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Article ; Online: "I never should have been a doctor": a qualitative study of imposter phenomenon among internal medicine residents.

Chodoff, Alaina / Conyers, Lynae / Wright, Scott / Levine, Rachel

2023 Volume 23, Issue 1, Page(s) 57

Abstract: Introduction: Imposter phenomenon is common among medical trainees and may influence learning and professional development. The authors sought to describe imposter phenomenon among internal medicine residents.: Methods: In 2020, using emailed invites ...

Abstract	Introduction: Imposter phenomenon is common among medical trainees and may influence learning and professional development. The authors sought to describe imposter phenomenon among internal medicine residents. Methods: In 2020, using emailed invites we recruited a convenience sample of 28 internal medicine residents from a teaching hospital in Baltimore, Maryland to participate in an exploratory qualitative study. In one-on-one interviews, informants described experiences of imposter phenomenon during residency training. Using thematic analysis to identify meaningful segments of text, the authors developed a coding framework and iteratively identified and refined themes. Informants completed the Clance Imposter Phenomenon Scale. Results: Informants described feelings and thoughts related to imposter phenomenon, the contexts in which they developed and the impact on learning. Imposter phenomenon has profound effects on residents including: powerful and persistent feelings of inadequacy and habitual comparisons with others. Distinct contexts shaping imposter phenomenon included: changing roles with increasing responsibilities; constant scrutiny; and rigid medical hierarchy. Learning was impacted by inappropriate expectations, difficulty processing feedback, and mental energy diverted to impression management. Discussion: Internal medicine residents routinely experience imposter phenomenon; these feelings distort residents' sense of self confidence and competence and may impact learning. Modifiable aspects of the clinical learning environment exacerbate imposter phenomenon and thus can be acted upon to mitigate imposter phenomenon and promote learning among medical trainees.
MeSH term(s)	Humans ; Physicians ; Self Concept ; Anxiety Disorders ; Internship and Residency ; Internal Medicine/education
Language	English
Publishing date	2023-01-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-022-03982-8
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Article ; Online: “I never should have been a doctor”

Alaina Chodoff / Lynae Conyers / Scott Wright / Rachel Levine

BMC Medical Education, Vol 23, Iss 1, Pp 1-

a qualitative study of imposter phenomenon among internal medicine residents

2023 Volume 8

Abstract: Abstract Introduction Imposter phenomenon is common among medical trainees and may influence learning and professional development. The authors sought to describe imposter phenomenon among internal medicine residents. Methods In 2020, using emailed ... ...

Abstract	Abstract Introduction Imposter phenomenon is common among medical trainees and may influence learning and professional development. The authors sought to describe imposter phenomenon among internal medicine residents. Methods In 2020, using emailed invites we recruited a convenience sample of 28 internal medicine residents from a teaching hospital in Baltimore, Maryland to participate in an exploratory qualitative study. In one-on-one interviews, informants described experiences of imposter phenomenon during residency training. Using thematic analysis to identify meaningful segments of text, the authors developed a coding framework and iteratively identified and refined themes. Informants completed the Clance Imposter Phenomenon Scale. Results Informants described feelings and thoughts related to imposter phenomenon, the contexts in which they developed and the impact on learning. Imposter phenomenon has profound effects on residents including: powerful and persistent feelings of inadequacy and habitual comparisons with others. Distinct contexts shaping imposter phenomenon included: changing roles with increasing responsibilities; constant scrutiny; and rigid medical hierarchy. Learning was impacted by inappropriate expectations, difficulty processing feedback, and mental energy diverted to impression management. Discussion Internal medicine residents routinely experience imposter phenomenon; these feelings distort residents’ sense of self confidence and competence and may impact learning. Modifiable aspects of the clinical learning environment exacerbate imposter phenomenon and thus can be acted upon to mitigate imposter phenomenon and promote learning among medical trainees.
Keywords	Imposter phenomenon ; Medical trainees ; Medical education ; Learning environment ; Special aspects of education ; LC8-6691 ; Medicine ; R
Subject code	370
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Promoting positive physical activity behaviours in children undergoing acute cancer treatment: feasibility of the CanMOVE intervention.

Grimshaw, Sarah L / Taylor, Nicholas F / Conyers, Rachel / Shields, Nora

Brazilian journal of physical therapy

2023 Volume 28, Issue 1, Page(s) 100577

Abstract: Background: Supporting children and adolescents with cancer to be physically active can improve medium- and long-term health outcomes.: Objective: To assess the feasibility of CanMOVE, a 10-week complex, theoretically-informed, behaviour change ... ...

Abstract	Background: Supporting children and adolescents with cancer to be physically active can improve medium- and long-term health outcomes. Objective: To assess the feasibility of CanMOVE, a 10-week complex, theoretically-informed, behaviour change intervention to promote physical activity for children and adolescents undergoing acute cancer treatment. Methods: A feasibility study using a single-group, repeated measures, mixed methods design. Participants completed CanMOVE, which included provision of a Fitbit (child/adolescent and carer) and structured support from a physical therapist. Feasibility domains of demand, acceptability, implementation, practicality, limited efficacy, and integration were evaluated. Data sources included service level data, objective assessment of physical activity, physical function, and health-related quality of life; and qualitative data collected via semi-structured interviews with participants and focus groups with staff. Results: Twenty children/adolescents (median age 13yrs, interquartile-range 9-14) with a mix of cancer diagnoses, 20 parents, and 16 clinicians participated. There was high demand with 95% enrolment rate. CanMOVE was acceptable for participants. All feasibility thresholds set for implementation were met. Under practicality, there were no serious adverse events related to the intervention. Limited efficacy data indicated CanMOVE showed positive estimates of effect in influencing child/adolescent physical activity behaviour, physical function, and health-related quality of life. Positive impacts were also seen in parent and staff attitudes towards physical activity promotion. To improve integration into the clinical setting, it was suggested the duration and scope of CanMOVE could be expanded. Conclusion: CanMOVE was feasible to implement in a paediatric cancer setting. CanMOVE is appropriate to be tested in a large-scale trial.
MeSH term(s)	Child ; Adolescent ; Humans ; Quality of Life ; Feasibility Studies ; Exercise ; Focus Groups ; Motor Activity ; Neoplasms
Language	English
Publishing date	2023-12-14
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2252917-2
ISSN	1809-9246 ; 1809-9246
ISSN (online)	1809-9246
ISSN	1809-9246
DOI	10.1016/j.bjpt.2023.100577
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Article ; Online: Melatonin does not reduce delirium severity in hospitalized older adults: Results of a randomized placebo-controlled trial.

Lange, Peter W / Turbić, Alisa / Soh, Cheng Hwee / Clayton-Chubb, Daniel / Lim, Wen Kwang / Conyers, Rachel / Watson, Rosie / Maier, Andrea B

Journal of the American Geriatrics Society

2024

Abstract: Background: Delirium is common in older inpatients, causing distress, cognitive decline, and death. Current therapies are unsatisfactory, limited by lack of efficacy and adverse effects. There is an urgent need for effective delirium treatment. Sleep ... ...

Abstract	Background: Delirium is common in older inpatients, causing distress, cognitive decline, and death. Current therapies are unsatisfactory, limited by lack of efficacy and adverse effects. There is an urgent need for effective delirium treatment. Sleep wake cycle is disturbed in delirium; endogenous Melatonin is perturbed, and exogenous Melatonin is a safe and effective medication for sleep disorders. This study aims to determine the effect of oral Melatonin 5 mg immediate release (IR) nightly for five nights on the severity of delirium in older (≥65 years) medical inpatients. Methods: This was a double-blinded, randomized controlled trial in general internal medicine units of a tertiary teaching hospital. Older inpatients with Confusion Assessment Method positive, hyperactive or mixed delirium within 48 h of admission or onset of in-hospital delirium were included. The primary outcome was change in delirium severity measured with the Memorial Delirium Assessment Scale (MDAS). A previous pilot trial showed 120 participants randomized 1:1 to Melatonin or Placebo would provide 90% power to demonstrate a 3-point reduction in the MDAS. Results: One hundred and twenty participants were randomized, 61 to Melatonin 5 mg and 59 to Placebo. The medication was well tolerated. The mean MDAS improvement was 4.9 (SD 7.6) in the Melatonin group and 5.4 (SD 7.2) in the Placebo group, p-value 0.42, a non-significant difference. A post-hoc analysis showed length of stay (LOS) was shorter in the intervention group (median 9 days [Interquartile Range (IQR) 4, 12] vs. Placebo group 10 [IQR 6, 16] p-value = 0.033, Wilcoxon Rank Sum test). Conclusions: This trial does not support the hypothesis that Melatonin reduces the severity of delirium. This may be due to no effect of Melatonin, a smaller effect than anticipated, an effect not captured on a multidimensional delirium assessment scale, or a type II statistical error. Melatonin may improve LOS; this hypothesis should be studied.
Language	English
Publishing date	2024-03-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.18825
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Article: Promoting positive physical activity behaviors for children and adolescents undergoing acute cancer treatment: Development of the CanMOVE intervention using the Behavior Change Wheel.

Grimshaw, Sarah L / Taylor, Nicholas F / Conyers, Rachel / Shields, Nora

Frontiers in pediatrics

2022 Volume 10, Page(s) 980890

Abstract: Background: Increasing participation in physical activity has the potential to improve outcomes for children and adolescents with cancer during treatment and into survivorship. The aim of this study is to outline the theoretical process behind ... ...

Abstract	Background: Increasing participation in physical activity has the potential to improve outcomes for children and adolescents with cancer during treatment and into survivorship. The aim of this study is to outline the theoretical process behind development of CanMOVE, a behavior change intervention designed to increase physical activity for children and adolescents with cancer. Study design: This study followed a theoretical design process consistent with the Behavior Change Wheel to inform the design of a complex intervention. Materials and methods: The three stages of the Behavior Change Wheel intervention design process include: (1) understanding physical activity behavior within the pediatric cancer setting, (2) identifying potential intervention functions, and (3) identifying appropriate behavior change and implementation strategies. Qualitative and behavior change literature relevant to the pediatric cancer treatment setting were used to inform each stage. Results: An individualized and flexible approach to physical activity promotion that considers intrinsic factors specific to the child/adolescent and their environment is required. Fifteen behavioral change strategies were identified to form the intervention components of CanMOVE. Implementation strategies were identified to build motivation, opportunity and capacity toward increasing physical activity behaviors. Key intervention components of CanMOVE include standardized assessment and monitoring (physical activity, physical function, and health-related quality of life), provision of an activity monitor to both child/adolescent and parent, and one-on-one capacity building sessions with a healthcare professional. Capacity building sessions include education, goal setting, an active supervised physical activity session, barrier identification and problem solving, and action planning. Conclusion: CanMOVE is a novel approach to physical activity promotion in the pediatric cancer treatment setting. The use of a theoretical intervention design process will aid evaluation and replication of CanMOVE when it is assessed for feasibility in a clinical setting. The design process utilized here can be used as a guide for future intervention development.
Language	English
Publishing date	2022-10-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2022.980890
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Article ; Online: A systematic review of knowledge, attitude and practice of pharmacogenomics in pediatric oncology patients.

Moore, Claire / Lazarakis, Smaro / Stenta, Tayla / Alexander, Marliese / Nguyen, Rachel Phan / Elliott, David A / Conyers, Rachel

Pharmacology research & perspectives

2023 Volume 11, Issue 6, Page(s) e01150

Abstract: Pharmacogenomics remains underutilized in clinical practice, despite the existence of internationally recognized, evidence-based guidelines. This systematic review aims to understand enablers and barriers to pharmacogenomics implementation in pediatric ... ...

Abstract	Pharmacogenomics remains underutilized in clinical practice, despite the existence of internationally recognized, evidence-based guidelines. This systematic review aims to understand enablers and barriers to pharmacogenomics implementation in pediatric oncology by assessing the knowledge, attitudes, and practice of healthcare professionals and consumers. Medline, Embase, Emcare, and PsycINFO database searches identified 146 relevant studies of which only three met the inclusion criteria. These studies reveal that consumers were concerned with pharmacogenomic test costs, insurance discrimination, data sharing, and privacy. Healthcare professionals possessed mostly positive attitudes toward pharmacogenomic testing yet identified lack of experience and training as barriers to implementation. Education emerged as the key enabler, reported in all three studies and both healthcare professionals and consumer groups. However, despite the need for education, no studies utilizing a pediatric oncology consumer or healthcare professional group have reported on the implementation or analysis of a pharmacogenomic education program in pediatric oncology. Increased access to guidelines, expert collaborations and additional guidance interpreting results were further enablers established by healthcare professionals. The themes identified mirror those reported in broader pediatric genetic testing literature. As only a small number of studies met inclusion criteria for this review, further research is warranted to elicit implementation determinants and advance pediatric pharmacogenomics.
MeSH term(s)	Humans ; Child ; Pharmacogenetics ; Health Knowledge, Attitudes, Practice ; Health Personnel/education ; Medical Oncology ; Neoplasms/drug therapy ; Neoplasms/genetics
Language	English
Publishing date	2023-11-27
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	2740389-0
ISSN	2052-1707 ; 2052-1707
ISSN (online)	2052-1707
ISSN	2052-1707
DOI	10.1002/prp2.1150
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Article ; Online: Pediatric Anthracycline-Induced Cardiotoxicity: Mechanisms, Pharmacogenomics, and Pluripotent Stem-Cell Modeling.

Tripaydonis, Anne / Conyers, Rachel / Elliott, David A

Clinical pharmacology and therapeutics

2019 Volume 105, Issue 3, Page(s) 614–624

Abstract: Anthracycline-induced cardiotoxicity (ACT) is a severe adverse drug reaction for a subset of children treated with anthracyclines as part of chemotherapy protocols. The identification of genetic markers associated with increased ACT susceptibility has ... ...

Abstract	Anthracycline-induced cardiotoxicity (ACT) is a severe adverse drug reaction for a subset of children treated with anthracyclines as part of chemotherapy protocols. The identification of genetic markers associated with increased ACT susceptibility has clinical significance toward improving patient care and our understanding of the molecular mechanisms involved in ACT. Human-induced pluripotent stem cell-derived cardiomyocytes represent a novel approach to determine the pharmacogenomics of ACT and guide the development of genetic screening tests.
MeSH term(s)	Anthracyclines/adverse effects ; Anthracyclines/chemistry ; Antibiotics, Antineoplastic/adverse effects ; Antibiotics, Antineoplastic/chemistry ; Cardiotoxins/adverse effects ; Cardiotoxins/chemistry ; Child ; Humans ; Induced Pluripotent Stem Cells/drug effects ; Induced Pluripotent Stem Cells/metabolism ; Myocytes, Cardiac/drug effects ; Myocytes, Cardiac/metabolism ; Pharmacogenetics/trends
Chemical Substances	Anthracyclines ; Antibiotics, Antineoplastic ; Cardiotoxins
Language	English
Publishing date	2019-01-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	123793-7
ISSN	1532-6535 ; 0009-9236
ISSN (online)	1532-6535
ISSN	0009-9236
DOI	10.1002/cpt.1311
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Article ; Online: Successful second bone marrow transplantation in a Wiskott-Aldrich syndrome patient with systemic vasculitis.

Conyers, Rachel K / Cole, Theresa S

The Journal of allergy and clinical immunology

2016 Volume 137, Issue 5, Page(s) 1615–1616

MeSH term(s)	Adolescent ; Bone Marrow Transplantation ; Humans ; Male ; Systemic Vasculitis/etiology ; Systemic Vasculitis/therapy ; Wiskott-Aldrich Syndrome/complications ; Wiskott-Aldrich Syndrome/therapy
Language	English
Publishing date	2016
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	121011-7
ISSN	1097-6825 ; 1085-8725 ; 0091-6749
ISSN (online)	1097-6825 ; 1085-8725
ISSN	0091-6749
DOI	10.1016/j.jaci.2015.11.008
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Article ; Online: Integrating CardioOncology Across the Research Pipeline, Policy, and Practice in Australia-An Australian Cardiovascular Alliance Perspective.

Singleton, Anna C / Redfern, Julie / Diaz, Abbey / Koczwara, Bogda / Nicholls, Stephen J / Negishi, Kazuaki / La Gerche, Andre / Playford, David / Conyers, Rachel / Cehic, Daniel A / Garvey, Gail / Williams, Trent D / Hunt, Lee / Doyle, Kerry / Figtree, Gemma A / Ngo, Doan T M / Sverdlov, Aaron L

Heart, lung & circulation

2024

Abstract: Over 18 million people worldwide were diagnosed with cancer in 2020, including over 150,000 people in Australia. Although improved early detection and treatment have increased the survival rates, cardiotoxic treatment and inadequate management of ... ...

Abstract	Over 18 million people worldwide were diagnosed with cancer in 2020, including over 150,000 people in Australia. Although improved early detection and treatment have increased the survival rates, cardiotoxic treatment and inadequate management of cardiovascular risk factors have resulted in cardiovascular disease (CVD) being one of the leading causes of non-cancer-related death and disability among cancer survivors. International guidelines outline the standards of care for CVD risk surveillance and management. However, Australian cardio-oncology policies and clinical guidelines are limited. There is increasing growth of cardio-oncology research in Australia and support from leading Australian professional bodies and advocacy and research networks, including the Cardiac Society of Australia and New Zealand, the Clinical Oncology Society of Australia, the National Heart Foundation of Australia, and the Australian Cardiovascular Alliance (ACvA). Thus, opportunities to drive multidisciplinary cardio-oncology initiatives are growing, including grant funding, position statements, and novel research to inform new policies. The ACvA has a unique flagship structure that spans the translational research pipeline from drug discovery to implementation science. This article aims to highlight how multidisciplinary cardio-oncology innovations could intersect with the seven ACvA flagships, and to showcase Australian achievements in cardio-oncology thus far. We summarise eight key priority areas for future cardio-oncology research that emerged. These strategies will strengthen cardio-oncology research and care in Australia, and drive new guidelines, policies, and government initiatives to ensure equity in health outcomes for all cardio-oncology patients.
Language	English
Publishing date	2024-02-08
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2020980-0
ISSN	1444-2892 ; 1443-9506
ISSN (online)	1444-2892
ISSN	1443-9506
DOI	10.1016/j.hlc.2024.01.011
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Article ; Online: Optimal Detection of Cardiac Sequelae: The Need for Rigorous, Harmonized Magnetic Resonance Studies in Pediatric Survivors.

Toro, Claudia / Elliott, David A / La Gerche, Andre / Lange, Peter W / Bsc, Francesca Bolk / O'Sullivan, Michael / Bhatia, Kanika / Conyers, Rachel

JACC. CardioOncology

2021 Volume 3, Issue 1, Page(s) 154–156

Language	English
Publishing date	2021-03-16
Publishing country	United States
Document type	Editorial
ISSN	2666-0873
ISSN (online)	2666-0873
DOI	10.1016/j.jaccao.2021.01.010
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