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...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2020-01-01
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| Series: | Medical Education Online |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/10872981.2020.1723950 |
| _version_ | 1798015876030529536 |
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| author | Sara Moukarzel Christoforos Mamas Antoine Farhat Antoine Abi Abboud Alan J Daly |
| author_facet | Sara Moukarzel Christoforos Mamas Antoine Farhat Antoine Abi Abboud Alan J Daly |
| author_sort | Sara Moukarzel |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-11T15:40:40Z |
| format | Article |
| id | doaj.art-b88f726e42744fb4ba9c7197e166713d |
| institution | Directory Open Access Journal |
| issn | 1087-2981 |
| language | English |
| last_indexed | 2024-04-11T15:40:40Z |
| publishDate | 2020-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Medical Education Online |
| spelling | doaj.art-b88f726e42744fb4ba9c7197e166713d2022-12-22T04:15:49ZengTaylor & Francis GroupMedical Education Online1087-29812020-01-0125110.1080/10872981.2020.17239501723950A qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in LebanonSara Moukarzel0Christoforos Mamas1Antoine Farhat2Antoine Abi Abboud3Alan J Daly4University of California San DiegoUniversity of California San DiegoNotre Dame UniversityLebanese UniversityUniversity of California San DiegoBackground: 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.http://dx.doi.org/10.1080/10872981.2020.1723950breastfeedingmedical educationpreventative medicineclinical trainingbarriersphysicianstheory of planned behaviorlebanon |
| spellingShingle | Sara Moukarzel Christoforos Mamas Antoine Farhat Antoine Abi Abboud Alan J Daly A qualitative examination of barriers against effective medical education and practices related to breastfeeding promotion and support in Lebanon Medical Education Online breastfeeding medical education preventative medicine clinical training barriers physicians theory of planned behavior 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 | breastfeeding medical education preventative medicine clinical training barriers physicians theory of planned behavior lebanon |
| url | http://dx.doi.org/10.1080/10872981.2020.1723950 |
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