Browsing by Author "Hemming, Patrick"

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    A Gay Couple Meets Their Mormon Doctor
    (Journal of General Internal Medicine, 2017-04) Hemming, Patrick
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    Being a Generalist and Donor Advocate: Seeing Both Sides of Transplantation
    (SGIM Forum, 2018-03-01) Hemming, Patrick
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    Chaplains on the Medical Team: A Qualitative Analysis of an Interprofessional Curriculum for Internal Medicine Residents and Chaplain Interns
    (Journal of Religion and Health, 2016-04) Hemming, Patrick; Teague, Paula J; Crowe, Thomas; Levine, Rachel
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    Demystifying Spiritual Care: An Interprofessional Approach for Teaching Residents and Hospital Chaplains to Work Together
    (Journal of Graduate Medical Education, 2016-07) Hemming, Patrick; Teague, Paula; Crowe, Ty; Levine, RB
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    Identifying core curricular components for behavioral health training in internal medicine residency: Qualitative interviews with residents, faculty, and behavioral health clinicians.
    (International journal of psychiatry in medicine, 2019-05) Hemming, Patrick; Revels, Jessica A; Tran, Anh N; Greenblatt, Lawrence H; Steinhauser, Karen E

    Objective

    Behavioral health services frequently delivered by primary care providers include care for mental health and substance abuse disorders and assistance with behavioral risk factor reduction. Internal medicine residencies in the United States lack formal expectations regarding training in behavioral health for residents. This qualitative study aimed to determine learners' and teachers' perceptions about appropriate behavioral health curricular components for internal medicine residents.

    Method

    Focus groups and interviews were conducted with the following individuals from the Duke Outpatient Clinic: residents with continuity practice (n = 27), advanced practice providers (n = 2), internal medicine attending physicians (n = 4), internal medicine/psychiatry attending physicians (n = 2), and behavioral health clinicians (n = 4). A focus group leader asked regarding residents' successes and challenges in managing behavioral health issues and about specific learning components considered necessary to understand and manage these behavioral health conditions. Transcripts were coded using an editing analysis style to identify central themes and concordance/discordance between groups.

    Results

    Regarding mental health management (Theme 1), residents emphasized a need for better care coordination with specialty mental health, while attendings and behavioral health clinicians gave priority to residents' skills in primary management of mental health. Residents, attendings, and behavioral health clinicians all emphasized advanced interviewing skills (Theme 2) with subthemes: eliciting the patient's perspective, managing time in encounters, improving patients' understanding, and patient counseling.

    Conclusions

    Internal medicine residents, attendings, and behavioral health clinicians may differ significantly in their perceptions of primary care's role in mental health care. Future internal medicine behavioral health curricula should specifically address these attitudinal differences. Curricula should also emphasize interview skills training as an essential component of behavioral health learning.
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    Internal Medicine Resident Barriers to Advance Care Planning in the Primary Care Continuity Clinic
    (American Journal of Hospice and Palliative Medicine, 2023-01-01) Dussault, Nicole; Nickolopoulos, Elissa; Henderson, Katherine; Hemming, Patrick; Cho, Alex; Ma, Jessica E
    Background: While primary care providers regularly engage in Advance Care Planning (ACP) conversations, it is not well known what challenges resident physicians face to achieving this core competency. Objectives: We aimed to assess resident perceptions of barriers and potential interventions to outpatient ACP. Methods: We distributed an electronic survey to Internal Medicine and Medicine-Psychiatry residents at our institution in 2022. Questions addressed outpatient ACP barriers and potential interventions in several domains: structural issues, personal knowledge, and communication skills. We reported results using descriptive statistics and Wilcoxon rank-sum tests, comparing responses by residency year (interns vs upperyears). Likert-scale responses were dichotomized to a “not at all or slightly” vs “moderate or extreme” barrier or helpful intervention. Results: Of 149 residents, 71 completed the survey (48%). Highest scoring barriers were structural, including 1) lack of clinic time (99%), 2) need to prioritize other medical problems (94%), and 3) lack of patient continuity (62%). Highest scoring interventions included the ability to schedule dedicated ACP visits with themselves (96%) or another clinician (82%). Interns were statistically significantly less confident in their ability to conduct ACP, and more likely to report lack of knowledge (i.e., not understanding ACP, patient prognosis, or how to complete paperwork, P <.05). Conclusions: Residents report significant structural barriers to outpatient ACP, including limitations in time, continuity, and competing medical priorities, that may warrant greater program attention to interventions such as clinic schedules and work-flow. Additional trainings may be most beneficial if targeted to the beginning of intern year.
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    Patients', Staff, and Providers' Factual Knowledge About Hospital Chaplains and Association with Desire for Chaplain Services.
    (Journal of general internal medicine, 2021-01-22) Stavig, Alissa; Bowlby, Lynn A; Oliver, John P; Henderson, Katherine K; Dillard, Jan; Nickolopoulos, Elissa; Hemming, Patrick
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    Recognizing and Managing Geriatric Depression: A Two-Part Self-Learning Module Set
    (MedEdPORTAL Publications, 2017) Lehmann, Susan W; Hemming, Patrick; Rios, Rebeca; Meriden, Zina
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    Risks, Benefits, and Recommendations for Pastoral Care on Inpatient Psychiatric Units
    (Journal of Psychiatric Practice, 2016-09) Pennybaker, Steven; Hemming, Patrick; Roy, Durga; Anton, Blair; Chisolm, Margaret S