qualitative interviews informed the questionnaire development. Responses to interview questions about knowledge, attitudes, and practices revealed sub-themes such as knowledge on the impact of feeding, attitude toward feeding role, and challenges to feeding. Of the 396 participants, 35% were primary caregivers (defined as the person who spends the most time with the grandchild and performs most of the caregiving tasks). Nutritional knowledge was fair (median score 5/8), with misconceptions centered around healthy feeding practices. Grandparents who were primary caregivers, female, Malay, and younger than 70 years old believed that they played an important role in feeding their grandchild (p < 0.05). Overall, 47.2% of the grandparents rarely or never set a maximum limit on the amount of unhealthy food eaten, of which 77.1% are non-primary caregivers. In comparison, primary caregivers tend to set a maximum limit to the amount of unhealthy food their grandchildren eat and choose a wide variety of food (p < 0.05). These findings support the need for further improvement of grandparents' feeding knowledge and practices as part of tackling childhood obesity.

Understanding the Mentoring Environment Through Thematic Analysis of the Learning Environment in Medical Education: a Systematic Review.

BACKGROUND: Mentoring's success has been attributed to individualised matching, holistic mentoring relationships (MRs) and personalised mentoring environments (MEs). Whilst there is growing data on matching and MRs, a dearth of ME data has hindered development of mentoring programme. Inspired by studies likening MEs to learning environments (LEs) and data highlighting common characteristics between the two, this systematic review scrutinises reports on LEs to extrapolate the findings to the ME context to provide a better understanding of ME and their role in the mentoring process. METHODS: Using identical search strategies, 6 reviewers carried out independent literature reviews of LEs in clinical medicine published between 1 January 2000 and 31 December 2015 using PubMed, ERIC, Cochrane Database of Systematic Reviews, Google Scholar and Scopus databases. Braun and Clarke's (2006) approach to thematic analysis was adopted to circumnavigate LE's evolving, context-specific, goal-sensitive, learner-tutor relationally dependent nature. RESULTS: A total of 4574 abstracts were identified, 90 articles were reviewed, and 58 full-text articles were thematically analysed. The two themes identified were LE structure and LE culture. LE structure regards the framework that guides interactions within the LE. LE culture concerns the values and practices influencing learner-tutor-host organisation interactions. DISCUSSION: LE is the product of culture and structure that influence and are influenced by the tutor-learner-host organisation relationship. LE structure guides the evolving tutor-learner-host organisation relationship whilst the LE culture nurtures it and oversees the LE structure. Similarities between LEs and MEs allow LE data to inform programme designers of ME's role in mentoring's success.