Papers by Lauren DeCaporale-Ryan
Journal of Geriatric Oncology
Journal of the American College of Surgeons
Journal of the American College of Surgeons, 2017
Statistical analysis was performed using Chi-squared and Mann-Whitney U tests, with significance ... more Statistical analysis was performed using Chi-squared and Mann-Whitney U tests, with significance p < 0.05.
Comprehensive Clinical Psychology, 2020
APA handbook of contemporary family psychology: Family therapy and training (Vol. 3)., 2019
Resident wellness is a topic of increasing discussion and study. The life of a surgery resident l... more Resident wellness is a topic of increasing discussion and study. The life of a surgery resident lends itself to unique challenges that threaten a trainee’s wellbeing. This issue is at the forefront of graduate medical education in terms of optimizing the clinical learning environment and mitigating the risk of burnout for residents. However, residency programs struggle to identify and implement actionable items for their trainees. In this chapter the authors review the scope of the problem as studied in the literature, describe the current stance of the Accreditation Council of Graduate Medical Education (ACGME) and provide examples of surgical programs that have embraced and implemented organizational and personal components to address resident wellbeing within their surgical training programs.
We attempted to prevent hospital readmissions by creating a new, interdisciplinary discharge clin... more We attempted to prevent hospital readmissions by creating a new, interdisciplinary discharge clinic at our urban, residency-based practice. Within a week of discharge, patients were scheduled by care management to meet with a team of clinicians, including a physician, psychologist, pharmacist, and nurse care manager within the same visit. During the visit, we discussed the hospitalization primarily from the patient’s point of view, including patient perceptions of care, readiness for discharge, and issues surrounding medication reconciliation in an attempt to come to a shared understanding of readmission risk. Patients were also screened for mental health disease that could impact care, including depression and cognitive disorders. The team worked collaboratively with each patient to enhance patient understanding of the hospitalization, including safety with medications, gaps in care, potential reasons for readmission, and next steps for the patient. We found that patients overwhelmingly enjoyed the visits if they could adapt to a team-based approach, and we were able to identify actionable items for each patient to advance their care in the outpatient setting.In this lecture we will present the specific content discussed in the visits, the rationale for this content in the post-discharge visit, and additional logistical workflows we created. Then we will present some of our preliminary findings from this work including the role of nonphysician leadership in the interdisciplinary team, potential for interprofessional education in the clinic, and where we hope to go next in doing this type of work in the field of hospital to medical home transition. Upon completion of this session, participants should be able to: Start their own interdisciplinary discharge clinic to address preventable hospital readmissions Value and maximize the role of non-physician leadership in the interdisciplinary team Integrate interprofessional education into the discharge clinic by utilizing medical residents, pharmacy students, and behavioral health trainees into the team-based settin
The American Journal of Geriatric Psychiatry, 2020
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Families, Systems, & Health, 2020
INTRODUCTION Physician-patient communication involves complex skills that affect quality, outcome... more INTRODUCTION Physician-patient communication involves complex skills that affect quality, outcome, and satisfaction for patients, families, and health care teams. Yet, institutional, regulatory, and scientific demands compete for physicians' attention. A framework is needed to support physicians continued development of communication skills: Coaching is 1 such evidence-based practice, and we assessed the feasibility of implementing such a program. METHOD Participants were 12 physicians, representing high and low scorers on the Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) survey. We added items to capture empathy and family experience to the Calgary-Cambridge Observation Guide for the Medical Interview. Coaches observed communication associated with patient satisfaction and quality measures: introductions (I), asking about concerns (C), and check for understanding (U), or ICU. Participants received a report describing their communication behaviors, emphasizing strengths, and identifying areas for improvement. RESULTS Scores on the ICU significantly discriminated between low and high HCAHPS scorers, physicians from surgical and cognitive specialties, men and women. We collected anonymous feedback regarding the value of this training; participants recommended expanding the program. DISCUSSION Based on physician endorsement, experienced coaches are expanding the coaching program to physicians throughout our institution. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Journal of Surgical Education, 2020
Surgical education requires more than time and commitment; it is a period of a professional devel... more Surgical education requires more than time and commitment; it is a period of a professional development that relies on one's resilience and fortitude. While training programs makes substantial efforts to onboard learners and prepare them for the experiences to come, most are likely underutilizing one of the greatest resources available to learners: their personal communities. Every intern who enters residency brings with them the emotional bonds and benefits of family, friends, and/or other community members who may or may not understand the nature of surgical training and the professional journey ahead. In an effort to support our own learners and increase the awareness of resources available to them, we hosted an orientation for interns' friends and families. The programming allowed for residents and their personal supports to better understand residency culture, meet educational leadership, and discuss the experiences of more senior residents, faculty and their families over time. Additionally, some education was provided regarding the signs and symptoms of burnout and depression; our aim was to help residents' communities feel better able to recognize and respond to such symptoms. The preliminary feedback regarding the program is strong, encouraging its continued implementation. (J Surg Ed 000:1À3.
Journal of the American College of Surgeons, 2018
Journal of the American College of Surgeons, 2018
Families, systems & health : the journal of collaborative family healthcare, 2017
A team-based service delivery model was applied to provide patients with biopsychosocial care fol... more A team-based service delivery model was applied to provide patients with biopsychosocial care following hospital discharge to reduce hospital readmission. Most previous interventions focused on transitions of care occurred in the inpatient setting with attention to predischarge strategies. These interventions have not considered psychosocial stressors, and few have explored management in primary care settings. A 7-week team-based service delivery model was implemented in a family medicine practice emphasizing a biopsychosocial approach. A physician, psychologist, pharmacist, care managers, and interdisciplinary trainees worked with 17 patients following hospital discharge. This comprehensive evaluation assessed patients' mood, cognitive abilities, and self-management of health behaviors. Modifications were made to improve ease of access to outpatient care and to improve patient understanding of the therapeutic plan. This pilot study was conducted to determine the utility of the ...
Journal of women & aging, 2016
The transition from "wife" to "caregiver" for a cognitively impaired husband ... more The transition from "wife" to "caregiver" for a cognitively impaired husband can be an overwhelming experience. Communication patterns change and small conflicts can grow, at times bringing angry feelings and new burdens. Engagement with forgiveness processes may benefit wives by lowering resentment over past tensions, restoring trust, and enhancing the overall caregiving experience. This study examined the utility of the Enright Forgiveness Inventory (EFI) within a sample of caregiving wives. Our intent was to better understand this population's experience with forgiveness when other contextual factors were likely to influence this process. Forgiveness scores on the EFI were positively related to the cognitive status of the care recipient, a particularly important finding for clinical intervention, and inversely related to marital distress and state anxiety.
Primary care, 2017
The US population has a subset of those that are underserved who are in need of primary care and ... more The US population has a subset of those that are underserved who are in need of primary care and also suffer from mental health disorders. In this article, categories of underserved populations are described. Each section defines the population being presented, identifies the mental health problems each is likely to encounter, explores the barriers that prevent access to care, and identifies potential methods to minimize such barriers. The ways in which psychiatric issues vary in underserved settings compared with the general population are differentiated. Recommendations are offered for primary care physicians to support improved recognition and management of psychosocial stressors and psychiatric illness among the underserved.
Families, Systems, & Health, 2016
Comments on the article, &amp;amp;amp;amp;amp;amp;quot;Stimulating Reflective Practice Using ... more Comments on the article, &amp;amp;amp;amp;amp;amp;quot;Stimulating Reflective Practice Using Collaborative Reflective Training in Breaking Bad News Simulations,&amp;amp;amp;amp;amp;amp;quot; by Kim, Hernandez, Lavery, and Denmark (see record 2016-18380-001). Kim et al. are applauded for engaging and supporting the development of simulation-based education, and for their efforts to create an interprofessional learning environment. However, we hope further work on alternate methods of debriefing leverage the already inherent activation of learners that builds on previous experience, fosters reflection and builds skills. What is needed is the transference of learning theories into our educational research efforts that measure the effectiveness, validation, and reliability of behavior based performance change. The majority of breaking bad news (BBN) curricula limit program evaluations to reports of learner satisfaction, confidence and self-efficacy, rather than determining the successful translation of effective and humanistic interpersonal skills into long-term clinical practice (Rosenbaum et al., 2004). Research is needed to investigate how educational programs affect provider-patient-family interaction, and ultimately patient and family understanding, to better inform our teaching BBN skills. (PsycINFO Database Record
Journal of Religion, Spirituality & Aging, 2013
Limited research has explored the measurement of forgiveness among middle-aged and older wives. R... more Limited research has explored the measurement of forgiveness among middle-aged and older wives. Recall of past trangressions can lead to “damaging ruminations” that jeopardize one's spiritual peace (Callaby, Coleman, & Mills, 2012) and emotional well-being, making forgiveness more important. This online study examined the utility of the Enright Forgiveness Inventory (EFI) (Subkoviak et al., 1995) within a sample of 67 women. Participants completed the EFI, measures of religious coping, depression, anger, anxiety, and marital satisfaction. The EFI demonstrated sound psychometric properties. Forgiveness scores were inversely related to all constructs except religious coping, with which there was no significant relationship. Implications for future research are discussed.
Gerontology & Geriatrics Education, 2014
The accuracy of the Content should not be relied upon and should be independently verified with p... more The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms &
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Papers by Lauren DeCaporale-Ryan