Interprofessional conflict and conflict management in an educational setting.

Background: Whenever health professionals work together as a team, conflict is inevitable - some would argue even necessary. However, conflict can have negative effects on patient care, job satisfaction, personal wellness, and professional productivity. Purpose: This study aims to describe interprofessional conflicts in a hospital setting from the perspective of three groups of health science students. Methods: An online questionnaire survey collected data from 225 health science students (medicine, nursing, and social work) in Northern California (USA). Quantitative and qualitative analyses were conducted resulting in seven central themes of conflict. Results: There are differences among health professional students in terms of how conflict is experienced and managed. Nursing students and medical students were more likely to take on the "victim" role when explaining their conflict, and their conflicts were more likely to be intra-professional. The most common cause of conflicts was related to hierarchy and power issues. The majority were dissatisfied with the way the conflict was resolved. Conclusions: Findings from this study can be used to design interprofessional curriculum to improve outcomes from conflicts and improve wellbeing, job satisfaction, and reduce patient turnover.

Determining the attitudes and use of complementary, alternative, and integrative medicine among undergraduates.

OBJECTIVES: To (1) determine the attitudes, perceptions, and use of complementary, alternative, and integrative medicine among undergraduate students; (2) assess whether these students would benefit from more academic exposure to complementary and alternative medicine (CAM) and promotion of integrative medicine (IM); and (3) gauge the need and desire of undergraduates, particularly pre-health learners, to take courses about CAM/IM. METHODS: This cross-sectional electronic survey study was conducted on the campus of the University of California (UC) Irvine. Selection criteria included being at least 18 years of age and a current undergraduate at UC Irvine. All survey responses were collected between November 20, 2010, and June 1, 2011. The data were analyzed by using Stata software, version 11-SE (Stata Corp., College Station, TX). RESULTS: Completed surveys were received from 2839 participants (mean age of respondents, 20.2 years). Thirty-five percent had used CAM within the past 12 months, and 92.8% believed CAM to be at least somewhat effective; however, only 31% had prior education on CAM. After adjustment for variables, familiarity and belief in effectiveness were both highly linked to the use of CAM, with ascending odds ratios (ORs; 95% confidence interval [CI]) of 3.9 (3.1-4.9), 8.1 (5.7-11.5), 13.4 (6.0-30.2), 2.1 (1.3-3.4), 4.9 (3.0-7.8), and 12.7 (6.9-23.4) among increasing categories (all p<0.01). Sex (OR, 1.26 [95% CI, 1.01-1.56]; p<0.05), Asian ethnicity (1.46 [1.14-1.88]; p<0.01), and prior education (1.26 [1.01-1.57]; p<0.05) were also significantly correlated to the use of CAM after adjustment. Most respondents indicated that they were likely to take a CAM college course if it fulfilled a graduation requirement (63.6%) or was offered within their major (56.4%). CONCLUSIONS: Overall, this large-scale study supports the ideas that education plays a pivotal factor in the decision to use CAM and that there is a large demand for additional CAM knowledge among college students.

Stroke prevention in the high-risk atrial fibrillation patient: Medical management.

Medical management of patients with atrial fibrillation (AF) at high risk for stroke is limited by problems of imperfect tools for assessment of thromboembolism and bleeding risks. Improved instruments, such as the CHA2DS2VASc and HAS-BLED risk stratification scores, have been incorporated into European practice guidelines. Until recently, the most effective therapy for stroke prevention has been anticoagulation with a vitamin K antagonist, but new oral anticoagulants in development, antiarrhythmic drugs that reduce adverse cardiovascular events in patients with AF, and interventional techniques for occlusion of the left atrial appendage represent promising options for stroke prevention. These new strategies will need focused evaluation in the most challenging AF patients-those with a high risk of bleeding, prior thromboembolism, or thrombosis-prone surfaces such as mechanical heart valve prostheses or drug-eluting coronary stents, for whom the limitations of currently available treatment options and a paucity of data are particularly acute.