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Abstract Meaningful communication between health service users and providers is essential. However, when stakeholders are unfamiliar with new health services, innovative communication methods are necessary to engage them. The aim of the study was to create, validate, and evaluate a video-vignette to enhance stakeholders’ (physicians, pharmacists, and laypeople) engagement and understanding of an innovative pharmacy-based diabetes screening and prevention program. Also, to assess the video-vignette’s capacity to measure appetite and appeal for such preventive programs. This mixed-methods study consisted of two phases. In phase one, a video-vignette depicting the proposed screening and prevention program was developed and validated following established international guidelines (n = 25). The video-vignette was then evaluated by stakeholders (n = 99). In phase two, the video-vignette’s capacity as a communication tool was tested in focus groups and interviews to explore stakeholders’ perspectives and engagement on the proposed service (n = 22). Quantitative data were analyzed descriptively, while qualitative data underwent thematic analysis. In total, 146 stakeholders participated. The script was well-received, deemed credible, and realistic. Furthermore, the video-vignette received high ratings for its value, content, interest, realism, and visual and audio quality. The focus groups and interviews provided valuable insights into the design and delivery of the new service. The video-vignette compellingly portrayed the novel pharmacy-based diabetes screening and prevention service. It facilitated in-depth discussions among stakeholders and significantly enhanced their understanding and appreciation of such health services. The video-vignette also generated significant interest in pharmacy-based diabetes screening and prevention programs, serving as a powerful tool to promote enrollment in these initiatives.

Background: Whistleblowing is recognised as part of solving wrongdoing. It requires individual reasoning as it is a potentially complicated process with a risk of possible negative consequences for oneself. Knowledge on how individuals reason for whistleblowing in healthcare context is lacking. Aim: This study aimed to create a theoretical construct to describe individual reasoning for whistleblowing. Methods: The methodology was grounded theory, with 244 nurses as informants. The data consisted of nurses' written narratives in response to a wrongdoing situation presented in a video vignette. To ensure the heterogeneity of the population and variation in nurses' professional expertise, experiences and geographical locations in health care to capture the multidimensionality of the responses, nurses were invited to participate, and data were collected electronically from the membership register of the Finnish Nurses' Association on a national level. Constant comparison was used to analyse the open data. Results: The core category of the theoretical construct, 'The formation of morally courageous intervening', was discovered, reflecting individual's values and beliefs. It forms mentally as an integration of cognition and emotion for recognising one's own strengths and limits to act to do the right thing despite the risk of negative consequences for oneself. The core category consists of three dimensions of reasoning: (1) Reasoning Actors, (2) Reasoning Justifications and (3) Reasoning Activities, their categories and three patterns of reasoning connecting the dimensions and their categories with each other: (I) Individual Reasoning, (II) Collaborative Reasoning and (III) Collective Reasoning. Discussion and conclusion: The theoretical construct indicate that reasoning is a multidimensional phenomenon. In future, a theoretical construct could be further developed. In health care, managers could use the theoretical construct to support employees in their whistleblowing. [ABSTRACT FROM AUTHOR]

This study aims to examine (a) whether there are differences in general practitioners' (GPs) attitudes towards native Belgian patients, patients of foreign descent and asylum seeking patients who all express symptoms of major depression, and (b) whether these differences depend on GPs' experience with cultural competency training and interethnic contact. Using a video vignette study among 404 Flemish (Belgium) GPs, we find evidence of a provider bias. While GPs regard a patient of foreign descent as less trustworthy and less able to adhere to medical recommendations than a native Belgian patient, they also hold more pessimistic views on a potential recovery of an asylum seeking patient. In addition, we find that cultural competency training might alter GPs' attitudes of asylum seeking patients in a positive way. Summarized, our research highlights the need to target stereotypes among GPs for interventions designed to reduce migration-based disparities in healthcare use and health status. [ABSTRACT FROM AUTHOR]

Background, Aim, and Hypothesis: This randomized controlled trial aimed to compare the impact of a physician's attire on the perceptions of patients with cancer of compassion, professionalism, and physician preference. Our hypothesis was that patients would perceive the physician with formal attire as more compassionate than the physician wearing casual attire. Materials and Methods: One hundred five adult follow‐up patients with advanced cancer were randomized to watch two standardized, 3‐minute video vignettes with the same script, depicting a routine physician‐patient clinic encounter. Videos included a physician in formal attire with tie and buttoned‐up white coat and casual attire without a tie or white coat. Actors, patients, and investigators were all blinded to the purpose and videos watched, respectively. After each video, patients completed validated questionnaires rating their perception of physician compassion, professionalism, and their overall preference for the physician. Results: There were no significant differences between formal and casual attire for compassion (median [interquartile range], 25 [10–31] vs. 20 [8–27]; p =.31) and professionalism (17 [13–21] vs. 18 [14–22]; p =.42). Thirty percent of patients preferred formal attire, 31% preferred casual attire, and 38% had no preference. Subgroup analysis did not show statistically significant differences among different cohorts of age, sex, marital status, and education level. Conclusion: Doctors' attire did not affect the perceptions of patients with cancer of physician's level of compassion and professionalism, nor did it influence the patients' preference for their doctor or their trust and confidence in the doctor's ability to provide care. There is a need for more studies in this area of communications skills. Clinical trial identification number. NCT03168763 Implications for Practice: The significance of physician attire as a means of nonverbal communication has not been well characterized. It is an important element to consider, as patient preferences vary geographically, are influenced by cultural beliefs, and may vary based on particular care settings. Previous studies consisted of nonblinded surveys and found increasing confidence in physicians wearing a professional white coat. Unfortunately, there are no randomized controlled trials, to the authors' knowledge, to confirm the survey findings. In this randomized, blinded clinical trial the researchers found that physician's attire did not affect patients' perception of the physician's level of compassion and professionalism. Attire also did not influence the patients' preferences for their doctor or their trust and confidence in the doctor's ability to provide care. Physician attire is an important element to consider in setting the tone for physician‐patient communications. Nonblinded studies have found greater confidence in physicians wearing a professional white lab coat. This randomized controlled trial compared the effect of physicians' attire on patients' preferences and perceptions of compassion and professionalism. [ABSTRACT FROM AUTHOR]

Teachers are confronted with multiple stimuli during instruction. To teach responsively, they must be able to identify and address classroom incidents that are critical for student learning. In the literature, the term "noticing" is used to refer to teachers' perception and interpretation of such incidents, as well as the associated decision-making. This qualitative study explores geography teachers' ability to notice pertinent stimuli. For this purpose, two staged video vignettes of subject-specific critical incidents were constructed. Expert geography teachers watched the vignettes, stopping them to comment whenever they noticed something critical. The findings indicate that a majority of teachers perceived the incidents in the manner intended by the authors. Analysis of the teachers' comments revealed four types of interpretation. While the participants did not always make a decision about how to respond to an incident, the analysis also identified two types of decision-making. [ABSTRACT FROM AUTHOR]

In structural-theoretical approaches to teacher professionalism, it is assumed that the teachers' adequate handling of antinomies is a central attribute of professionalism. From a didactical point of view the 'Sachantinomie' concerning the relationship between subject norm and students' conceptions is particularly relevant in this context. Video vignettes offer the possibility of a case-based perception and reflection of antinomies in university teacher education. Assuming that the perception of classes is also based on implicit knowledge, it is helpful for the configuration of the practice of university teacher education to first reconstruct the implicit knowledge of pre-service teachers. In the present paper, the question is pursued which implicit knowledge of pre-service teachers influences the perception of students' conceptions in evolution classes and the way teachers deal with it. This explorative study uses video vignette and conducts group discussions for data collection. Data analysis is carried out using the documentary method. Based on the first results, perspectives on the ‚Sachantinomie' are provided considering implicit knowledge in teacher education [ABSTRACT FROM AUTHOR]

Background: The laparoscopic Roux en-Y gastric bypass (LRYGB) is performed worldwide and is considered by many the gold standard treatment for morbid obesity. However, the difficult access to the gastric remnant and duodenum represents intrinsic limitations. The functional laparoscopic gastric bypass with fundectomy and gastric remnant exploration (LRYGBfse) is a new technique described in attempt to overcome the limitations of the LRYGB. The purpose of this video was to demonstrate the LRYGBfse in a 48-year-old man with type II diabetes and hypertension. Methods: An intraoperative video has been anonymized and edited to demonstrate the feasibility of LRYGBfse. Results: The operation started with the opening of the gastrocolic ligament. Staying close to the gastric wall, the stomach is prepared up to the angle of His. After the placement of a 36-Fr orogastric probe, gastric fundectomy is completed in order to create a 30cc gastric pouch. A polytetrafluoroethylene banding (ePTFE) is placed at the gastro-gastric communication, 7cm below the cardia, and gently closed after bougie retraction. The bypass is completed by the creation of an antecolic Roux-en-Y 150cm alimentary and 150cm biliopancreatic limb. Conclusion: The LRYGBfse is a feasible and safe technique. The possibility to endoscopically explore the excluded stomach with an easy access to the Vater's papilla is a major advantage. Further studies are warranted to deeply explore and compare outcomes with the standard LRYGB. [ABSTRACT FROM AUTHOR]

Purpose: Esophageal dysmotility and disorders of the lower esophageal sphincter are well documented in morbidly obese patients. Esophageal achalasia has been reported in up to 1% of obese patients but the development of such esophageal motility disorder after laparoscopic sleeve gastrectomy (LSG) is extremely rare. The purpose of this video was to demonstrate the management of a type II esophageal achalasia diagnosed in a 46-year-old female patient 4-year after LSG. Materials and Methods: An intraoperative video has been anonymized and edited to demonstrate the feasibility of laparoscopic Heller myotomy and anterior Dor fundoplication on the mentioned patient. Results: The operation started with the section of the perigastric adhesions. Proceeding in a clockwise direction, the esophagogastric junction, the anterior esophageal wall, and the His angle were freed. A residual slightly dilated fundus was found and isolated. After mobilization of the distal esophagus and identification of the anterior vagus nerve, a "hockey stick" myotomy was carried out for 6 cm on the esophagus and for 2 cm on the gastric side. An anterior Dor fundoplication was fashioned using the residual gastric fundus. Conclusion: Esophageal achalasia in patients that previously underwent LSG is exceptional but should always be suspected in case of pathognomonic symptoms onset. In tertiary referral centers, laparoscopic Heller myotomy and, if technically feasible, an anterior Dor fundoplication seem safe and effective to relieve gastroesophageal outflow obstruction and prevent gastroesophageal reflux. [ABSTRACT FROM AUTHOR]

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This article focuses on the use of the vignette method in social worker teams and thereby collective or shared aspects of practice, which cannot be reached through a presentation of a vignette separately to the individual members of the team. A video vignette case was presented to four social worker teams in connection with a focus group session in order to compare the teams' assessment of the client. The negotiations in the focus groups accentuate how teams interpret the same client in different ways and actualize questions as to where these differences stem from and what they are related to. The results support two methodological conclusions that we discuss in the article: that it is beneficial to use vignette in a multi-method design when comparing teams and that a focus group context is an advantage, when the characteristics of the team should be accentuated, while individual differences become secondary. [ABSTRACT FROM AUTHOR]