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Cardiac Rehabilitation Knowledge & Attitudes of Cardiology Fellows

Kellar, Garrett (2019) Cardiac Rehabilitation Knowledge & Attitudes of Cardiology Fellows. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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In the United States, cardiac rehabilitation (CR) is vastly underutilized with only 19-34% of eligible patients participate. Lack of physician endorsement and referral to CR is a significant modifiable barrier that often stems from lack of CR knowledge. Studies show that physicians, of varying specialties, lack the necessary knowledge of CR and referral processes significantly limiting their endorsement but none have isolated cardiology fellows. Cardiology fellows spend a significant amount of time treating eligible patients, making them critically important to increasing participation at teaching hospitals where referral is lowest. University of Pittsburgh Department of Medicine (DOM) Cardiology Fellows were surveyed and interviewed to assess cardiology fellows’ knowledge (what they know about CR) and attitudes (what they think about CR), and their perceived facilitators and barriers to CR endorsement and referral. The fellows had low knowledge scores regarding eligibility, benefits and what CR entails. In regards to attitudes, the fellows believe in the benefits of CR, local CR programs and cost-effectiveness. Furthermore, fellows state they do not refer patients to CR because they forget or are unaware how to refer. Barriers to endorsement and referral included: logistics of CR operations, limited communication, limited time with patients, presumed patient barriers, intrinsic fellow barriers, understanding referral processes, and multiple hospital rotations. Facilitators to endorsement and referral included: evidence-based outcomes, patient-centered outcomes, ease of access to order-sets, and reminders. The findings of this study present in-depth thought processes regarding lack of CR knowledge, and barriers to CR endorsement and referral that were previously unknown in cardiology fellows. Addressing these specific barriers through fellowship education programming may increase endorsement and referrals. Additionally, targeting the specific thought processes that lead to these perceived fellow barriers could ultimately lead to improved CR participation.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Kellar, Garrettggk3@pitt.eduggk3
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairFertman,
Committee MemberFredrick,
Committee MemberHickey,
Date: 25 September 2019
Date Type: Publication
Defense Date: 29 April 2019
Approval Date: 25 September 2019
Submission Date: 17 June 2019
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 66
Institution: University of Pittsburgh
Schools and Programs: School of Education > Health and Physical Activity
Degree: EdD - Doctor of Education
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: cardiac rehabilitation, cardiology fellows
Date Deposited: 25 Sep 2019 14:43
Last Modified: 25 Sep 2019 14:43


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