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A qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in Lebanon

Background: Insufficient breastfeeding promotion and support by physicians contribute to suboptimal breastfeeding rates globally. Understanding setting-specific barriers against breastfeeding promotion and support from the perspective of medical students and addressing those that can be modified thr...

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Autores principales: Moukarzel, Sara, Mamas, Christoforos, Farhat, Antoine, Abi Abboud, Antoine, Daly, Alan J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034461/
https://www.ncbi.nlm.nih.gov/pubmed/32013806
http://dx.doi.org/10.1080/10872981.2020.1723950
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author Moukarzel, Sara
Mamas, Christoforos
Farhat, Antoine
Abi Abboud, Antoine
Daly, Alan J
author_facet Moukarzel, Sara
Mamas, Christoforos
Farhat, Antoine
Abi Abboud, Antoine
Daly, Alan J
author_sort Moukarzel, Sara
collection PubMed
description Background: Insufficient breastfeeding promotion and support by physicians contribute to suboptimal breastfeeding rates globally. Understanding setting-specific barriers against breastfeeding promotion and support from the perspective of medical students and addressing those that can be modified through undergraduate medical education may help improve learning outcomes, medical practice, and ultimately health outcomes associated with breastfeeding. Objectives: We selected the underserved and under-supported public medical school in Lebanon to explore psychosocial, institutional, and societal barriers hindering effective preventative medicine practices using breastfeeding promotion and support as an exemplar case. Methods: One-on-one semi-structured interviews, each lasting around 60 min, were conducted with medical interns (in Med III and Med IV) at their training hospitals. Interviews were voice-recorded, transcribed verbatim, coded, and analyzed thematically based on Theory of Planned Behavior. Results: Interns (n= 49; 96% response rate) completed the study. Five major themes emerged addressing barriers at various levels. At the health care system level at large, interns identified the predominant focus on pathophysiology and treatment rather than on disease prevention and health promotion as a barrier. At the level of trainees and their education experiences, interns reported limited and optional clerkship training in obstetrics/gynecology and in neonatology which contributes to their insufficient knowledge and low self-efficacy. Competing financial interests from infant formula companies and social pressures to promote infant formula were identified as two main barriers at the level of physicians and clinical practice. Conclusions: Our work using breastfeeding as an exemplary case highlights how undergraduate medical education and its learning outcomes and how medical practices and patient behavior are highly intertwined with psychosocial, institutional, and social drivers and constraints. Re-evaluating the success of undergraduate medical curricula in light of overcoming these constraints and not only based on meeting national accreditation and certification guidelines might prove helpful in improving medical education and ultimately clinical practice.
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spelling pubmed-70344612020-03-03 A qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in Lebanon Moukarzel, Sara Mamas, Christoforos Farhat, Antoine Abi Abboud, Antoine Daly, Alan J Med Educ Online Research Article Background: Insufficient breastfeeding promotion and support by physicians contribute to suboptimal breastfeeding rates globally. Understanding setting-specific barriers against breastfeeding promotion and support from the perspective of medical students and addressing those that can be modified through undergraduate medical education may help improve learning outcomes, medical practice, and ultimately health outcomes associated with breastfeeding. Objectives: We selected the underserved and under-supported public medical school in Lebanon to explore psychosocial, institutional, and societal barriers hindering effective preventative medicine practices using breastfeeding promotion and support as an exemplar case. Methods: One-on-one semi-structured interviews, each lasting around 60 min, were conducted with medical interns (in Med III and Med IV) at their training hospitals. Interviews were voice-recorded, transcribed verbatim, coded, and analyzed thematically based on Theory of Planned Behavior. Results: Interns (n= 49; 96% response rate) completed the study. Five major themes emerged addressing barriers at various levels. At the health care system level at large, interns identified the predominant focus on pathophysiology and treatment rather than on disease prevention and health promotion as a barrier. At the level of trainees and their education experiences, interns reported limited and optional clerkship training in obstetrics/gynecology and in neonatology which contributes to their insufficient knowledge and low self-efficacy. Competing financial interests from infant formula companies and social pressures to promote infant formula were identified as two main barriers at the level of physicians and clinical practice. Conclusions: Our work using breastfeeding as an exemplary case highlights how undergraduate medical education and its learning outcomes and how medical practices and patient behavior are highly intertwined with psychosocial, institutional, and social drivers and constraints. Re-evaluating the success of undergraduate medical curricula in light of overcoming these constraints and not only based on meeting national accreditation and certification guidelines might prove helpful in improving medical education and ultimately clinical practice. Taylor & Francis 2020-02-04 /pmc/articles/PMC7034461/ /pubmed/32013806 http://dx.doi.org/10.1080/10872981.2020.1723950 Text en © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Moukarzel, Sara
Mamas, Christoforos
Farhat, Antoine
Abi Abboud, Antoine
Daly, Alan J
A qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in Lebanon
title A qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in Lebanon
title_full A qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in Lebanon
title_fullStr A qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in Lebanon
title_full_unstemmed A qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in Lebanon
title_short A qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in Lebanon
title_sort qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in lebanon
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034461/
https://www.ncbi.nlm.nih.gov/pubmed/32013806
http://dx.doi.org/10.1080/10872981.2020.1723950
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