1.The typology of physicians according to perspectives on telemedicine during and beyond the COVID-19 pandemic
Marcellus Francis L. Ramirez ; Maria Minerva P. Calimag
Journal of Medicine University of Santo Tomas 2023;7(1):1090-1111
Introduction:
The coronavirus (CoVid-19) pandemic brought about a massive impact to the healthcare system, including disruption of patient follow-ups and consultations. Subsequently, an increase in physicians’ use of telemedicine was seen. While this technology has been documented to improve delivery of care, it has encountered varied acceptance among physicians. Gaps in specific national legislation, lack of established rules and accreditation standards, and ethical/legal implications add to the concerns. Anchored on the Unified Theory of Acceptance and Use of Technology model, this study aimed to segment physicians according to their perspectives regarding telemedicine during the pandemic.
Methods
A mixed methods sequential explanatory design using Q-methodology was applied to identify distinct patterns and perceptions of physicians on the use of telemedicine during the pandemic. A Q-sample of 25 statements on perceptions of telemedicine was developed through literature review, and 24 physicians were purposively selected. Participants were instructed to sort statements into a distribution grid according to their degree of agreement/disagreement. Post-sorting interview was conducted to expound on their response. Data were analyzed using by-person factor analysis through the PQMethod software version 2.35.
Telemedicine
;
Physicians
;
Pandemic
;
COVID-19
2.'When all think alike, then no one is thinking': Understanding the praxis of creative insubordination as a decision-making strategy in Philippine medical schools.
Maria Minerva P. CALIMAG ; Allan B DE GUZMAN
Journal of Medicine University of Santo Tomas 2022;6(1):916-926
<p style="text-align: justify;">Background: Exercising discretion is vital when making decisions. While decision-making implies having to choose between predefined alternatives, discretion requires sifting through several solutions and critically choosing the desired one that implies a choice between many alternatives without rigid guidelines pointing to one direction or the other. While previous studies have constantly investigated the nature and dynamics of creative insubordination or discretionary insubordination in primary and secondary education little is known as to how such a construct operates in higher education.p><p style="text-align: justify;">Purpose: This study was undertaken to address the central question: "What attributes define creative insubordination as a decision-making strategy among Philippine medical school deans?"p><p style="text-align: justify;">Design: Anchored on descriptive phenomenology, 21 medical deans who have been in the position for at least 4.5 years (range 4.5-26 years) were purposively selected for in-depth semi-structured interviews. Guided by the rules of cool and warm analyses, transcribed texts were phenomenologically reduced and interpreted, and validated via member checking procedure.p><p style="text-align: justify;">Findings: Five interesting elements that typify the modes of behavior in the practice of creative insubordination surfaced, namely: cognitional elasticity, emotional sensitivity, conational sincerity, relational mobility and axiological reflectivity.p><p style="text-align: justify;">Conclusion: This study provides eidetic images of the multidimensional facets of individual attributes necessary for the praxis of discretionary decision-making by a select group of Philippine medical deans in varied instances.p>
3.Betwixt and between: Exploring the liminal space of the 'first generation' Filipino physician through the lens of the rites of passage.
Lawrence George P. GARCIA ; Maria Minerva P. CALIMAG ; Alejandro C. BAROQUE ; Ma. Lourdes P. CORRALES-JOSON
Journal of Medicine University of Santo Tomas 2021;5(1):564-571
<p style="text-align: justify;">Introduction: The 'first generation' physician gathers a lot of strength to venture into a world unknown to him. Unlike a physician born to a family of physicians who has a family to guide him, the 'first generation' physician only has himself to survive this endeavor. Through the life worlds of a select group of 'first generation' physician-in-training, this study seeks to answer the following central question: How do 'first generation' Filipino physicians collectively characterize their liminal spaces in transition from medical school to clinical practice?p><p style="text-align: justify;">Methodology: Anchored on the Theory of the Rites of Passage, this phenomenological inquiry, intends to surface the lebenswelt or essence of the experience of being the only physician in the family. Respondents comprised a purposive sample of physicians-in-training (residents and fellows), who are the only physicians in the family. Data were gathered using semi-structured interviews. Triangulation and member checking procedures were done to ensure the data reliability. Data were then subjected to cool (categorization) and warm analysis (thematization) using the Colaizzi's method.p><p style="text-align: justify;">Findings and Discussion: With all the transcribed experiences summarized and those with the same meaning analyzed, the following categories and themes were generated: The Intending Facet / Purpose: From Uncertainty towards Redefinition; The Thinking Facet / Process: From Perplexity towards Self-efficacy; The Relating Facet / People: From Isolation towards Integration; and The Transforming Facet / Power: From Vulnerability towards Empowerment. It was shown that a 'first generation' physician in this liminal space undergoes challenges and struggles during his training in medicine. This served as his Rite of Passage to transition him to someone dreaming only to become a physician, to become redefined with conviction, supported and integrated into the health system, empowered and transformed to the physician he is meant to be.p><p style="text-align: justify;">Recommendations: Physicians undergo a lot of challenges and mental stress and it means a lot for trainers to enter into the trainees' life-world, especially that of a 'first generation' physician, so that they can build socio-emotional learning and mentoring programs and counselling services that address different facets of liminal space that the trainees go through.p>
Physicians
4.Surfacing anger and anxiety in graduate research writing: A prose poetic journey.
Journal of Medicine University of Santo Tomas 2021;5(2):675-686
<p style="text-align: justify;">Research writing evokes feelings of anger and anxiety even among graduate students. Feelings are an inseparable part of the human lived experience and are important to learning and decision making. Research anxiety is powerful but not impossible to overcome. Various affective, cognitive, linguistic, and pedagogical mitigating strategies can be employed. By simply acknowledging its existence, we lead our students in the direction of doing just that... towards a transformational mindset to overcome research anxiety. Written qualitatively in the hermeneutic strand, this paper explores the lived experience and collective portrayals of the phenomenon of graduate research writing anxiety using prose poetry. The main forms of poetry qualitative researchers create vary from data poems or transcription poems, research poems, and autoethnographic poetry. Autoethnographic poetry is created by the author through self-reflection and writing to explore anecdotal and personal experiences and connect this autobiographical story to wider cultural, political, and social meanings and understandings. In this paper, the author writes from an emic perspective utilizing intertextual chaining to create an autoethnographic research prose poetry. The paper describes in rich detail, the dominant feelings about research writing anxiety and anger that surfaced from participants' narratives of their shared experience of research writing anxiety. Prose poetry is written in paragraphs rather than verse but contains the elements of poetry, such as poetic meter, language play, and a focus on images rather than narrative, plot, and character.p>
Hermeneutics
5.The C.O.P.E. typology of coping with stressors at sea among Filipino merchant marine ratings: A Q methodology study.
Clarissa M. MENDOZA ; Maria Minerva P. CALIMAG ; Susannah O. SALVADOR
Journal of Medicine University of Santo Tomas 2021;5(2):727-731
<p style="text-align: justify;">Background: The seafarers' poor mental health has been associated with significant morbidity, inefficiency, and accidents on board. Mental and physical health is largely dependent on the way seafarers handle stressors.
Anchored on the Transactional Model of Stress and Coping, this study aimed to identify the typology of Filipino merchant marine ratings according to their coping strategies to stressors on board vessels.p><p style="text-align: justify;">Methods: Thirty-seven (37) Filipino merchant marine ratings participated in this study. They were chosen by purposive sampling. They rank-ordered 25 opinion statements on various stressors and coping mechanisms. The rank-ordered sorts were subjected to by-person factor analysis with Varimax rotation using the PQ Method version 2.32. The resulting factors were interpreted using the inductive approach, aided by the interview done after Q sorting.p><p style="text-align: justify;">Results: Four factors were generated: solution-focused seafarers, stressor-focused seafarers, self-management- focused seafarers, and the social milieu-focused seafarers. There is a consensus on the supplication-focused seafarers who ask for God's help in times of stress.p><p style="text-align: justify;">Conclusion: The generated typology provides a better understanding of seafarers' outlook on stress and coping and may help the stakeholders craft individualized strategies to help improve their coping mechanisms and overall mental health. Occupational health research must continue to focus on understanding the role of culture and adaptation on stress and coping behaviors to retain quality seafarers and promote a healthier workplace.p>
Mental Health
6.We got to move it, move it: The lived experiences of family carers of youth with chronic neurodevelopmental disorders as they enter into adult health care
Michelle G SY ; Maria Minerva P CALIMAG ; Rosalina Q DE SAGUN ; Maria Antonia Aurora M VALENCIA
Journal of Medicine University of Santo Tomas 2020;4(2):486-499
Background and objective :
Neurodevelopmental
disabilities in adolescents have signifi cant effects on
medical and social function. One of these challenges
is their transition into adult care. Parental involvement
is critical because these young adults may have more
diffi culties in making informed decisions independently. Thus, the transition process involves not only the
direct health care needs of the young adult, but the
needs and concerns of the parents or carers who are
instrumental in guiding that process. This study aims
to explore the expectations and experiences of family carers of youths with chronic neurodevelopmental
disorders who have undergone or are about to undergo transition into adult healthcare in a Filipino-based
health care system.
Methods:
A descriptive phenomenology was used to
gain an in-depth understanding of parents’ perceptions
and experiences of their youths’ transition process from
a pediatric to an adult health care setting. The results
were analyzed manually using Colaizzi’s method, which
involves integrating both the destructured and restructured analysis principles of phenomenology. Purposive
sampling was used to interview 13 family carers of 13
youths with various neurodevelopmental disorders using a semi-structured interview questionnaire.
Results :
Despite the lack of information on the transition process, our study found that carers did not have
a strong inclination to resist the transition event. Most
of the carers treat the health care provider as a major
decision maker in determining the timing and manner
of transition, adopting a “doctor knows best” attitude.
Several other hindrances and facilitators to successful
transition were also identifi ed and are similar to the
current literature.
Conclusion
This study provides a greater understanding of carers’ perceptions and experiences of
transition care for youths with neurodevelopmental
disorders in the local setting. They exhibited trust and confi dence in the medical profession as a whole, and
had a “doctor knows best” attitude that may enable
successful transitioning.
Transitional Care
;
Neurology
;
Neurodevelopmental Disorders
;
Caregivers
7.Life on a tightrope: An interpretive phenomenological analysis of narratives of coping with academic stress among Filipino medical students
Elizabeth Aileen GARAN-GILLER ; Dominico Carlo S DATOR ; Mart Blas Angelo P JUAN ; Genevieve Anne R QUERUBIN ; Tiphanie P SEVILLA ; Maria Minerva P CALIMAG
Journal of Medicine University of Santo Tomas 2019;3(1):248-259
Background:
Life in a medical school is stressful
for just about every medical student. Academic stress
in small doses heightens the energy and awareness,
giving one that mood most refer to as “pumped up”
or “wired”. When the incremental progression of
stress brought about by health and emotional factors
compounded by social and fi nancial problems, overwhelmingly surpasses one’s ability to cope, it leads
to feelings of being “burnt out” or “stressed out”. It
can have a negative impact on a medical student’s
cognitive and psychological functioning resulting in poor academic performance. Each person has his
or her own unique way of dealing with it; some may
outwit pressure without a bad outcome, while others
just simply succumb to it.
Purpose:
A vast majority of research on academic
stress is centered on its contributing factors and how
they affect other aspects of students’ lives. Coping
mechanisms and effective ways in dealing with stress
have also been delved into, but none have dwelt on
a study of the medical students’ lived experience of
academic stress. There was no study found in literature which examined and collectively characterized
the different phases that medical students go through
in coping with academic stress, hence the impetus to
undertake this study. Anchored on the Transactional
Model of coping with stress, this study was undertaken
to answer the central question: How do Filipino medical students collectively characterize the phases they
undergo in coping with the stresses in medical school?
Design:
The methodological underpinnings of this
study are based on phenomenology. The objective of Interpretive Phenomenological Analysis (IPA) is to
understand how a particular phenomenon is constituted from the participant’s perspective. It offers researchers the opportunity to learn from the insights
of experts – the research participants themselves.
The respondents’ insights were gathered through
narratives culled through a guided semi-structured
questionnaire patterned after social networking
sites, allowing the respondents to liberally exploit
their voices and thoughts. Narrative accounts gathered focused on the medical student’s daily activities, matters that precipitate anxiety, their views on
stress, and methods of coping. Through cool and
warm analyses, the narratives were ultimately subjected to phenomenological reduction.
Findings :
Fascinatingly, after subjecting the narratives to a thorough and comprehensive phenomenological analysis, six emergent themes surfaced
which collectively characterized the phases our respondent medical students underwent in coping with
academic stress: Self-effacement Phase (Sensing inner trepidation), Self-awareness Phase (Settling in
new surroundings), Self-weariness Phase (Struggling
through stress) Self-attentiveness Phase (Staying focused to survive), Self-equilibrium Phase (Sustaining
a state of symmetry), and Self-mastery Phase
(Striving towards sovereignty and satisfaction). The
“Tightrope” is a representation that lucidly embodies
these six themes.
Conclusion
Our respondents have experienced
substantial challenges in medicine: they surmounted
their inner trepidation; settled and acclimatized to
their new surroundings; gained the courage to outwit stress and struggles; fought to strive, survive and
stay focused; learned to maintain a state of balance
and symmetry; and fi nally lived up to a sense of
sovereignty and self-satisfaction. It is just a matter
of perspective and attitude that demarcates a victor
from a slacker.
Students, Medical
8.‘I am who I am’: A phenomenology of strategic roles portrayed by creatively insubordinate Filipino medical academic leaders
Maria Minerva P CALIMAG ; Allan B DE GUZMAN
Journal of Medicine University of Santo Tomas 2018;2(1):224-236
Background
Organizational life is a drama in
which all are actors playing different roles, hence it
is made relevant by its contextually-embedded focus
on role enactment.
Philippines


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