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Nowicki KD, Balboni IM, Cidon MJ, Dhanrajani AD, Driest KD, Fair DC, Imundo LF, Mehta JJ, Tarvin SE, Walters HM, Woolnough LC, Edgar LC, Curran ML. Assessing Pediatric Rheumatology Fellow Competence in the Milestone Era: Past, Present, and Future. Arthritis Care Res (Hoboken) 2024; 76:600-607. [PMID: 38108087 DOI: 10.1002/acr.25276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/15/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
Starting in 2015, pediatric rheumatology fellowship training programs were required by the Accreditation Council for Graduate Medical Education to assess fellows' academic performance within 21 subcompetencies falling under six competency domains. Each subcompetency had four or five milestone levels describing developmental progression of knowledge and skill acquisition. Milestones were standardized across all pediatric subspecialties. As part of the Milestones 2.0 revision project, the Accreditation Council for Graduate Medical Education convened a workgroup in 2022 to write pediatric rheumatology-specific milestones. Using adult rheumatology's Milestones 2.0 as a starting point, the workgroup revised the patient care and medical knowledge subcompetencies and milestones to reflect requirements and nuances of pediatric rheumatology care. Milestones within four remaining competency domains (professionalism, interpersonal and communication skills, practice-based learning and improvement, and systems-based practice) were standardized across all pediatric subspecialties, and therefore not revised. The workgroup created a supplemental guide with explanations of the intent of each subcompetency, 25 in total, and examples for each milestone level. The new milestones are an important step forward for competency-based medical education in pediatric rheumatology. However, challenges remain. Milestone level assignment is meant to be informed by results of multiple assessment methods. The lack of pediatric rheumatology-specific assessment tools typically result in clinical competency committees determining trainee milestone levels without such collated results as the foundation of their assessments. Although further advances in pediatric rheumatology fellowship competency-based medical education are needed, Milestones 2.0 importantly establishes the first pediatric-specific rheumatology Milestones to assess fellow performance during training and help measure readiness for independent practice.
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Affiliation(s)
- Katherine D Nowicki
- University of Colorado, Denver, and Children's Hospital Colorado, Aurora, Colorado
| | | | - Michal J Cidon
- Children's Hospital Los Angeles, Los Angeles, California
| | - Anita D Dhanrajani
- The University of Mississippi Medical Center, Jackson, Mississippi, Tulane University School of Medicine, New Orleans, and Children's Hospital of New Orleans, New Orleans, Louisiana
| | - Kyla D Driest
- Nationwide Children's Hospital and The Ohio State University, Columbus
| | | | - Lisa F Imundo
- Columbia University Medical Center, New York City, New York
| | - Jay J Mehta
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stacey E Tarvin
- Riley Hospital for Children at Indiana University, Indianapolis
| | - Heather M Walters
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hamptstead, New York, and Cohen Children's Medical Center of New York, New Hyde Park
| | | | - Laura C Edgar
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Megan L Curran
- University of Colorado, Denver, and Children's Hospital Colorado, Aurora, Colorado
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Soliman SI, McGuire W, Santos T, Goldberg C, Coffey C, Wooten D. Chalk Talks for the Clinical Setting: Evaluation of a Medical Education Workshop for Fellows. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2024; 20:11385. [PMID: 38445069 PMCID: PMC10912192 DOI: 10.15766/mep_2374-8265.11385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/20/2023] [Indexed: 03/07/2024]
Abstract
Introduction Chalk talks are effective teaching tools in the clinical setting. However, data on optimal strategies for teaching medical educators how to develop and deliver them are limited. We designed and implemented two 50-minute workshops to help subspecialty fellows across GME create and deliver a chalk talk. Methods The first workshop comprised a demonstration of an effective chalk talk and a discussion of best practices for creating chalk talks; the second was a practice session where fellows presented their chalk talks and received feedback from faculty and peers. We evaluated pre- and postworkshop confidence in the ability to create and deliver a chalk talk and develop learning objectives. Secondary outcomes were faculty and peer evaluations of the chalk talks. Results Eighteen of 33 participants (54% response rate) completed both pre- and postsession surveys. Fellows reported improved confidence in their ability to create a chalk talk (22% vs. 83%, p < .001), deliver a chalk talk (17% vs. 83%, p < .001), and develop well-written learning objectives (11% vs. 83%, p < .001). After the workshop, participants were more likely to correctly identify a chalk talk that made use of an advanced organizer (67% vs. 89%, p < .05). Thirty-eight faculty and peers completed feedback evaluations of participants' chalk talks; most rated fellows' chalk talks highly in domains of content, delivery, design, learning objectives, and engagement. Discussion The incorporation of these workshop within a course on medical education can effectively develop clinical teaching skills among subspecialty fellows in GME.
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Affiliation(s)
- Shady I. Soliman
- First-Year Resident, Department of Otolaryngology, University of California, Los Angeles, David Geffen School of Medicine
| | - William McGuire
- Assistant Professor of Medicine, Department of Medicine, University of California, San Diego, School of Medicine
| | - Tricia Santos
- Professor of Medicine, Department of Medicine, University of California, San Diego, School of Medicine
| | - Charlie Goldberg
- Professor of Medicine, Department of Medicine, University of California, San Diego, School of Medicine
| | - Charles Coffey
- Professor of Surgery, Department of Otolaryngology, University of California, San Diego, School of Medicine
| | - Darcy Wooten
- Professor of Medicine, Department of Medicine, University of California, San Diego, School of Medicine
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Feuille C, Sewell JL. Senior trainee as endoscopy teacher: impact on trainee learning and attending experience. Frontline Gastroenterol 2024; 15:14-20. [PMID: 38487568 PMCID: PMC10935537 DOI: 10.1136/flgastro-2023-102410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/18/2023] [Indexed: 03/17/2024] Open
Abstract
Objective Training in how to effectively teach endoscopy is not included in most gastroenterology (GI) training programme curricula, yet many gastroenterologists are expected to teach endoscopy in their careers. Near-peer teaching could help senior GI trainees learn how to teach endoscopy and have benefits for junior trainees. We performed a qualitative study of a peer teaching initiative where senior trainees taught endoscopy to junior trainees under attending supervision. Design We observed endoscopy sessions where the senior trainee taught a junior trainee under attending supervision, and then conducted individual interviews with the senior trainee teacher, junior trainee learner and attending to characterise affordances and barriers to learning. We performed thematic analysis on anonymised interview transcripts. Results 10 observations and 30 interviews were completed. Junior trainees reported senior trainees more approachable than attendings and explained concepts in more understandable ways. Senior trainees reported the teaching role improved skill at both teaching and performing endoscopy. Attendings reported positive impressions of the experience for senior trainees, and generally positive impressions with some reservations of the experience for junior trainees. A few barriers to learning were reported, but they were generally perceived as being outweighed by affordances. An area for improvement was setting clear expectations for senior trainee and attending roles before the session. Conclusion Near-peer endoscopy teaching was feasible and provided perceived affordances for junior and senior trainees alike, with few barriers. Incorporating formal training in teaching endoscopy into GI training programme curricula may produce both better endoscopists and better endoscopy teachers.
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Affiliation(s)
- Colin Feuille
- Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Justin L Sewell
- Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
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Rutsky J, Schumacher D, Mallon D. Relevance, quick hits, and vibe: Features of meaningful teaching and learning during trainee consult interactions. J Hosp Med 2024; 19:24-30. [PMID: 38073059 PMCID: PMC10842903 DOI: 10.1002/jhm.13256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/15/2023] [Accepted: 11/29/2023] [Indexed: 01/04/2024]
Abstract
BACKGROUND Consults are increasingly frequent in inpatient pediatric services. Consult interactions between trainees provide a rich opportunity for teaching and learning. What constitutes meaningful teaching interactions with trainees has not been described. OBJECTIVE Explore how consulting fellows and residents define "meaningful teaching interactions" associated with inpatient consult interactions. METHODS Four focus groups were conducted with 21 pediatric trainees (11 subspecialty fellows and 10 residents) at one institution. Transcriptions were analyzed using thematic analysis to inductively create categories and themes. RESULTS Five factors define meaningful teaching interactions: (1) Relevance; (2) Quick Hits; (3) Vibe; (4) Face-to-face Interactions; and (5) Timing and Busyness. Meaningful content was described as relevant to current or future patient care. Residents valued content that would enable them to explain the reasoning behind recommendations and think through the next steps. Trainees highlighted brief clinical pearls as superior to longer teaching sessions. The "vibe" between resident and fellow was described as a prerequisite to meaningful teaching and included aspects of interest, receptivity, tone, and attitude. Face-to-face interactions were preferred by many trainees, from initial consults to seeing patients or co-rounding. Timing and workload reflected discordant schedules, including time of day and week, but setting a planned time for teaching was beneficial. CONCLUSION Relevant, bite-sized educational content combined with a good vibe and optimal timing creates a context in which consult fellows can foster meaningful teaching opportunities for residents.
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Affiliation(s)
- Jessica Rutsky
- Department of Pediatrics and Communicable Disease, Division of Pediatric Gastroenterology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor MI 48109, U.S.A
| | - Daniel Schumacher
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229-3026, U.S.A
- Department of Pediatrics, University of Cincinnati College of Medicine, 331 Albert Sabin Way, Cincinnati, Ohio 45229-3026, U.S.A
| | - Daniel Mallon
- Department of Pediatrics, University of Cincinnati College of Medicine, 331 Albert Sabin Way, Cincinnati, Ohio 45229-3026, U.S.A
- Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center
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Priamvada GS, Kotzen ES, Jain K. Clinician Educator Pathway for Nephrology Fellows: The University of North Carolina Experience. Adv Chronic Kidney Dis 2022; 29:516-519. [PMID: 36371115 DOI: 10.1053/j.ackd.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/16/2022] [Accepted: 04/25/2022] [Indexed: 11/11/2022]
Abstract
Nephrologists have a significant role in educating and mentoring trainees. They are considered role models and a major reason for fellows to be attracted to the specialty. Nephrology training programs not only support fellows in their teaching endeavors but also provide them with the necessary knowledge and skills required for advancing their careers as clinician educators. However, such career development tracks are limited in number and most focus on early career faculty. Here we present an overview of the various teaching opportunities for fellows at the University of North Carolina (UNC) Nephrology fellowship program and the development of a fellow-oriented clinician educator track. Our goal as part of the nephrology community is to empower the current nephrology fellows to develop fulfilling careers as nephrology clinician educators.
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Affiliation(s)
- Gargi S Priamvada
- Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Elizabeth S Kotzen
- Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Koyal Jain
- Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Caruso C, Arias-Shah A, Rent S, Mukthapuram S, Dadiz R. Fellows as Teachers: Supporting Future Educators. Neoreviews 2022; 23:e438-e447. [PMID: 35773507 DOI: 10.1542/neo.23-7-e438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Teaching is inherent to the practice of medicine, as physicians are relied on to educate those around them, including staff, trainees, colleagues, and the patients and families for whom they provide care. Neonatal-perinatal medicine fellows uniquely serve as both trainee and subspecialty expert and are additionally expected to be strong teachers. In this article, the authors review the benefits of developing fellows as teachers, the challenges and potential mitigating strategies of fulfilling this objective, and the educational foundations and future directions that may inform the development of curricula for training fellows as teachers.
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Affiliation(s)
- Catherine Caruso
- Division of Neonatology, Department of Pediatrics, Oregon Health and Science University, Portland, OR
| | - AnnaMarie Arias-Shah
- Division of Neonatology, Department of Pediatrics, Children's Hospital of Orange County, Orange, CA
| | - Sharla Rent
- Division of Neonatology, Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | - Shanmukha Mukthapuram
- The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Rita Dadiz
- Division of Neonatology, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY
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Basic ultrasound head-to-toe skills for intensivists in the general and neuro intensive care unit population: consensus and expert recommendations of the European Society of Intensive Care Medicine. Intensive Care Med 2021; 47:1347-1367. [PMID: 34787687 PMCID: PMC8596353 DOI: 10.1007/s00134-021-06486-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/16/2021] [Indexed: 01/21/2023]
Abstract
Purpose To provide consensus, and a list of experts’ recommendations regarding the basic skills for head-to-toe ultrasonography in the intensive care setting. Methods The Executive Committee of the European Society of Intensive Care (ESICM) commissioned the project and supervised the methodology and structure of the consensus. We selected an international panel of 19 expert clinicians–researchers in intensive care unit (ICU) with expertise in critical care ultrasonography (US), plus a non-voting methodologist. The panel was divided into five subgroups (brain, lung, heart, abdomen and vascular ultrasound) which identified the domains and generated a list of questions to be addressed by the panel. A Delphi process based on an iterative approach was used to obtain the final consensus statements. Statements were classified as a strong recommendation (84% of agreement), weak recommendation (74% of agreement), and no recommendation (less than 74%), in favor or against. Results This consensus produced a total of 74 statements (7 for brain, 20 for lung, 20 for heart, 20 for abdomen, 7 for vascular Ultrasound). We obtained strong agreement in favor for 49 statements (66.2%), 8 weak in favor (10.8%), 3 weak against (4.1%), and no consensus in 14 cases (19.9%). In most cases when consensus was not obtained, it was felt that the skills were considered as too advanced. A research agenda and discussion on training programs were implemented from the results of the consensus. Conclusions This consensus provides guidance for the basic use of critical care US and paves the way for the development of training and research projects. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-021-06486-z.
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Matsuo T, Hayashi K, Uehara Y, Mori N. Essential consultants' skills and attitudes (Willing CONSULT): a cross-sectional survey. BMC MEDICAL EDUCATION 2021; 21:366. [PMID: 34217282 PMCID: PMC8254944 DOI: 10.1186/s12909-021-02810-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/04/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Despite multi-professional collaboration via consultation being increasingly important given the variety of disease diagnoses and treatment, the key elements as consultants remain unclear. The study aimed to identify the skills and attitudes that are important for consultants from the residents' perspective so that they can be targeted as priority goals in subsequent educational interventions. METHODS We conducted our research in two phases: a preliminary survey (May 1 to 14, 2020) and a main survey (June 1 to 14, 2020). As a preliminary survey, first-year postgraduate residents at St. Luke's International Hospital in Tokyo, Japan, were first asked an open-ended question about the types of skills and attitudes that are important for consultants. After eliminating duplicate answers, there were 19 skills and attitudes in total. In the main survey with residents who completed their residency training at our institute, from 2014 to 2018 and current residents (2019-2020), we first asked them about their demographic characteristics (gender, years of postgraduate education, and type of specialty). Then, they answered how important each skill and attitude are for consultants. All 19 items were scored on a seven-point Likert scale that ranged from 0 (completely disagree) to 6 (totally agree). Cronbach's alpha confirmed the internal consistency of the questionnaire items. Principal component analysis and exploratory factor analysis were performed. RESULTS The survey included 107 individuals (61.1 %, 175 potential participants). The median postgraduate years of education was four (interquartile range: 2-5), and 64.5 % were men (n = 69). Seven key elements for consultants were identified and termed Willing CONSULT. These included (1) willingness (willingness to accept consultation requests), (2) contact (easy access to consultants), (3) needs (consideration of consulters' needs), (4) suggestions and support (providing clear recommendations and suggestions, following up on the patients, and supporting the consulters continuously), (5) urgency (considering the situation's urgency and responding appropriately), (6) learning opportunities (providing teaching points), and (7) text (writing medical records). CONCLUSIONS We propose Willing CONSULT, which are important skills and attitudes for consultants.
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Affiliation(s)
- Takahiro Matsuo
- Department of Infectious Diseases, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, Japan.
| | - Kuniyoshi Hayashi
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Yuki Uehara
- Department of Infectious Diseases, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, Japan
- Department of Clinical Laboratory, St. Luke's International Hospital, Tokyo, Japan
- Department of Microbiology, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Nobuyoshi Mori
- Department of Infectious Diseases, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, Japan
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Serling-Boyd N, Miloslavsky EM. Enhancing the Inpatient Consultation Learning Environment to Optimize Teaching and Learning. Rheum Dis Clin North Am 2021; 46:73-83. [PMID: 31757288 DOI: 10.1016/j.rdc.2019.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Subspecialty consultation is an increasingly used resource in inpatient medicine. Teaching the primary team is an important element of effective consultation and has many potential benefits. However, within academic medical centers many barriers to effective consultation and the consult learning environment exist. High workload, burnout, inexperience, lack of familiarity between teams, quality of the consult requests, and pushback may impede teaching and learning. Herein, the authors review the role of teaching and learning during consultation, challenges to effective consultation facing fellows, and interventions that can enhance primary team-fellow interactions and learning.
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Affiliation(s)
- Naomi Serling-Boyd
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Bulfinch 165, Boston, MA 02114, USA
| | - Eli M Miloslavsky
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Bulfinch 165, Boston, MA 02114, USA.
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Chirch LM, Armstrong WS, Balba GP, Kulkarni PA, Benson CA, Konold V, Luther VP, Nnedu ON, Perloff S, Razonable RR, Stead W, Thompson GR, Melia MT. Education of Infectious Diseases Fellows During the COVID-19 Pandemic Crisis: Challenges and Opportunities. Open Forum Infect Dis 2020; 8:ofaa583. [PMID: 33553468 PMCID: PMC7798664 DOI: 10.1093/ofid/ofaa583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/09/2020] [Indexed: 11/21/2022] Open
Abstract
One of the many challenges that has befallen the Infectious Diseases and Graduate Medical Education communities during the coronavirus disease 2019 (COVID-19) pandemic is the maintenance of continued effective education and training of the future leaders of our field. With the remarkable speed and innovation that has characterized the responses to this pandemic, educators everywhere have adapted existing robust and safe learning environments to meet the needs of our learners. This paper will review distinct aspects of education and training of the Infectious Diseases fellows we believe the COVID-19 pandemic has impacted most, including mentoring, didactics, and wellness. We anticipate that several strategies developed in this context and described herein will help to inform training and best practices during the pandemic and beyond.
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Affiliation(s)
- Lisa M Chirch
- Division of Infectious Diseases, Department of Internal Medicine, The University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | | | - Gayle P Balba
- Division of Infectious Diseases, Georgetown University Hospital, Washington, DC, USA
| | - Prathit A Kulkarni
- Infectious Diseases Section, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Constance A Benson
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, California, USA
| | - Victoria Konold
- Section of Infectious Diseases, Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA
| | - Vera P Luther
- Department of Internal Medicine, Section of Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Obinna N Nnedu
- Infectious Disease Department, Ochsner Clinic Foundation, New Orleans, Louisiana, USA
| | - Sarah Perloff
- Infectious Disease Fellowship Program, Internal Medicine Residency Program, Einstein Medical Center, Philadelphia, Pennsylvania, USA
| | - Raymund R Razonable
- Division of Infectious Diseases and Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Wendy Stead
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - George R Thompson
- Division of Infectious Diseases, Department of Internal Medicine, University of California - Davis, Sacramento, California, USA
| | - Michael T Melia
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Lopez MA, Campbell J. Developing a communication curriculum for primary and consulting services. MEDICAL EDUCATION ONLINE 2020; 25:1794341. [PMID: 32691694 PMCID: PMC7482829 DOI: 10.1080/10872981.2020.1794341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 06/30/2020] [Accepted: 07/04/2020] [Indexed: 06/11/2023]
Abstract
Communication skills are fundamental to effective patient care, and inter-subspecialty communication is frequently identified as a key component of medical education curriculums globally. The team primarily responsible for a patient, the 'primary service', may often request a consult from a specialist, the 'consulting service', for questions of diagnosis, management, or assistance in arranging or performing a procedure or test. Few resources exist to support the development and growth of communication curriculums across primary and consulting services. We provide tips to improve communication across services in patient care and enhance learning for multiple levels of providers. This article provides a guide for the planning and implementation of a communication curriculum and highlights key components for success, based on our experience as teaching faculty on primary and consulting services, at a large academic institution. With the proper collaborations, teaching touch points, specialist consult communication tool, peer coaches, and timely feedback, this course can meet numerous educational and institutional priorities.
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Affiliation(s)
- Michelle A Lopez
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Judith Campbell
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
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Skelly K, Shen W, Wilbur J, Thoma K, Endres J, Lynch A, Gaglioti A, Rosenbaum M. A Curriculum for Teaching Clinical Efficiency Focusing on Specific Communication Skills While Maximizing the Electronic Health Record. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2020; 16:10989. [PMID: 33150199 PMCID: PMC7597939 DOI: 10.15766/mep_2374-8265.10989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 05/10/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION All physicians must learn comprehensive patient care delivery within the electronic health record (EHR). No studies have considered EHR communication training with an emphasis on clinical efficiency. This curriculum provides a method of teaching clinic efficiency while practicing effective patient communication in any EHR clinical situation. The target audience is resident physicians, fellow physicians, faculty physicians, and physician extenders practicing in a primary care setting where the EHR is present. METHODS This curriculum of four separate workshops provides a structured EHR approach while addressing communication strategies for preclinical preparation, rapport building, encounter initiation, agenda setting, and visit closure. The curriculum contains interactive presentations, tools, and an evaluation survey. Presenting efficiency issues with the EHR using the ATTEND mnemonic and agenda setting allows documentation while practicing communication techniques that maximize efficiency. RESULTS Postworkshop surveys revealed that participants felt the workshops were helpful (84%). One measurement of efficiency revealed improvement through decreased number of days to note completion after workshop participation. At the Program Directors Workshop, curriculum value was demonstrated by high attendance, with 94% feeling the workshops provided easily utilizable strategies. DISCUSSION The curriculum utilized only the EPIC EHR but would be generalizable. Future directions could include measurement of effective communication and visit efficiency through direct observation and expanded EHR timing data.
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Affiliation(s)
- Kelly Skelly
- Associate Professor, Department of Family Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine
| | - Wendy Shen
- Associate Professor, Department of Family Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine
| | - Jason Wilbur
- Professor, Department of Family Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine
| | - Kate Thoma
- Associate Professor, Department of Family Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine
| | - Jill Endres
- Professor, Department of Family Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine
| | - Alison Lynch
- Professor, Department of Family Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine
| | - Anne Gaglioti
- Associate Professor, Department of Family Medicine, Morehouse School of Medicine
| | - Marcy Rosenbaum
- Professor, Department of Family Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine
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Ferrer Marrero TM, Zhou Y, Espina TD, Chepuri R, Pluskota A, Ramalingam V. Fellows as teachers: a teaching curriculum at a Veterans Affairs Medical Center. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2020; 11:138-139. [PMID: 32653880 PMCID: PMC7870449 DOI: 10.5116/ijme.5edd.f8ab] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Tirsa M. Ferrer Marrero
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Yan Zhou
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Toni-Denise Espina
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rasika Chepuri
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Amy Pluskota
- Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA
| | - Vijaya Ramalingam
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Making the Consult Interaction More Than a Transaction: Helping Fellows Be Better Teachers and Residents Be Better Learners. J Pediatr 2019; 209:3-4.e2. [PMID: 31128730 DOI: 10.1016/j.jpeds.2019.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/02/2019] [Indexed: 11/22/2022]
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