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Thepwongsa I, Muthukumar R, Sripa P, Waraassawapati S, Jenwitheesuk K, Virasiri S, Nonjui P. The perspectives of learners at a public medical school on the evaluation of an online learning management system for degree and non-degree courses. Med Educ Online 2024; 29:2299535. [PMID: 38159283 PMCID: PMC10763867 DOI: 10.1080/10872981.2023.2299535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND There has been a rapid development and adoption of online learning in medical education. However, it is difficult to adopt the currently available online learning management systems (LMS). This study aimed to examine learners' perspectives on the evaluation of online LMS. METHODS An online LMS was developed based on the evidence-based guidelines. Two cross-sectional studies were conducted. A short survey was conducted with 716 learners registered on the LMS to obtain their perspectives on the online participation. A satisfaction survey was conducted with 255 learners enrolled in the courses taught solely online. Data from the LMS monitoring system was used to report the uptake of online courses. Data were analyzed using descriptive statistics. RESULTS Participants reported that the major factor influencing LMS uptake was the ability to be accessed anytime and anywhere (n = 556, 77.7%). The participants had good experience in using the LMS and were satisfied with it (n = 255, mean = 4.53, SD = 0.62). For online degree courses, the course had a high completion rate of 90% provided that a mark was assigned for course attendance. For non-degree courses, irrespective of whether they were free, paid, exam-based, or participation only, the completion rate was considered low (range 4.3-36.7%). CONCLUSION Under a limited budget, a medical school in a low- to middle-income country could develop an effective online LMS to meet learners' needs. Our newly developed online LMS is relevant, accepted and to the satisfaction of the learners. Medical schools in the same context are encouraged to develop their own online LMS that serve and support learning in both degree and non-degree courses.
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Affiliation(s)
- Isaraporn Thepwongsa
- Family Medicine Unit, Department of Community, Family and Occupational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Poompong Sripa
- Inverkeithing Medical Group, 5 Friary Court, Inverkeithing, UK
| | - Sakda Waraassawapati
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Surapol Virasiri
- Academic Affairs, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pat Nonjui
- Family Medicine Unit, Department of Community, Family and Occupational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Ly A, Garcia V, Blenman KRM, Ehinger A, Elfer K, Hanna MG, Li X, Peeters DJE, Birmingham R, Dudgeon S, Gardecki E, Gupta R, Lennerz J, Pan T, Saltz J, Wharton KA, Ehinger D, Acs B, Dequeker EMC, Salgado R, Gallas BD. Training pathologists to assess stromal tumour-infiltrating lymphocytes in breast cancer synergises efforts in clinical care and scientific research. Histopathology 2024; 84:915-923. [PMID: 38433289 PMCID: PMC10990791 DOI: 10.1111/his.15140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/15/2023] [Accepted: 12/31/2023] [Indexed: 03/05/2024]
Abstract
A growing body of research supports stromal tumour-infiltrating lymphocyte (TIL) density in breast cancer to be a robust prognostic and predicive biomarker. The gold standard for stromal TIL density quantitation in breast cancer is pathologist visual assessment using haematoxylin and eosin-stained slides. Artificial intelligence/machine-learning algorithms are in development to automate the stromal TIL scoring process, and must be validated against a reference standard such as pathologist visual assessment. Visual TIL assessment may suffer from significant interobserver variability. To improve interobserver agreement, regulatory science experts at the US Food and Drug Administration partnered with academic pathologists internationally to create a freely available online continuing medical education (CME) course to train pathologists in assessing breast cancer stromal TILs using an interactive format with expert commentary. Here we describe and provide a user guide to this CME course, whose content was designed to improve pathologist accuracy in scoring breast cancer TILs. We also suggest subsequent steps to translate knowledge into clinical practice with proficiency testing.
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Affiliation(s)
- Amy Ly
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Victor Garcia
- Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Imaging, Diagnostics, and Software Reliability, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Kim RM Blenman
- Department of Internal Medicine, Section of Medical Oncology and Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
- Department of Computer Science, Yale School of Engineering and Applied Science, New Haven, CT, USA
| | - Anna Ehinger
- Department of Genetics, Pathology and Molecular Diagnostics, Laboratory Medicine, Region Skane, Lund University, Lund, Sweden
| | - Katherine Elfer
- Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Imaging, Diagnostics, and Software Reliability, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Matthew G Hanna
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Xiaoxian Li
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Dieter JE Peeters
- Department of Pathology, University Hospital Antwerp, Edegem, Belgium
- Department of Pathology, Algemeen Ziekenhuis (AZ) Sint-Maarten, Mechelen, Belgium
| | - Ryan Birmingham
- Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Imaging, Diagnostics, and Software Reliability, U.S. Food and Drug Administration, Silver Spring, MD, USA
- Department of Biomedical Informatics, Emory University, Atlanta, GA, USA
| | - Sarah Dudgeon
- Center for Computational Health, Yale School of Medicine, New Haven, CT, USA
| | - Emma Gardecki
- Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Imaging, Diagnostics, and Software Reliability, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Rajarsi Gupta
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| | - Jochen Lennerz
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital, Boston, MA, USA; currently at BostonGene, Boston, MA
| | - Tony Pan
- Department of Biomedical Informatics, Emory University, Atlanta, GA, USA
| | - Joel Saltz
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| | | | - Daniel Ehinger
- Department of Clinical Sciences, Division of Oncology, Lund University, Lund, Sweden
- Department of Genetics, Pathology, and Molecular Diagnostics, Skane University Hospital, Lund, Sweden
| | - Balazs Acs
- Department of Oncology and Pathology, Cancer Centre Karolinska, Karolinksa Institutet, Stockholm, Sweden
- Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden
| | - Elisabeth MC Dequeker
- Department of Public Health and Primary Care, Biomedical Quality Assurance Research Unit, University of Leuven, Leuven, Belgium
| | - Roberto Salgado
- Department of Pathology, Gasthuiszusters Antwerpen-Ziekenhuis Netwerk Antwerpen (GZA-ZNA) Hospitals, Antwerp, Belgium
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Brandon D Gallas
- Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Imaging, Diagnostics, and Software Reliability, U.S. Food and Drug Administration, Silver Spring, MD, USA
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Hopayian K, Dimosthenous S. The utility of the classification tools in National Institute of Health and Clinical Excellence's Clinical Knowledge Summaries for primary care. Fam Pract 2024; 41:194-197. [PMID: 37703115 PMCID: PMC11017775 DOI: 10.1093/fampra/cmad091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND The National Institute of Health and Clinical Excellence provides a web-based resource, Clinical Knowledge Summaries (CKS), whose aim is to give evidence-based guidance for primary care practitioners and students. Included in the information it provides, are tools for the classification of conditions. OBJECTIVES The objective of this study was to measure the proportion and utility of the classification tools that have implications for management. METHODS Each topic on the CKS website was screened in alphabetical order for the presence of a classification tool. The linkage to management and the strength of recommendations were extracted by 2 researchers working independently. Disagreements were resolved through discussion. RESULTS Classification tools were present for 35 conditions. There were 52 tools in all. A strong recommendation for their use was made in 37% while for a sizeable minority, 46%, the strength of recommendation was uncertain. There was a relation between strength of recommendation and linkage: for the stronger recommendation, 76% had some form of implication for management. CONCLUSION Relevance is an important feature of a guideline for general practitioners (GPs). Given that nearly half its tools have no utility in guiding management, CKS may need to consider whether extraneous information should be disposed of or retained.
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Affiliation(s)
- Kevork Hopayian
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Sotiris Dimosthenous
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
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Chen J, Bai T, Liu J, Xiong L, Wang W, Wang H, Wang R, Hou X. Significant improvement of physicians' knowledge and clinical practice: an opportune, effective, and convenient continuing medical education program on functional dyspepsia. Front Med (Lausanne) 2024; 11:1338206. [PMID: 38660419 PMCID: PMC11039830 DOI: 10.3389/fmed.2024.1338206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/07/2024] [Indexed: 04/26/2024] Open
Abstract
Aims This cohort study aimed to explore the effect of a one-day online continuing medical education (CME) on the improvement of physicians' knowledge and clinical practice on functional dyspepsia (FD). Methods Physicians were invited to participate in this CME via medical education applications. FD training videos made in advance were sent to participants via a weblink. Before and after training, participants were required to finish the FD knowledge test and provide case information of FD patients. McNemar test, Wilcoxon rank-sum test, Freidman test, Chi-square test, quantile regression, and generalized estimating equations (GEE) were used to perform statistical analysis. Results There were 397 of 430 (92.33%) physicians finished this CME program. The total score of the FD knowledge test after training was significantly higher compared with before training [488.3 (468.3-510.0) vs. 391.7 (341.7-450.0), p < 0.001]. Particularly, physicians from primary hospitals show more increase in total scores than physicians from secondary and tertiary hospitals. According to the GEE model, receiving this online training was an independent predictor of physicians' choice of upper gastrointestinal endoscopy in patients with FD [OR 1.73, 95%CI (1.09-2.73), p = 0.020], especially in PDS. Also, it was an independent predictor of physicians' choice of acid-suppressive drugs in patients with FD [OR 1.30, 95%CI (1.03-1.63), p = 0.026], especially in EPS and PDS overlapping EPS. Conclusion This one-day online CME program effectively and conveniently improved physicians' knowledge and clinical practice, providing new ideas for future CME and facilitating precise clinical management of FD patients with different subtypes especially in primary hospitals.
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Affiliation(s)
- Jie Chen
- Division of Gastroenterology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Bai
- Division of Gastroenterology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinsong Liu
- Division of Gastroenterology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lishou Xiong
- Division of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Weifeng Wang
- Division of Gastroenterology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Huahong Wang
- Division of Gastroenterology, The First Hospital of Peking University, Beijing, China
| | - Rongquan Wang
- Division of Gastroenterology, The Southwest Hospital of Third Military Medical University, Chongqing, China
| | - Xiaohua Hou
- Division of Gastroenterology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Daeschler D, Fugh-Berman A. Parkinson's Disease Psychosis and the Marketing of Pimavanserin. Int J Soc Determinants Health Health Serv 2024:27551938241231531. [PMID: 38592164 DOI: 10.1177/27551938241231531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
In 2016, Nuplazid (pimavanserin) became the first FDA-approved treatment for Parkinson's Disease Psychosis (PDP). We explored the possibility that PDP was a term created to market Nuplazid. We examined trends in perceptions of psychosis in Parkinson's disease from the 1990s to 2020 through MEDLINE search term frequency, neurology textbooks, guidance from professional societies, Acadia annual reports, sponsored websites, and a sponsored meeting held by the National Institutes of Health (NIH). We analyzed continuing medical education (CME) activities on PDP and analyzed the connection between payments by the manufacturer of pimavanserin and prescriptions. Our analysis of nine sponsored CME activities reveals misleading themes, including: PDP is common, progressive, and not always drug-induced; there is no such thing as a benign hallucination, and psychotic symptoms always worsen; PDP increases mortality; and competing treatments are ineffective or dangerous while pimavanserin is safe and effective for treating PDP. Industry-sponsored CME was used to disseminate inaccurate and misleading marketing messages on psychosis related to Parkinson's disease. Some professional societies and some textbooks also resisted the PDP label. Reframing PDP as a unique condition is a typical example of condition branding. The establishment of PDP expanded the use of pimavanserin and is likely to have resulted in many avoidable deaths.
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Affiliation(s)
- Daisy Daeschler
- Health and the Public Interest MS program, Georgetown University, Washington, DC, USA
| | - Adriane Fugh-Berman
- Pharmacology and Physiology, Georgetown University Medical Center, Washington, DC, USA
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Koester M, Motz R, Porto A, Reyes Nieves N, Ashley K. Using Project Extension for Community Healthcare Outcomes to Enhance Substance Use Disorder Care in Primary Care: Mixed Methods Study. JMIR Med Educ 2024; 10:e48135. [PMID: 38557477 PMCID: PMC11019412 DOI: 10.2196/48135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/06/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Substance use and overdose deaths make up a substantial portion of injury-related deaths in the United States, with the state of Ohio leading the nation in rates of diagnosed substance use disorder (SUD). Ohio's growing epidemic has indicated a need to improve SUD care in a primary care setting through the engagement of multidisciplinary providers and the use of a comprehensive approach to care. OBJECTIVE The purpose of this study was to assess the ability of the Weitzman Extension for Community Healthcare Outcomes (ECHO): Comprehensive Substance Use Disorder Care program to both address and meet 7 series learning objectives and address substances by analyzing (1) the frequency of exposure to the learning objective topics and substance types during case discussions and (2) participants' change in knowledge, self-efficacy, attitudes, and skills related to the treatment of SUDs pre- to postseries. The 7 series learning objective themes included harm reduction, team-based care, behavioral techniques, medication-assisted treatment, trauma-informed care, co-occurring conditions, and social determinants of health. METHODS We used a mixed methods approach using a conceptual content analysis based on series learning objectives and substances and a 2-tailed paired-samples t test of participants' self-reported learner outcomes. The content analysis gauged the frequency and dose of learning objective themes and illicit and nonillicit substances mentioned in participant case presentations and discussions, and the paired-samples t test compared participants' knowledge, self-efficacy, attitudes, and skills associated with learning objectives and medication management of substances from pre- to postseries. RESULTS The results of the content analysis indicated that 3 learning objective themes-team-based care, harm reduction, and social determinants of health-resulted in the highest frequencies and dose, appearing in 100% (n=22) of case presentations and discussions. Alcohol had the highest frequency and dose among the illicit and nonillicit substances, appearing in 81% (n=18) of case presentations and discussions. The results of the paired-samples t test indicated statistically significant increases in knowledge domain statements related to polysubstance use (P=.02), understanding the approach other disciplines use in SUD care (P=.02), and medication management strategies for nicotine (P=.03) and opioid use disorder (P=.003). Statistically significant increases were observed for 2 self-efficacy domain statements regarding medication management for nicotine (P=.002) and alcohol use disorder (P=.02). Further, 1 statistically significant increase in the skill domain was observed regarding using the stages of change theory in interventions (P=.03). CONCLUSIONS These findings indicate that the ECHO program's content aligned with its stated learning objectives; met its learning objectives for the 3 themes where significant improvements were measured; and met its intent to address multiple substances in case presentations and discussions. These results demonstrate that Project ECHO is a potential tool to educate multidisciplinary providers in a comprehensive approach to SUD care.
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Affiliation(s)
- MacKenzie Koester
- Weitzman Institute, Moses Weitzman Health System, Washington, DC, United States
| | - Rosemary Motz
- Weitzman Institute, Moses Weitzman Health System, Washington, DC, United States
| | - Ariel Porto
- Weitzman Institute, Moses Weitzman Health System, Washington, DC, United States
| | - Nikita Reyes Nieves
- Weitzman Institute, Moses Weitzman Health System, Washington, DC, United States
| | - Karen Ashley
- Weitzman Institute, Moses Weitzman Health System, Washington, DC, United States
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Gnant M, Abdullah KL, Boyle F, Huang CS, Bickford K, Neunie S, Noble A, Nunn A, Sproat C, Harbeck N, Barrios C. Assessing Knowledge, Competence, and Performance Following Web-Based Education on Early Breast Cancer Management: Health Care Professional Questionnaire Study and Anonymized Patient Records Analysis. JMIR Form Res 2024; 8:e50931. [PMID: 38512328 PMCID: PMC10995792 DOI: 10.2196/50931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Web-based learning activities are key components of continuing medical education (CME) for health care professionals (HCPs). However, the published outcomes of web-based educational interventions for early breast cancer (EBC) are limited. OBJECTIVE This study aims to objectively assess knowledge, competence, and performance among HCPs following participation in 2 EBC-focused CME activities and to identify the remaining educational gaps. METHODS We developed 2 CME-accredited web-based educational activities addressing high-risk EBC, including integration of shared decision-making to optimize patient care (touchMDT) and stratification for early identification of high-risk patients and novel treatment strategies (touchPANEL DISCUSSION). Knowledge, competence, and performance were assessed before and after the activities against an expanded outcomes framework (levels 1-5) using self-reported questionnaires and an analysis of anonymized data extracted from patient records. RESULTS Six months after the launch of the activity, 7047 and 8989 HCP participants engaged with touchMDT and touchPANEL DISCUSSION, respectively. The overall satisfaction was 82% (a total score of 20.6 out of 25) for the touchMDT and 88% (a total score of 21.9 out of 25) for the touchPANEL DISCUSSION. For the evaluation of knowledge and competence (50 respondents before the activity and 50 learners after the activity), there was a significant increase in the mean number of correctly answered questions from pre- to postactivity (touchMDT: median 4.0, IQR 3.0-5.0 to median 5.5, IQR 4.0-7.0; mean 4.00, SD 1.39 to mean 5.30, SD 1.56 and touchPANEL DISCUSSION: median 4.0, IQR 4.0-5.0 to median 6.0, IQR 5.0-7.0; mean 4.32, SD 1.30 to mean 5.88, SD 1.49; both P<.001). A significant improvement in self-reported performance (50 respondents before the activity and 50 learners after the activity) was observed in a combined analysis of both activities (median 3.0, IQR 2.0-3.0 to median 4.0, IQR 3.0-5.0; mean 2.82, SD 1.08 to mean 4.16, SD 1.45; P<.001). Patient record analysis (50 respondents before the activity and 50 learners after the activity) showed that the HCPs used a range of measures to determine EBC recurrence risk and revealed no significant differences in adjuvant therapies used before and after the activity (P=.97 and P>.99 for Ki-67 <20% and Ki-67 ≥20% tumors, respectively). The remaining educational gaps included strategies for implementing shared decision-making in clinical practice and the use of genetic and biomarker testing to guide treatment selection. CONCLUSIONS Brief, web-based CME activities on EBC were associated with an improvement in HCP knowledge, competence, and self-reported performance and can help identify unmet needs to inform the design of future CME activities.
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Affiliation(s)
- Michael Gnant
- Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Khatijah Lim Abdullah
- Department of Nursing, School of Medical and Life Sciences, Sunway University, Selangor, Malaysia
| | - Frances Boyle
- Patricia Ritchie Centre for Cancer Care and Research, University of Sydney, Sydney, Australia
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei City, Taiwan
| | - Katie Bickford
- touch Independent Medical Education Limited, Stockport, United Kingdom
| | - Sola Neunie
- touch Independent Medical Education Limited, Stockport, United Kingdom
| | - Alexander Noble
- touch Independent Medical Education Limited, Stockport, United Kingdom
| | - Anne Nunn
- touch Independent Medical Education Limited, Stockport, United Kingdom
| | - Caroline Sproat
- touch Independent Medical Education Limited, Stockport, United Kingdom
| | - Nadia Harbeck
- Breast Center, Department of Obstetrics & Gynecology and Comprehensive Cancer Center Munich, University Hospital of Munich Ludwig Maximilian, Munich, Germany
| | - Carlos Barrios
- Latin American Cooperative Group and Oncoclínicas Group, Hospital São Lucas da Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Bhargava H, Salomon C, Suresh S, Chang A, Kilian R, Stijn DV, Oriol A, Low D, Knebel A, Taraman S. Promises, Pitfalls, and Clinical Applications of Artificial Intelligence in Pediatrics. J Med Internet Res 2024; 26:e49022. [PMID: 38421690 PMCID: PMC10940991 DOI: 10.2196/49022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/01/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
Artificial intelligence (AI) broadly describes a branch of computer science focused on developing machines capable of performing tasks typically associated with human intelligence. Those who connect AI with the world of science fiction may meet its growing rise with hesitancy or outright skepticism. However, AI is becoming increasingly pervasive in our society, from algorithms helping to sift through airline fares to substituting words in emails and SMS text messages based on user choices. Data collection is ongoing and is being leveraged by software platforms to analyze patterns and make predictions across multiple industries. Health care is gradually becoming part of this technological transformation, as advancements in computational power and storage converge with the rapid expansion of digitized medical information. Given the growing and inevitable integration of AI into health care systems, it is our viewpoint that pediatricians urgently require training and orientation to the uses, promises, and pitfalls of AI in medicine. AI is unlikely to solve the full array of complex challenges confronting pediatricians today; however, if used responsibly, it holds great potential to improve many aspects of care for providers, children, and families. Our aim in this viewpoint is to provide clinicians with a targeted introduction to the field of AI in pediatrics, including key promises, pitfalls, and clinical applications, so they can play a more active role in shaping the future impact of AI in medicine.
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Affiliation(s)
- Hansa Bhargava
- Children's Hospital of Atlanta, Atlanta, GA, United States
- School of Medicine, Emory University, Atlanta, GA, United States
- Healio, South New Jersey, NJ, United States
| | | | - Srinivasan Suresh
- Division of Health Informatics, Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United States
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Anthony Chang
- Fowler School of Engineering, Chapman University, Orange, CA, United States
| | | | | | - Albert Oriol
- Rady Children's Hospital, San Diego, CA, United States
| | | | | | - Sharief Taraman
- Cognoa, Inc, Palo Alto, CA, United States
- Children's Hospital of Orange County, Orange, CA, United States
- University of California Irvine School of Medicine, Irvine, CA, United States
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Zhao QJ, Rozenberg D, Nourouzpour S, Orchanian-Cheff A, Flannery J, Kaul R, Agbeyaka S, Barber M, dePeiza P, Maria Doumouras A, Draper H, Gebara N, Lau J, Liberman D, Luther RA, Sanh M, Furlan AD. Positive impact of a telemedicine education program on practicing health care workers during the COVID-19 pandemic in Ontario, Canada: A mixed methods study of an Extension for Community Healthcare Outcomes (ECHO) program. J Telemed Telecare 2024; 30:365-380. [PMID: 34962167 DOI: 10.1177/1357633x211059688] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION In addition to shifting and expanding clinical responsibilities, rapidly evolving information and guidelines during the COVID-19 pandemic has made it difficult for health care workers (HCW) to synthesise and translate COVID-19 information into practice. This study evaluated whether a COVID-19-specific telemedicine education program (ECHO COVID) would impact health care workers' self-efficacy and satisfaction in the management of patients with COVID-19. METHODS A prospective mixed methods parallel-design study was conducted among ECHO COVID participants using pre-post questionnaires and a focus group discussion. Questionnaire results were examined for changes in health care workers' self-efficacy and satisfaction. Focus group discussion data were analysed to explore health care workers' experience in ECHO COVID and the context of their practice during the COVID-19 pandemic. RESULTS 239 health care workers registered in ECHO COVID and 114 (47.7%) completed questionnaires and attended at least one ECHO COVID session. Median self-efficacy scores increased from 5 (IQR 4-6) to 6 (IQR 6-6) (p < 0.0001), independent of profession, years in practice, age group, or practice environment. Participants were highly satisfied with ECHO COVID sessions with a median score of 4 (IQR 4-5). Focus group discussion data indicated that health care workers gained knowledge through ECHO COVID and revealed facilitators for ECHO COVID program success, including the transition to virtual care, the practicability of knowledge provided, and a 'perspective from the trenches.' DISCUSSION This study demonstrated that a telemedicine education program aimed to support health care workers in managing patients with COVID-19 had a positive impact on health care workers' self-efficacy and satisfaction. This impact was specifically mediated by the ECHO COVID program.
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Affiliation(s)
- Q Jane Zhao
- ECHO at UHN, University Health Network, Toronto, Canada
| | - Dmitry Rozenberg
- ECHO at UHN, University Health Network, Toronto, Canada
- Mount Sinai Hospital, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canda
| | | | - Ani Orchanian-Cheff
- ECHO at UHN, University Health Network, Toronto, Canada
- Library and Information Services, University Health Network, Toronto, Canada
| | - John Flannery
- ECHO at UHN, University Health Network, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canda
| | - Rupert Kaul
- ECHO at UHN, University Health Network, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canda
| | | | - Mary Barber
- ECHO at UHN, University Health Network, Toronto, Canada
| | | | | | - Haley Draper
- ECHO at UHN, University Health Network, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Nadine Gebara
- ECHO at UHN, University Health Network, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Jenny Lau
- ECHO at UHN, University Health Network, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Dan Liberman
- Department of Medicine, McGill University
- Jewish General Hospital, Montreal, Quebec, Canada
| | - Ryan A Luther
- ECHO at UHN, University Health Network, Toronto, Canada
- Mount Sinai Hospital, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canda
| | - Monica Sanh
- ECHO at UHN, University Health Network, Toronto, Canada
- Library and Information Services, University Health Network, Toronto, Canada
| | - Andrea D Furlan
- ECHO at UHN, University Health Network, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canda
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10
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Saeki S. Continuous Writing, Reviewing, and Editing by Physicians. JMA J 2024; 7:136-137. [PMID: 38314415 PMCID: PMC10834179 DOI: 10.31662/jmaj.2023-0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/20/2023] [Indexed: 02/06/2024] Open
Affiliation(s)
- Soichiro Saeki
- Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
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11
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Goldowsky A, Singh R, Moss A. Speaker Diversity and Audience Ratings at a National Inflammatory Bowel Diseases Conference. Inflamm Bowel Dis 2024; 30:78-82. [PMID: 36932989 DOI: 10.1093/ibd/izad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Indexed: 03/19/2023]
Abstract
BACKGROUND There is a need to improve speaker diversity at gastroenterology conferences, but little public data exist to quantify this. In addition, the perception of diverse speakers by conference audiences is not appreciated. We sought to identify time trends in speaker profiles and audience ratings at a national inflammatory bowel diseases conference. METHODS Faculty profiles and audience feedback forms from 2014 to 2020 were reviewed for an annual inflammatory bowel diseases meeting. Speaker demographics including gender, race, and years of experience post-training were collected. Continuing medical education surveys were examined for audience ratings of speakers' knowledge level and teaching ability. RESULTS Six years of data were collected, including 560 main program faculty and 13 905 total feedback forms. The percentage of female speakers increased from 25% in 2016 to 39% in 2020. All-male panels decreased from 47% in 2014 to 2017 to 11% in 2018 to 2020. Racial diversity of speakers remained unchanged (13% Asian, 5% Hispanic/Latinx, 1% Black). In audience feedback forms, female speakers from all sessions were perceived as having equal knowledge base and teaching ability compared with male speakers. However, speakers with <10 years of experience post-training were viewed as less knowledgeable and with poorer teaching abilities compared with more senior faculty. CONCLUSIONS Gender diversity at inflammatory bowel disease conferences is improving. However, there remain significant gaps, particularly in racial diversity and improving perceptions of early-career speakers. These data should inform program committees for future gastroenterology conferences.
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Affiliation(s)
- Alexander Goldowsky
- Section of Gastroenterology and Hepatology, Boston University School of Medicine, Boston, MA, USA
| | - Roshni Singh
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Alan Moss
- Section of Gastroenterology and Hepatology, Boston University School of Medicine, Boston, MA, USA
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12
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Monahan K, Gould E, Rice T, Wright P, Vasilevskis E, Harrell F, Drago M, Mitchell S. Impact of the COVID-19 Pandemic on Medical Grand Rounds Attendance: Comparison of In-Person and Remote Conferences. JMIR Med Educ 2024; 10:e43705. [PMID: 38029287 PMCID: PMC10766009 DOI: 10.2196/43705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/23/2023] [Accepted: 07/19/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Many academic medical centers transitioned from in-person to remote conferences due to the COVID-19 pandemic, but the impact on faculty attendance is unknown. OBJECTIVE This study aims to evaluate changes in attendance at medical grand rounds (MGR) following the transition from an in-person to remote format and as a function of the COVID-19 census at Vanderbilt Medical Center. METHODS We obtained the faculty attendee characteristics from Department of Medicine records. Attendance was recorded using a SMS text message-based system. The daily COVID-19 census was recorded independently by hospital administration. The main attendance metric was the proportion of eligible faculty that attended each MGR. Comparisons were made for the entire cohort and for individual faculty. RESULTS The observation period was from March 2019 to June 2021 and included 101 MGR conferences with more than 600 eligible faculty. Overall attendance was unchanged during the in-person and remote formats (12,536/25,808, 48.6% vs 16,727/32,680, 51.2%; P=.44) and did not change significantly during a surge in the COVID-19 census. Individual faculty members attendance rates varied widely. Absolute differences between formats were less than -20% or greater than 20% for one-third (160/476, 33.6%) of faculty. Pulmonary or critical care faculty attendance increased during the remote format compared to in person (1450/2616, 55.4% vs 1004/2045, 49.1%; P<.001). A cloud-based digital archive of MGR lectures was accessed by <1% of faculty per conference. CONCLUSIONS Overall faculty attendance at MGR did not change following the transition to a remote format, regardless of the COVID-19 census, but individual attendance habits fluctuated in a bidirectional manner. Incentivizing the use of a digital archive may represent an opportunity to increase faculty consumption of MGR.
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Affiliation(s)
- Ken Monahan
- Vanderbilt University Medical Center, Nashville, TN, United States
| | - Edward Gould
- Vanderbilt University Medical Center, Nashville, TN, United States
| | - Todd Rice
- Vanderbilt University Medical Center, Nashville, TN, United States
| | - Patty Wright
- Vanderbilt University Medical Center, Nashville, TN, United States
| | | | - Frank Harrell
- Vanderbilt University Medical Center, Nashville, TN, United States
| | - Monique Drago
- Vanderbilt University Medical Center, Nashville, TN, United States
| | - Sarah Mitchell
- Vanderbilt University Medical Center, Nashville, TN, United States
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13
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Romanenko GK, Avdiukhina TI. [Educational trajectory of forensic medical expert in the system of continuous medical education]. Sud Med Ekspert 2024; 67:53-56. [PMID: 38587160 DOI: 10.17116/sudmed20246702153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
The objective of the study is to determine the possibility and the right to choose the directions of self-education and self-development by forensic medical experts within the framework of personal and professional development program in the educational trajectory formation. The materials of special and encyclopaedic literature including pedagogical and sociological sciences, as well as legal framework regulating the processes of continuing medical education have been studied. The choice of educational trajectory of forensic physician depending on personal benchmarks, self-education building and participation in educational activities has been defined.
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Affiliation(s)
- G Kh Romanenko
- Russian Medical Academy of Continuing Professional Education, Moscow, Russia
| | - T I Avdiukhina
- Russian Medical Academy of Continuing Professional Education, Moscow, Russia
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Tawhari I, AlQahtani OA, Alqahtani MS, Alshehri RM, Alsairy MA, Alqahtani SM, Aljaber AM, Alshahrani MM, Alqahtani AM, Alahmary MA, Alsuairi NM. Assessment of Primary Healthcare Providers' Knowledge and Practices in Addressing Asymptomatic Hyperuricemia and Gout in the Asir Region of Saudi Arabia. Cureus 2024; 16:e51745. [PMID: 38187028 PMCID: PMC10771121 DOI: 10.7759/cureus.51745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 01/09/2024] Open
Abstract
Introduction and aim Gout, the most common form of inflammatory arthritis, arises from hyperuricemia, a condition where elevated levels of uric acid lead to the deposition of monosodium urate (MSU) crystals in the joints. Nevertheless, it's important to note that not all cases of hyperuricemia result in gout. Methodology This cross-sectional study was conducted in the Asir region of Saudi Arabia, targeting primary healthcare physicians (PHPs) specializing in family medicine and general practice. The study utilized a modified electronic questionnaire, inspired by similar studies and aligned with recent guidelines, to assess PHPs' knowledge and practices concerning asymptomatic hyperuricemia (AH) and gout. The questionnaire encompassed the PHPs' demographic data and their knowledge and practices for AH and gout management. Results Out of 201 participating PHPs, the majority were male (68.2%), predominantly aged 25-34 years (73.1%), and practicing as general practitioners (61.2%). A significant proportion of PHPs had less than five years of experience (63.7%). In terms of education, 36.8% attended continuing medical education (CME) on AH or gout, and 66.7% were aware of the related management guidelines. The study revealed that the total knowledge score among PHPs averaged 5.18 out of seven, indicating a moderate level of knowledge. However, their practice level was moderate, with a mean practice score of 6.75 out of 12. The study also found no significant differences in knowledge scores based on gender, age, or years of experience, but significant variations were noted based on medical specialty. Conclusion There is a moderate level of knowledge and practice among PHPs in managing AH and gout in the Asir region. Despite adequate knowledge levels, there appears to be a gap in implementing this knowledge into practice, particularly in long-term management strategies. The findings emphasize the need for ongoing medical education and specialized training programs to bridge these gaps. The study provides a valuable framework for identifying and addressing similar challenges in other regions and medical practices.
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Affiliation(s)
- Ibrahim Tawhari
- Internal Medicine, College of Medicine, King Khalid University, Abha, SAU
| | - Omar A AlQahtani
- Medicine, College of Medicine, King Khalid University, Abha, SAU
| | | | - Rayan M Alshehri
- Medicine, College of Medicine, King Khalid University, Abha, SAU
| | | | - Saad M Alqahtani
- Medicine, College of Medicine, King Khalid University, Abha, SAU
| | | | | | - Ali M Alqahtani
- Medicine, College of Medicine, King Khalid University, Abha, SAU
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15
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Ward SA, Cornely RM, Mendiola M, Royce CS, Winkelman WD, Hacker MR, Anand M. Education in Female Sexual Function and Dysfunction among American Urogynecologic Society Members: An Unmet Need. South Med J 2024; 117:7-10. [PMID: 38151244 PMCID: PMC10756638 DOI: 10.14423/smj.0000000000001637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
OBJECTIVES Sexual function is an important component of women's health that has not been traditionally emphasized during medical training, suggesting that further education is needed to provide comprehensive patient care. The purpose of this study was to describe education and interest in female sexual function among urogynecology providers. METHODS Conducted in 2020, this was a cross-sectional survey of American Urogynecologic Society members assessing educational and clinical experience with female sexual function. RESULTS Of 642 members who opened the survey, 123 (19%) completed it. Most of the respondents were fellowship trained (70%), and 74% reported ≥10% of their patients had sexual function questions or concerns unrelated to prolapse or incontinence. Most (71%) of the members strongly agreed/agreed that they were comfortable evaluating and managing these patients. This was more common in providers who saw more patients (≥25%) with sexual function concerns (83%) compared with those who saw <25% (65%; P = 0.04). Most of the respondents reported receiving ≤1 lecture on normal sexual function (82%) or sexual dysfunction (85%) during medical training. Most (67%) would expand their practice if they received additional education. The most requested topics were disorders of desire (72%), orgasm (71%), and arousal (67%). The most common reasons for not expanding practice even with additional education were female sexual function not being of significant interest (30%) and time and interruption of practice flow (28%). CONCLUSIONS Most of the respondents felt comfortable caring for patients with sexual function concerns, but reported that they would expand their practice with additional education. The majority reported having received ≤1 female sexual function/dysfunction lecture during their medical training. This highlights a critical need and desire for more female sexual function education among the urogynecologic provider population.
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Affiliation(s)
- Sarah A. Ward
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
- Department of Obstetrics and Gynecology, Mount Auburn Hospital, Cambridge, Massachusetts
| | | | - Monica Mendiola
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
| | - Celeste S. Royce
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
| | - William D. Winkelman
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
- Department of Obstetrics and Gynecology, Mount Auburn Hospital, Cambridge, Massachusetts
| | - Michele R. Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
| | - Mallika Anand
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
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Gastineau KAB, Bell R, Hanes A, McKay S, Sigel E, Popescu F, Sommer EC, Barkin S. One Step Closer to Safer: Counseling Outcomes from American Academy of Pediatrics Firearm Safe Storage Education Training. J Pediatr 2024; 264:113767. [PMID: 37802387 DOI: 10.1016/j.jpeds.2023.113767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To assess pre and postself-reported counseling outcomes for Safer: Storing Firearms Prevents Harm, an American Academy of Pediatrics universal firearm safe storage counseling training for pediatric clinicians providing health maintenance in outpatient settings. STUDY DESIGN Safer was developed by a national multidisciplinary committee of firearm injury prevention experts with input from firearm-owning families and launched in June 2021. Pediatric clinicians completed baseline and 1-month posttraining surveys after signing up for the Pedialink course from February through June 2022. Primary outcomes included self-reported measures of counseling self-efficacy and frequency. Wilcoxon matched-pairs signed-rank tests compared outcome distributions at baseline and follow-up. Two adjusted, multilevel mixed-effects regression models were conducted. RESULTS Of 230 clinicians who completed baseline surveys, 146 (64%) completed 1-month postsurveys. Regional representation included Southeast = 67 (46%), Northeast = 24 (16%), Midwest = 21 (14%), Pacific = 15 (10%), Southwest = 11 (8%), and Rocky Mountain = 8 (5%). At follow-up, there was significant improvement in both the distribution of self-efficacy (median [first Quartile-third Quartile = 50 [20-70] at baseline and 80 [60-85] at follow-up; P < .001) and self-reported counseling frequency (median [first Quartile-third Quartile] = 10 [0-50] at baseline and 50 [10-80] at follow-up; P < .001). Adjusted regression model results suggested that self-efficacy significantly improved from baseline to follow-up (time coefficient 25.3; 95% CI = [21.0, 29.5]; P < .001) as did counseling frequency (time coefficient 13.6; 95% CI = [9.2, 18.0]; P < .001). CONCLUSIONS Significant improvement in self-reported counseling self-efficacy and frequency was demonstrated 1 month following Safer training.
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Affiliation(s)
- Kelsey A B Gastineau
- Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, TN.
| | - Rebecca Bell
- Department of Pediatrics, Larner College of Medicine at the University of Vermont and the University of Vermont Children's Hospital, Burlington, VT
| | | | - Sandra McKay
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX
| | - Eric Sigel
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Filoteia Popescu
- Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, TN
| | - Evan C Sommer
- Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, TN
| | - Shari Barkin
- Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, TN
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Papadakis S, Anastasaki M, Gamaletsou M, Papagiannopoulou X, Aligizakis E, Lionis C. Development of an eLearning intervention for enhancing health professionals' skills for addressing COVID-19 vaccine hesitancy. Front Med (Lausanne) 2023; 10:1290288. [PMID: 38155659 PMCID: PMC10753786 DOI: 10.3389/fmed.2023.1290288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Like many countries, Greece has faced resistance to coronavirus disease 2019 (COVID-19) vaccination among residents for both the initial and booster doses. Supporting healthcare professionals with delivering brief advice on COVID-19 vaccination may assist with reaching national vaccination targets. We sought to rapidly develop, pilot test, and deploy an eLearning intervention on skills training on effective techniques for addressing COVID-19 vaccine hesitancy for primary health and social care professionals in Greece. A five-part, 1.5-h eLearning was produced in Greek which featured two behavior change techniques, Very Brief Advice (VBA) and Motivational Interviewing (MI) adapted for use in addressing COVID-19 vaccine hesitancy. Six-film-based case studies modeling the use of VBA and MI in the context of challenging scenarios typically seen in Greek health and social settings were produced for the eLearning. The CME was pilot tested using a pre-post design in a small convenience sample (n = 17) of health care professionals. Pilot study results found the training provided new knowledge (80%), improved provider skills (80%), and was useful to provider's clinical practice (90%). There was a mixed effect in provider capability, motivation, and opportunity. Ninety percent of providers strongly agreed or agreed that they planned to use the information and skills provided by the training in their clinical practice. This project has resulted in new training assets for use by health and social professional tailored to the nationally context in Greece including supporting uptake of booster doses of the COVID-19 vaccine.
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Maria ARJ, Serra H, Castro MG, Heleno B. Telemedicine as a tool for continuing medical education. Fam Pract 2023; 40:569-574. [PMID: 37579324 PMCID: PMC10667068 DOI: 10.1093/fampra/cmad085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND There is a growing interest in the use of digital technologies to foster learning in the health professions, along with the drive to expand teleconsultations arising from the COVID-19 pandemic. This study aims to explore whether telemedicine between levels of care can act as continuous medical education (CME) tool for general practitioners (GPs) and hospital consultants at the referral cardiology department. METHODS This qualitative study was embedded in an organizational case study of the introduction of a new service model in the Portuguese health system. Semi-structured interviews were audio-recorded and pseudonymized. The transcribed interviews were stored, coded, and content analysis was performed in MAXQDA. RESULTS A total of 11 physicians were interviewed. GPs and cardiologists recognized that telemedicine between levels of care could act as a CME tool. Although they departed with different expectations, telemedicine helped them collaborate as a multidisciplinary team, exchanging feedback about clinical decisions, and constructing knowledge collaboratively. Telemedicine also supplemented existing learning meetings. The consequences of technology adoption may be viewed as a result of the actors involved (including the technology itself), characteristics of the context (including the organization), and an interaction between such factors. CONCLUSION Teleconsultations can be a learning opportunity for the health professionals involved. Our findings suggest that, in the context of the Portuguese health system, telemedicine as a CME tool helped to build multidisciplinary teams which exchanged feedback and constructed shared knowledge to improve patients' outcomes. It also helped to identify practice-changing contents to be included in face-to-face educational meetings.
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Affiliation(s)
- Ana Rita J Maria
- Regional Health Administration of Lisbon and Tagus Valley; Comprehensive Health Research Centre (CHRC), Nova Medical School | Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Helena Serra
- Interdisciplinary Centre of Social Sciences (CICS. NOVA), NOVA School of Social Sciences and Humanities | Faculdade de Ciências Sociais e Humanas, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Maria G Castro
- Cardiology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Bruno Heleno
- Regional Health Administration of Lisbon and Tagus Valley; Comprehensive Health Research Centre (CHRC), Nova Medical School | Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal
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Li Y, Shu X, Huo W, Wang X. Promoting public skin health through a national continuing medical education project on cosmetic and dermatologic sciences: a 15-year experience. Front Public Health 2023; 11:1273950. [PMID: 38035281 PMCID: PMC10687160 DOI: 10.3389/fpubh.2023.1273950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023] Open
Abstract
Background The developments in cosmetic sciences and technologies have generated a gap between the cosmetics and their users. Users including regular customers, clinicians, industry personnel, researchers, testing agencies, beauty salon workers, and mass media hardly possess the ability to distinguish truth from falsehood. The gap remained as one major reason for inappropriate cosmetics usage, insufficient efficacy, and even cosmetics adverse reactions (CARs). Methods Aiming at enhancing the relevant practitioners' cosmetic and dermatologic sciences, we launched a cosmetic and dermatologic sciences continuing medical education (CME) since 2008. The objective of the current study was to evaluate the effectiveness of the CME. We summarized and analyzed the project for the last 15 years. Meanwhile, an online survey consisted of three parts was performed to evaluate the CME and to collect the trainees' comments. Results A total of 3,923 trainees have participated in the CME project from 2008 to 2022. The trainees included clinicians, industry staffs, biomedical researchers, third-party cosmetics testing staffs, beauty salon staffs, students, and media staffs. The trainees had theory courses on cosmetic and dermatologic sciences, cosmetics DIY practice & video watching, and an optional guided tour during the 4.5-day CME. Eight hundred and twenty-three trainees and 586 control subjects responded to the online survey. The comprehensive test in the second part of the survey demonstrated that compared with the control group, the CME project significantly enhanced the trainees' perception and knowledge regarding the cosmetics formula sciences, basic dermatologic sciences, cosmetics usage, noninvasive measurements, new advances, CARs, and laws (p = 0.000). Trainees of all occupations ranked "basic dermatologic sciences and skin diseases" as the most significant sections. Trainees of all occupations believed the CME has contributed most in "understand the function & efficacy of cosmetics." We noticed the occupational variances. Over 97% of trainees were willing to recommend the CME to the others. Conclusion The CME project significantly enhanced the trainees' cosmetic and dermatologic sciences, which bridged the gap between cosmetics and public skin health. This multidisciplinary CME also contributed to establishing an interdisciplinary interaction and cooperation platform for the multiple occupations involved in the public skin health maintenance and promotion.
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Affiliation(s)
- Yiming Li
- Department of Dermatology and Venerology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaohong Shu
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Huo
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, China
| | - Xi Wang
- Department of Dermatology and Venerology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, China
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20
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Blomberg D, Stephenson C, Atkinson T, Blanshan A, Cabrera D, Ratelle JT, Mohabbat AB. Continuing Medical Education in the Post COVID-19 Pandemic Era. JMIR Med Educ 2023; 9:e49825. [PMID: 37966881 PMCID: PMC10687685 DOI: 10.2196/49825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/12/2023] [Accepted: 10/27/2023] [Indexed: 11/16/2023]
Abstract
Continuing medical education (CME) is a requirement for medical professionals to stay current in their ever-changing fields. The recent significant changes that have occurred due to the COVID-19 pandemic have significantly impacted the process of providing and obtaining CME. In this paper, an updated approach to successfully creating and administering CME is offered. Recommendations regarding various aspects of CME development are covered, including competitive assessment, marketing, budgeting, property sourcing, program development, and speaker and topic selection. Strategies for traditional and hybrid CME formats are also explored. Readers and institutions interested in developing CME, especially in the setting of the ongoing pandemic, will be able to use these strategies as a solid framework for producing CME. The recommendations and strategies presented within this paper are based on the authors' opinions, expert opinions, and experiences over 13 years of creating CME events and challenges brought about due to the COVID-19 pandemic.
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Affiliation(s)
- Debra Blomberg
- General Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | | | - Teresa Atkinson
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN, United States
| | | | - Daniel Cabrera
- School of Continuous Professional Development, Mayo Clinic, Rochester, MN, United States
| | - John T Ratelle
- Department of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Arya B Mohabbat
- General Internal Medicine, Mayo Clinic, Rochester, MN, United States
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21
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Syder NC, Omar D, McKenzie S, Brown-Korsah JB, Taylor SC, Elbuluk N. Gaps in medical education curricula on skin of color in medical school, residency, and beyond: Part 1. J Am Acad Dermatol 2023; 89:885-892. [PMID: 35390429 DOI: 10.1016/j.jaad.2022.03.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 11/20/2022]
Abstract
Various studies have revealed a disproportionately low representation of skin of color (SOC) dermatology in the medical education system of the United States. This disparity contributes to adverse experiences, missed and/or delayed diagnoses, and overall health inequities for individuals of color. The lack of sufficient SOC education begins at the medical school level and continues throughout residency, fellowship, and beyond formal training. This lack of education can be seen in the dearth of images of common and uncommon skin conditions in darker skin in widely used textbooks and educational resources as well as in the lack of formal training in SOC in many residency programs. Thus far, there have been valuable strides to make dermatologic education more inclusive of all skin colors, but there remains significant work to be done. With the population of the United States expected to continue to diversify and with the expectation that SOC will be a trait of over half of the population of the United States by 2050, it is important to strive for health equity by ensuring that comprehensive and inclusive medical training incorporates SOC. This paper will explore the issue of gaps in medical education in SOC dermatology at all levels and offer a strategic call to action to aid in rectifying this situation.
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Affiliation(s)
- Nicole C Syder
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Deega Omar
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; George Washington School of Medicine and Health Sciences, Washington, DC
| | - Shanice McKenzie
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jessica B Brown-Korsah
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California.
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Zalzal HG, Cheng J, Shah RK. Evaluating the Current Ability of ChatGPT to Assist in Professional Otolaryngology Education. OTO Open 2023; 7:e94. [PMID: 38020045 PMCID: PMC10663981 DOI: 10.1002/oto2.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/11/2023] [Accepted: 11/04/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To quantify ChatGPT's concordance with expert Otolaryngologists when posed with high-level questions that require blending rote memorization and critical thinking. Study Design Cross-sectional survey. Setting OpenAI's ChatGPT-3.5 Platform. Methods Two board-certified otolaryngologists (HZ, RS) input 2 sets of 30 text-based questions (open-ended and single-answer multiple-choice) into the ChatGPT-3.5 model. Responses were rated on a scale (correct, partially correct, incorrect) by each Otolaryngologist working simultaneously with the AI model. Interrater agreement percentage was based on binomial distribution for calculating the 95% confidence intervals and performing significance tests. Statistical significance was defined as P < .05 for 2-sided tests. Results In testing open-ended questions, the ChatGPT model had 56.7% of initially answering questions with complete accuracy, and 86.7% chance of answer with some accuracy (corrected agreement = 80.1%; P < .001). For repeat questions, ChatGPT improved to 73.3% with complete accuracy and 96.7% with some accuracy (corrected agreement = 88.8%; P < .001). For multiple-choice questions, the ChatGPT model performed substantially worse (43.3% correct). Conclusion ChatGPT currently does not provide reliably accurate responses to sophisticated questions in Otolaryngology. Professional societies must be aware of the potential of this tool and prevent unscrupulous use during test-taking situations and consider guidelines for clinical scenarios. Expert clinical oversight is still necessary for myriad use cases (eg, hallucination).
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Affiliation(s)
- Habib G. Zalzal
- Division of Otolaryngology–Head and Neck SurgeryChildren's National HospitalWashingtonDistrict of ColumbiaUSA
| | - Jenhao Cheng
- Quality, Safety, AnalyticsChildren's National HospitalWashingtonDistrict of ColumbiaUSA
| | - Rahul K. Shah
- Division of Otolaryngology–Head and Neck SurgeryChildren's National HospitalWashingtonDistrict of ColumbiaUSA
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de Beaux A, Becker S, Parent T, Temporal G, Kummer R, Allouard C, East B. Hernia Basecamp-A Free to Use, Online Hernia Learning Platform. Analysis of Its Use Since Launch in June 2021. J Abdom Wall Surg 2023; 2:11803. [PMID: 38312406 PMCID: PMC10831634 DOI: 10.3389/jaws.2023.11803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/21/2023] [Indexed: 02/06/2024]
Abstract
Introduction: Hernia Basecamp is an online learning platform hosted within the WebSurg website. One of the drivers of its development was to cover the syllabus of the UEMS AWS examination, but it is a learning resource in its own right. There are currently 205 video lectures, with a number of them selected to create 10 modules of 3 h each with UEMS CME accreditation. The aim of this study was to review the Hernia Basecamp usage since launch in June 2021. Methods: The Hernia Basecamp WebSurg platform was interrogated using Matomo Analytics in January 2023 (19 month period since launch). Data on the number of visits, pages looked at and time spent on the platform per visit, along with the number of CME modules taken and passed were collected. Results: Users from 146 countries visited the Hernia Basecamp site 17,171 times (6,586 times, 38.4% in first 9 months). The top 5 countries by visitors were the United Kingdom, Mexico, Spain, United States and Germany (accounting for 29.4% of the visits). The average time spent per visit was 11 min 37 s (range: 47 s-49 min 4 s), and the number of pages/videos viewed per visit was 8.1 (range: 2-21). The number of UEMS CME modules taken was 675, and 326 (48%) of these tests were passed. Conclusion: In the first 19 months from launch, Hernia Basecamp provided over 3,000 h of hernia education. The UEMS approved CME accreditation tests were commonly used.
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Affiliation(s)
- A. de Beaux
- Spire Murrayfield Hospital, Edinburgh, United Kingdom
| | - S. Becker
- WebSurg, The Online University of IRCAD, Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France
| | - T. Parent
- WebSurg, The Online University of IRCAD, Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France
| | - G. Temporal
- WebSurg, The Online University of IRCAD, Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France
| | - R. Kummer
- Medtronic International Trading Sarl, Tolochenaz, Switzerland
| | | | - B. East
- 3rd Department of Surgery, 1st Medical Faculty of Charles University at Motol University Hospital, Prague, Czechia
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Gerber B, Roth EP, Laubach TA, De Jong L, Kasper TJ, Perry J, Johnson A, Krogman WL, Newton FA, Powell S, Bragg DA, Regehr J. Educating Family Physician Residents for Anesthetic Preoperative Evaluation and Assessment. Kans J Med 2023; 16:234-236. [PMID: 37791030 PMCID: PMC10544880 DOI: 10.17161/kjm.vol16.20986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction Encounters for preoperative assessments are common within primary care offices, so it is imperative that family medicine residents learn how to perform preoperative evaluations. We assessed family medicine residents' knowledge of preoperative evaluation in preparation for surgery by providing a pre- and post-test alongside a didactic seminar. Methods A didactic seminar on preoperative evaluations was presented at a family medicine resident didactics session by two senior anesthesiology residents. A 16-question, multiple choice test was used as both a pre-test and post-test to assess family medicine residents' knowledge. Results A total of 31 participants took the pre-test (residents = 24; medical students = 7), and 30 participants took the post-test (residents = 23; medical students = 7). Mean scores and standard deviations were calculated for both tests with an average score of 37.50% ± 10.58% and 45.42% ± 11.12% on the pre- and post-test, respectively. Using the Kruskal-Wallis test, residents showed a significant improvement in test scores following the didactic presentation (p = 0.041), while overall results (residents and medical students) also reported a significant difference (p = 0.004). Conclusions Our results demonstrated that educating family medicine residents and medical students on preoperative evaluation showed significant, quantifiable gains in knowledge following a brief didactic presentation. Given the current gap between guidelines and practice, our results emphasize the need for a formal medical school and residency-based curriculum related to preoperative patient evaluation.
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Affiliation(s)
- Ben Gerber
- Department of Anesthesiology, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Eyan P Roth
- Family Medicine Residency Program at Ascension Via Christi, Wichita, KS
| | - Tyler A Laubach
- Family Medicine Residency Program at Ascension Via Christi, Wichita, KS
| | - Luke De Jong
- Family Medicine Residency Program at Ascension Via Christi, Wichita, KS
| | - Travis J Kasper
- Family Medicine Residency Program at Ascension Via Christi, Wichita, KS
| | - Jarrett Perry
- Department of Anesthesiology, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Allan Johnson
- Department of Anesthesiology, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - William L Krogman
- Department of Anesthesiology, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Felecia A Newton
- Department of Anesthesiology, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Sara Powell
- Department of Anesthesiology, University of Kansas School of Medicine-Wichita, Wichita, KS
- Wichita Anesthesiology Chartered, Wesley Medical Center, Wichita, KS
| | - Dee Ann Bragg
- Family Medicine Residency Program at Ascension Via Christi, Wichita, KS
| | - Jared Regehr
- Family Medicine Residency Program at Ascension Via Christi, Wichita, KS
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Okemah J, Neunie S, Noble A, Wysham C. Impact on Knowledge, Competence, and Performance of a Faculty-Led Web-Based Educational Activity for Type 2 Diabetes and Obesity: Questionnaire Study Among Health Care Professionals and Analysis of Anonymized Patient Records. JMIR Form Res 2023; 7:e49115. [PMID: 37703084 PMCID: PMC10534284 DOI: 10.2196/49115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Strategies for managing type 2 diabetes (T2D) and obesity are evolving with the introduction of targeted therapies, including incretin-based dual agonists and growing knowledge of the importance of multidisciplinary care. Accessible, effective continuing medical education (CME) activities are required to ensure that health care professionals (HCPs) understand and can implement the most recent data to optimize patient outcomes. OBJECTIVE We aimed to measure changes in knowledge, competence, and self-reported performance and quantitatively evaluate changes in performance using anonymized patient data following participation in a web-based educational activity. The faculty-led CME-accredited activity was based on incretin-based dual agonists and patient education on T2D and obesity. The remaining educational gaps in this field were also identified. METHODS A CME-accredited, web-based, multidisciplinary (touchMDT) educational activity titled "The future for glycemic control and weight loss in T2D and obesity: Incretin-based dual-agonists and optimizing patient education" was developed. HCP knowledge, competence, and performance were assessed before and after the activity against Moore's expanded outcomes framework (levels 1-5), using self-reported questionnaires and by analyzing anonymized patient record data. RESULTS For evaluating knowledge and competence (50 respondents before and 50 learners after the activity), the mean number of correctly answered questions was significantly higher post activity (median 5.0, IQR 4.0-6.0 to 6.0, IQR 5.0-7.0; mean 4.98, SD 1.22 to 5.78, SD 1.13; P<.001). Modest, nonsignificant improvements in self-reported performance (N=50 respondents preactivity; N=50 learners postactivity) from before to after the activity were observed (median 4.0, IQR 3.25-4.0 to 4.0, IQR 4.0-4.0; mean 3.64, SD 0.69 to 3.76, SD 0.48; P=.32). PPatient data analysis indicated that patients were being treated more intensively postactivity: before the activity, the most commonly used treatment regimens were metformin monotherapy (13/50, 26%) and dual therapy with metformin plus injectable glucagon-like peptide-1 (GLP-1) receptor agonist (RA; 11/50, 22%); post activity, this changed to dual therapy with metformin plus injectable GLP-1 RA (12/50, 24%) and triple therapy with metformin plus injectable GLP-1 RA plus sodium-glucose cotransporter-2 inhibitor (SGLT2i; 10/50, 20%). In addition, there was an increased number of referrals to a combination of specialists (physicians referred 27%, 8/30 of patients to ≥2 specialists before the activity and 36%, 10/28 to ≥2 specialists post activity). The remaining educational gaps included understanding the biology and psychology of obesity, efficacy and safety data for incretin-based dual agonists, and the role of the diabetes educator or diabetes care and education specialist in managing T2D and obesity. CONCLUSIONS This short, web-based CME activity on the management of T2D and obesity led to improvements in HCP knowledge, competence, and performance. Several remaining unmet needs were identified, which can be used to inform the content of future educational activities in this disease area.
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Affiliation(s)
| | - Sola Neunie
- touch Independent Medical Education, Stockport, Cheshire, United Kingdom
| | - Alexander Noble
- touch Independent Medical Education, Stockport, Cheshire, United Kingdom
| | - Carol Wysham
- Rockwood Center for Diabetes and Endocrinology, Spokane, WA, United States
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Briggs MR, Kaljo K. Development of a New Resident-Centric Sex Trafficking Education Program for Obstetrics/Gynecology, Emergency Medicine, and Family Medicine Programs. AJPM Focus 2023; 2:100088. [PMID: 37790666 PMCID: PMC10546594 DOI: 10.1016/j.focus.2023.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Human sex trafficking is widespread and a nationally recognized public health crisis. Trafficked individuals and survivors often utilize the healthcare system, yet healthcare professionals cite a lack of formal training to identify and provide appropriate care. This study aims to increase obstetrics/gynecology, emergency medicine, and family medicine residents' knowledge and confidence when caring for individuals involved in sex trafficking. Methods Obstetrics/gynecology, emergency medicine, and family medicine residents voluntarily attended an evidence-based education session and received an electronic pre-, immediate post-, and 5-month post-session survey measuring knowledge, attitudes, beliefs, and confidence. Validated survey items were adapted from previous studies. Paired t-tests (p<0.05) and descriptive analyses were used to determine differences. A concluding focus group was facilitated to further understand trainee experiences and awareness when caring for suspected sex-trafficked individuals and survivors. Thematic analysis determined reoccurring themes. Results Between 2019 and 2021, 48 pre-session, 28 immediate post-session, and 13 5-month post-session surveys were collected. Resident knowledge and confidence increased from the pre-session to the immediate post-session period. Session pre- and post-surveys were linked (n=14) and showed a statistically significant increase in knowledge (p<0.05) and an increase in confidence. The mean number of correct knowledge questions remained higher 5 months after the session than in the pre-session period. Focus group themes included increased resident knowledge and confidence. Conclusions Improvement and retention in resident knowledge and confidence in caring for sex-trafficked individuals illustrate the utility of this education intervention and expand on current literature. This study provides an example of an education session that can be adapted for other medical trainees.
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Affiliation(s)
- Morgan R. Briggs
- Department of Obstetrics & Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Kristina Kaljo
- Department of Obstetrics and Gynecology, Faculty Pillar of the Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee, Wisconsin
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Langaas HC, Salvesen Ø, Dyrkorn R, Blix HS, Spigset O. Academic detailing as a method to improve general practitioners' drug prescribing in type 2 diabetes: evaluation of changes in prescribing. Scand J Prim Health Care 2023; 41:224-231. [PMID: 37326464 PMCID: PMC10478614 DOI: 10.1080/02813432.2023.2222781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 06/04/2023] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVE To investigate the effect of an academic detailing intervention on the utilisation of type 2 diabetes medication among general practitioners. DESIGN We developed an academic detailing campaign based on the revised national treatment guideline for diabetes and the best available evidence. General practitioners were offered a 20-minute one-to-one visit by a trained academic detailer. SETTING AND SUBJECTS A total of 371 general practitioners received a visit and represented the intervention group. The control group consisted of 1282 general practitioners not receiving a visit. MAIN OUTCOME MEASURES Changes in prescribing from 12 months before to 12 months after the intervention. The primary endpoint was a change in metformin. Secondary endpoints were changes in other groups of Type 2 diabetes medication and of these drugs in total. RESULTS Prescribing of metformin increased by 7.4% in the intervention group and 5.2% in the control group (p = .043). Sodium-glucose cotransporter-2 inhibitors increased by 27.6% in the intervention group and 33.8% in the control group (p = .019). For sulfonylureas there was a decrease of 3.6% in the intervention group vs. 8.9% in the control group (p = .026). The total amount of prescribed medications for type 2 diabetes increased by 9.1% in the intervention group and 7.3% in the control group (p = .08). CONCLUSION Academic detailing initiated a small but statistically significant increase in the prescription of metformin. For a complex subject like type 2 diabetes, we recommend reserving more time in the visit than the 20 min our campaign aimed for.
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Affiliation(s)
- Harald Christian Langaas
- KUPP – The Norwegian Academic Detailing Program, Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
- Regional Medicines Information and Pharmacovigilance Centre (RELIS), Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Øyvind Salvesen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Roar Dyrkorn
- KUPP – The Norwegian Academic Detailing Program, Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
- Department of Clinical Pharmacology, St Olav University Hospital, Trondheim, Norway
| | - Hege Salvesen Blix
- Department of Drug Statistics, Norwegian Institute of Public Health, Oslo, Norway
- Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Olav Spigset
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Clinical Pharmacology, St Olav University Hospital, Trondheim, Norway
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Lucero KS, Larkin A, Zakharkin S, Wysham C, Anderson J. The Impact of Web-Based Continuing Medical Education Using Patient Simulation on Real-World Treatment Selection in Type 2 Diabetes: Retrospective Case-Control Analysis. JMIR Med Educ 2023; 9:e48586. [PMID: 37642994 PMCID: PMC10498312 DOI: 10.2196/48586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/01/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Despite guidelines recommending the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in certain patients with type 2 diabetes (T2D), they are not being prescribed for many of these patients. Web-based continuing medical education (CME) patient simulations have been used to identify clinicians' practice gaps and improve clinical decision-making as measured within a simulation, but the impact of this format on real-world treatment has not been researched. OBJECTIVE This study aimed to evaluate the effect of a simulation-based CME intervention on real-world use of GLP-1 RAs by endocrinologists and primary care physicians. METHODS Two evaluation phases of the CME simulation were conducted: phase I, the CME simulation phase, was a paired, pre-post study of 435 physician learners in the United States; and phase II, the real-world phase, was a retrospective, matched case-control study of 157 of the 435 physicians who had claims data available for the study period. RESULTS Phase I CME results showed a 29 percentage point increase in correct decisions from pre- to postfeedback (178/435, 40.9% to 304/435, 69.9%; P<.001) in selecting treatment that addresses both glycemic control and cardiovascular event protection. Phase II results showed that 39 of 157 (24.8%) physicians in the intervention group increased use of GLP-1 RAs, compared to 20 of 157 (12.7%) in the comparison group. Being in the intervention group predicted GLP-1 RA use after education (odds ratio 4.49; 95% CI 1.45-13.97; P=.001). CONCLUSIONS A web-based CME simulation focused on secondary prevention of cardiovascular events in a patient with T2D was associated with increased use of evidence-based treatment selection in the real world.
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Affiliation(s)
| | - Amy Larkin
- Medscape, LLC, New York, NY, United States
| | | | - Carol Wysham
- University of Washington School of Medicine Spokane, Spokane, WA, United States
- MultiCare Rockwood Diabetes & Endocrinology Center, Spokane, WA, United States
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Talcott W, Ford E, Johnson J, Lincoln H, Evans S. Self-reported COVID-19 infection, and illness severity associated with a large professional-society meeting of the AAPM in 2022. Med Phys 2023; 50:4689-4694. [PMID: 37415569 DOI: 10.1002/mp.16592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Many in-person conferences were suspended during the initial stages of the COVID-19 pandemic but have recently begun to return to in-person or hybrid formats. However the incidence and severity of COVID-19 infection during conferences, as well as behaviors at meetings associated with infection, are not well known. PURPOSE We performed a targeted, systematic survey of self-reported COVID-19 infection and severity rates among in-person attendees and potential attendees of a large national medical conference held in hybrid format during the during the Omicron subvariant wave, to provide guidance for future meeting attendees and organizers on COVID-19 risk. METHODS A survey was sent to all members of the American Association of Physicists in Medicine (AAPM) as well as all attendees of the AAPM 2022 Annual Meeting (held July 10th-14th 2022 in Washington DC) with hybrid format) (total n = 10,627). The survey assessed relevant respondent demographics, views of COVID-19 and in-person meetings, COVID-19 infection during the meeting or the following 7 days, and any COVID-19 treatment received. Descriptive statistics and multivariable logistic regression with odds ratios (OR) and 95% confidence intervals (CI) were used for analysis. RESULTS The response rate was 13.7% (n = 1464) among the total invitees. Of respondents, 62.9% (n = 921) attended the meeting in person and 37.1% (n = 543) did not. Among in-person meeting attendees, 82.1% (n = 756) attended indoor social events during the meeting including 67.5% (n = 509) who attended a large, AAPM-coordinated social event. Reported COVID-19 infection rates were higher among in-person attendees (15.3%, n = 141) versus those that did not attend in-person (6.1%, n = 33) (p < 0.001). Of those infected, 97.9% (n = 138) recovered entirely at home, with the remaining 2 (1.4%) undergoing emergency room visit without admission, and 1 (unvaccinated) individual (0.7%) reported hospital admission. On multivariable analysis of reported in-person attendee behaviors, only attendance of the large, AAPM-coordinated social event remained significantly associated with COVID-19 infection (OR 2.8, CI 1.8-4.2, p < 0.001). Among in-person attendees, 74.1% (n = 682) agreed that they would feel comfortable attending in-person conferences in the future, 11.8% (n = 109) disagreed, and 14.0% (n = 129) neither agreed nor disagreed. CONCLUSIONS Despite higher than previously reported COVID-19 infection rates than prior studies, severity of infection was self-limited with no hospitalizations among vaccinated attendees. In-person attendees showed a willingness to return to large-scale indoor social interaction, with a higher rate of COVID-19 infection noted among those who attended a large conference-affiliated social gathering. Most individuals reported feeling comfortable attending other in-person meetings in the future.
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Affiliation(s)
- Wesley Talcott
- Northwell Health Cancer Institute, Department of Radiation Medicine, Lake Success, New York, USA
| | - Eric Ford
- University of Washington Medical Center, Department of Radiation Oncology, Seattle, USA
| | | | - Holly Lincoln
- University of Connecticut, Department of Radiation Oncology, Stamford, USA
| | - Suzanne Evans
- Yale School of Medicine, Department of Therapeutic Radiology, New Haven, USA
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Magalski GR, Obermair A, Hanna GB, Graves N, Coleman MG, Horsham C, Sanjida S, Silva CV, Rao A, Janda M. Experience of practicing obstetrician-gynecologists in a surgical training program in total laparoscopic hysterectomy. AJOG Glob Rep 2023; 3:100249. [PMID: 37521746 PMCID: PMC10374960 DOI: 10.1016/j.xagr.2023.100249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Advanced surgical techniques, such as total laparoscopic hysterectomy, are often challenging to acquire beyond fellowship training programs for practicing obstetrician-gynecologists. A lack of formative data currently exist for continuing medical education programs, limiting our understanding of how improvement in surgical skills and training programs occur. OBJECTIVE This study aimed to investigate how practicing obstetrician-gynecologists acting as trainees experience a program that aims to teach them total laparoscopic hysterectomy, and to assess whether their surgical skills improve according to data from formative assessment tools and qualitative data from open-ended survey questions and in-depth interviews. STUDY DESIGN We report a process analysis of formative data collected during a pilot implementation trial of a surgical training program targeting practicing obstetrician-gynecologists. Eleven consultant obstetrician-gynecologists and 4 experienced surgical mentors participated in 4 hospitals in Queensland, Australia. Total laparoscopic hysterectomy was performed in 700 patients over the course of the study. A total laparoscopic hysterectomy surgical mentorship training program of 10 training days with up to 3 total laparoscopic hysterectomy procedures per day was performed. Both the obstetrician-gynecologists and the surgical mentor completed a formative assessment questionnaire analyzing the trainee's performance after each surgical procedure. Mentors were formatively assessed by the Structured Training Trainer Assessment Report (STTAR) and at the completion of the study by the mini-STTAR, a summative assessment of quality of mentorship. Obstetrician-gynecologists, mentors, hospital leaders, and surgical administrative staff participated in qualitative interviews about the training program. RESULTS Over time, there was a demonstrated improvement in trainee performance reported by both mentors and trainees in all competency assessment tool domains as the case number increased, with mentors consistently rating trainees' performance higher than the trainees themselves. Most trainees were satisfied with their mentor in all 31 areas during formative assessment, and at the end of the training, structure, attributes, and role modeling were all rated high (average score >4.5; range, 3.79-5.00), whereas training behavior was rated slightly lower at 4.1 (range, 3.79-4.45). Qualitative interviews demonstrated that the trainees found the training to be a beneficial, hands-on experience. CONCLUSION Formative assessment clearly documented improvement in surgical skills during a total laparoscopic hysterectomy training program for consultant obstetrician-gynecologists.
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Affiliation(s)
- Gabrielle R. Magalski
- Centre for Clinical Research, The University of Queensland, Brisbane, Australia (Drs Magalski, Obermair and Rao)
| | - Andreas Obermair
- Centre for Clinical Research, The University of Queensland, Brisbane, Australia (Drs Magalski, Obermair and Rao)
- Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Herston, Australia (Drs Obermair and Rao)
| | - George B. Hanna
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom (Dr Hanna)
| | - Nicholas Graves
- Health Services and Systems Research, Duke-NUS Medical School, Singapore (Dr Graves)
| | - Mark G. Coleman
- Department of Surgery, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom (Dr Coleman)
| | - Caitlin Horsham
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia (Ms Horsham, Dr Sanjida, Ms Silva, and Dr Janda)
| | - Saira Sanjida
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia (Ms Horsham, Dr Sanjida, Ms Silva, and Dr Janda)
| | - Carina V. Silva
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia (Ms Horsham, Dr Sanjida, Ms Silva, and Dr Janda)
| | - Archana Rao
- Centre for Clinical Research, The University of Queensland, Brisbane, Australia (Drs Magalski, Obermair and Rao)
- Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Herston, Australia (Drs Obermair and Rao)
| | - Monika Janda
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia (Ms Horsham, Dr Sanjida, Ms Silva, and Dr Janda)
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Lyu X, Li S. Professional medical education approaches: mobilizing evidence for clinicians. Front Med (Lausanne) 2023; 10:1071545. [PMID: 37575990 PMCID: PMC10419302 DOI: 10.3389/fmed.2023.1071545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 07/07/2023] [Indexed: 08/15/2023] Open
Abstract
Rapidly proliferating high-quality evidence supports daily decision-making in clinical practice. Continuing professional medical education links this evidence to practicing clinicians who are strongly motivated to improve the quality of their care by using the latest information. Approaches to professional education vary, and their effects depend on specific scenarios. This narrative review summarizes the main approaches for professional medical education that facilitate the mobilization of evidence for clinicians. It includes traditional learning (passive and active dissemination of educational materials, lectures, and mass media dissemination), constructivist learning (engaging in local consensus processes and education outreach visits, interfacing with local opinion leaders, conducting patient-mediated interventions, employing audit and feedback processes, and utilizing clinical decision-supporting systems), and blended learning approaches (the integration of in-person or online passive learning with active and creative learning by the learners). An optimized selection from these approaches is challenging but critical to clinicians and healthcare systems.
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Affiliation(s)
- Xiafei Lyu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Sheyu Li
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
- Division of Guideline and Rapid Recommendation, Cochrane China Center, MAGIC China Center, Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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Raumer-Monteith L, Kennedy M, Ball L. Web-Based Learning for General Practitioners and Practice Nurses Regarding Behavior Change: Qualitative Descriptive Study. JMIR Med Educ 2023; 9:e45587. [PMID: 37498657 PMCID: PMC10415945 DOI: 10.2196/45587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/26/2023] [Accepted: 06/27/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Supporting patients to live well by optimizing behavior is a core tenet of primary health care. General practitioners and practice nurses experience barriers in providing behavior change interventions to patients for lifestyle behaviors, including low self-efficacy in their ability to enact change. Web-based learning technologies are readily available for general practitioners and practice nurses; however, opportunities to upskill in behavior change are still limited. Understanding what influences general practitioners' and practice nurses' adoption of web-based learning is crucial to enhancing the quality and impact of behavior change interventions in primary health care. OBJECTIVE This study aimed to explore general practitioners' and practice nurses' perceptions regarding web-based learning to support patients with behavior change. METHODS A qualitative, cross-sectional design was used involving web-based, semistructured interviews with general practitioners and practice nurses in Queensland, Australia. The interviews were recorded and transcribed using the built-in Microsoft Teams transcription software. Inductive coding was used to generate codes from the interview data for thematic analysis. RESULTS In total, there were 11 participants in this study, including general practitioners (n=4) and practice nurses (n=7). Three themes emerged from the data analysis: (1) reflecting on the provider of the Healthy Lifestyles suite; (2) valuing the web-based learning content and presentation; and (3) experiencing barriers and facilitators to using the Healthy Lifestyles suite. CONCLUSIONS Provider reputation, awareness of availability, resources, content quality, usability, cost, and time influence adoption of web-based learning. Perceived quality is associated with culturally tailored information, resources, a balance of information and interactivity, plain language, user-friendly navigation, appealing visual presentation, communication examples, and simple models. Free web-based learning that features progress saving and module lengths of less than 2 hours alleviate perceived time and cost barriers. Learning providers may benefit by including these features in their future behavior change web-based learning for general practitioners and practice nurses.
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Affiliation(s)
- Lauren Raumer-Monteith
- Nutrition and Dietetics, School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | - Madonna Kennedy
- Prevention Strategy Branch, Queensland Health, Brisbane, Australia
| | - Lauren Ball
- Centre for Community Health and Wellbeing, University of Queensland, Brisbane, Australia
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Kandasamy G, Almaghaslah D, Almanasef M. An Evaluation of Continuing Medical Education among Pharmacists in Various Pharmacy Sectors in the Asir Region of Saudi Arabia. Healthcare (Basel) 2023; 11:2060. [PMID: 37510500 PMCID: PMC10379422 DOI: 10.3390/healthcare11142060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Continuing medical training is an important component of modern medical practice because it maintains the ability of physicians to provide up-to-date patient care. This study explored pharmacists' involvement in CME activities and investigated the barriers to undertaking CME activities in Saudi Arabia. It also aimed to highlight the obstacles that prevent pharmacists from participating in CE activities. METHODS This study used a cross-sectional self-administered web-based questionnaire. It was conducted among practising pharmacists in various pharmacy fields in the Asir region of Saudi Arabia. The structured questionnaire consisted of four domains. A convenience sampling strategy was used to select and recruit study participants. The results were described in terms of frequencies and percentages. A Chi-square test was used to assess the differences for categorical data. p value of <0.05 was considered significant. RESULTS AND CONCLUSIONS A total of 173 pharmacists participated in the study. Attending the conference was the most popular activity (67%), followed by training courses (61.8%) and approved web-based activities (60.1%). Regarding barriers that prevented pharmacists from participating in CME activities, a lack of a scientific database or books was the top-rated barrier that hindered pharmacists from obtaining the required CME hours (79.8%). Another important barrier was the cost of the activities (74.6%). Regarding the area of practice for which pharmacists would be interested in attending CME activities, public health was the favourite (89.6%), followed by personal skills (82.7%). Gathering the required CME hours for re-registration was the main motive for attending CME activities in most of the pharmacy sectors. Policymakers should consider shifting the current CME system to the Continuing Professional Development (CPD) model, which promotes engagement in professional development activities that are relevant to the scope of practice.
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Affiliation(s)
- Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia
| | - Dalia Almaghaslah
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia
| | - Mona Almanasef
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia
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Day K, Bredenoord AJ, Skypala I, Spergel J, Bickford K, Noble A, Nunn AM. Addressing educational gaps through multidisciplinary team education in eosinophilic oesophagitis management. J CME 2023; 12:2230033. [PMID: 37426427 PMCID: PMC10327516 DOI: 10.1080/28338073.2023.2230033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/13/2023] [Accepted: 06/21/2023] [Indexed: 07/11/2023]
Abstract
Once considered a rare disease, eosinophilic oesophagitis (EoE) is becoming increasingly prevalent, yet many healthcare professionals (HCPs) remain unfamiliar with the underlying pathophysiology and optimal management approaches. For this study, we developed a faculty-led, online, continuing medical education activity on EoE. The effectiveness of this activity was evaluated according to Moore's framework, with changes in knowledge and competence (Moore's Levels 3 and 4) assessed for a cohort of gastroenterologists, dietitians, allergists and immunologists (N = 300), using questionnaires completed before and after participation. Changes in HCP confidence in treating EoE were also reported and remaining educational gaps were identified. The activity was viewed by a global audience of 5,330 participants within 6 months, and significant improvements in knowledge and competence were reported following participation in the activity across all specialities, regions and experience (mean [standard deviation] score pre- versus post-activity: 4.32 [1.38] versus 5.46 [0.82]; p < 0.001). Confidence in treating EoE also increased from pre- to post-activity, with the proportion of participants reporting that they felt moderately or extremely confident increasing from 53% to 82%. Several educational unmet needs were identified, which can be used to inform the design of future educational activities in EoE.
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Affiliation(s)
- Kathy Day
- Medical and Editorial, touchIME Ltd, Stockport, UK
| | - Albert J Bredenoord
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Isabel Skypala
- Department of Allergy and Clinical Immunology, Royal Brompton & Harefield Hospitals, Part of Guys & St Thomas NHS Foundation Trust, London, UK
| | - Jonathan Spergel
- Allergy Section, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | - Anne M Nunn
- Medical and Editorial, touchIME Ltd, Stockport, UK
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Gurckoy LD, Zudin AB, Melerzanov AV. [The telemedicine and digital technologies in education programs of training medical personnel of higher qualification]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2023; 31:625-631. [PMID: 37642107 DOI: 10.32687/0869-866x-2023-31-4-625-631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/13/2023] [Indexed: 08/31/2023]
Abstract
The article considers application of telemedicine and digital technologies in educational programs of training medical personnel in residency and graduate school for the Russian health care system. The possibilities of telemedicine and digital technologies that currently are in use for remote medical care, consultations of medical workers by qualified medical specialists and for training and re-training of medical personnel are investigated. The key topics of modern health care are improvement of system of training medical manpower, personalization of medical care in health care, individualization of professional orientation in the process of continuing medical education and current methods of information environment management in health care sector. The conclusion is made that owing to new technologies,such innovations as telemedicine, artificial intelligence, medical decision-making systems, remote platforms of patient health monitoring and other modern inventions are implemented into health care. The purpose of the study is to examine impact of transformational processes in higher medical education in epoch of digitization.
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Affiliation(s)
- L D Gurckoy
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia,
- The Federal State Budget Educational Institution of Higher Education "The Rostov State Medical University" of Minzdrav of Russia, 344022, Rostov-on-Don, Russia
| | - A B Zudin
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia
| | - A V Melerzanov
- The Federal State Autonomous Educational Institution of Higher Education "The Moscow Institute of Physics and Technologies", 141701, Dolgoprudny, the Moscow Oblast, Russia
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Leung KCY, Peisah C. A Mixed-Methods Systematic Review of Group Reflective Practice in Medical Students. Healthcare (Basel) 2023; 11:1798. [PMID: 37372916 DOI: 10.3390/healthcare11121798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/02/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Used primarily as a pedagogical evaluation tool for didactic teaching and skill development, reflective practice (RP) for its own merits is poorly understood. This study aimed to systematically review the literature regarding the role of group RP in fostering empathy, wellbeing, and professionalism in medical students. METHODS Electronic searches of empirical studies published between 1 January 2010 and 22 March 2022 from Medline, Embase, and PsychINFO databases were conducted. Empirical studies of any design (qualitative or quantitative) which included RP (1) involving medical students; (2) with a focus on fostering empathy, or professionalism, or personal wellbeing; and (3) provided in a group setting were included. Duplicates, non-English articles, grey literature and articles using RP to examine pedagogy and specific technical skills were excluded. Both authors screened articles independently to derive a final list of included studies, with any discrepancies resolved by discussion, until consensus reached. Articles were rated for methodological quality using the Attree and Milton checklist for qualitative studies; the Oxford Centre for Evidence-Based Medicine criteria, and the Alberta Heritage Foundation for Medical Research Standard Quality Assessment Criteria for quantitative studies. RESULTS Of 314 articles identified, 18 were included: 9 qualitative; 4 quantitative and 5 mixed methodology. Settings included United States (6), United Kingdom (3), Australia (3), France (2), Taiwan (2), Germany (1), and Ireland (1). Themes were (i) professionalism: bridging theoretical paradigms and practice; (ii) halting empathy decline; (iii) wellbeing: shared experience. Additional themes regarding the "successful" delivery of RP groups in facilitating these outcomes also emerged. CONCLUSIONS This first systematic review of group RP in medical students shows that RP may bring theory to life in clinical dilemmas, while fostering collegiality and mitigating against isolation amongst students, despite the absence of studies directly examining wellbeing. These findings support the value of RP integration focusing on emotive and humanitarian processes into contemporary medical education for medical students. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022322496.
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Affiliation(s)
- Kelvin C Y Leung
- Research and Education Network, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Carmelle Peisah
- Research and Education Network, Westmead Hospital, Sydney, NSW 2145, Australia
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Specialty of Psychiatry, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
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Malik A, Kohli M, Sood J, Singh B, Radhakrishnan B, Kanchi M. Postgraduate training in anaesthesiology - A modular curriculum. Indian J Anaesth 2023; 67:548-555. [PMID: 37476448 PMCID: PMC10355357 DOI: 10.4103/ija.ija_674_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 07/22/2023] Open
Abstract
The primary objective of postgraduate medical education is to produce specialists who provide highest quality of health care to suffering patients and return them to the community in the most functional capability. The secondary objective is to advance the cause of science through research and training. A postgraduate, after undergoing the required training in anaesthesiology, should be able to recognise the health needs of the community and apply cognitive and psychomotor skills to provide optimal anaesthetic care. Additionally, the anaesthesiologist should function as a perioperative physician being adept in perioperative care, pain medicine and critical care medicine. The 3-year postgraduate curriculum comprises experience in basic, subspeciality and advanced anaesthesia training. This structured training programme with a curriculum of increasing difficulty and learning incorporates ascending grades of difficulty, posing a challenge to the trainee's intellect and technical skills. Experience in basic anaesthesia training is aimed to lay stress on basic and fundamental aspects of anaesthetic management. Subspeciality anaesthesia training is needed to lay stress on the theory, special considerations and practice of subdisciplines of anaesthesiology. This document proposes a modular-structured, continuous, objectively evaluated, systematic training process that is monitored frequently and periodically, such that the trainee, at the end of training, is capable of appropriate anaesthetic management of disease conditions in a wide variety of situations.
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Affiliation(s)
- Anita Malik
- Anaesthesiology and Critical Care, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Monica Kohli
- Anaesthesiology and Critical Care, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Jayashree Sood
- Chairperson, Institute of Anaesthesiology, Pain and Perioperative Medicine, Sir Gangaram Hospital, New Delhi, India
| | - Baljit Singh
- Department of Anaesthesiology, SGT Medical College Hospital and Research Institute, Gurugram, Haryana, India
| | | | - Muralidhar Kanchi
- Department of Anaesthesiology and Intensive Care, Narayana Institute of Cardiac Sciences, Narayana Health City, Bengaluru, Karnataka, India
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Levandowski BA, Steinke J, Stewart C, Urbina AE, Wilder TL, Bevec E, Dye TD. Ending the Epidemic: Building Health Care Capacity Through HIV and HCV Preceptorship Programs. AIDS Educ Prev 2023; 35:213-224. [PMID: 37410371 DOI: 10.1521/aeap.2023.35.3.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Since 2015, Mount Sinai HIV/HCV Center of Excellence has implemented two-day HIV and HCV preceptorships for New York State health care. Participants assessed their knowledge of and confidence to perform 13 HIV or 10 HCV prevention- and treatment-related skills, measured on a 4-point Likert scale from "not at all" to "very" knowledgeable/confident at baseline, exit survey, and a recent evaluation. Wilcoxon signed rank sum tests determined mean differences at all three time points. Between baseline to exit assessment and baseline to evaluation assessment, HIV and HCV preceptorship attendees reported significant increases in knowledge for five HIV and three HCV components and confidence for two HIV and three HCV tasks (p < .05), respectively. The preceptorship significantly and positively impacted short-term and long-term knowledge and confidence around HCV and HIV clinical skills. The implementation of HIV and HCV preceptorship programs may increase HIV and HCV treatment and prevention service efficacy within key population areas.
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Affiliation(s)
- Brooke A Levandowski
- Clinical Education Initiative, Resource Center of Excellence, and the Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York
| | - Jessica Steinke
- Columbia University Mailman School of Public Health, New York City, New York (current affiliation)
- Clinical Education Initiative, HIV/HCV Center of Excellence, Mt. Sinai Institute for Advanced Medicine, New York City, New York
| | - Cheyenne Stewart
- Clinical Education Initiative, HIV/HCV Center of Excellence, Mt. Sinai Institute for Advanced Medicine, New York City, New York
- EngageWell IPA, New York City, New York (current affiliation)
| | - Antonio E Urbina
- Clinical Education Initiative, HIV/HCV Center of Excellence, Mt. Sinai Institute for Advanced Medicine, New York City, New York
| | - Terri L Wilder
- Clinical Education Initiative, HIV/HCV Center of Excellence, Mt. Sinai Institute for Advanced Medicine, New York City, New York
| | - Erin Bevec
- University of Rochester, Rochester, New York
| | - Timothy D Dye
- Clinical Education Initiative, Resource Center of Excellence, and the Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York
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Allsop S, McKinley RK, Douglass C, Pope L, Macdougall C. Every doctor an educator? Med Teach 2023; 45:559-564. [PMID: 36622887 DOI: 10.1080/0142159x.2022.2158069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
INTRODUCTION The education of the future health care workforce is fundamental to ensuring safe, effective, and inclusive patient care. Despite this there has been chronic underinvestment in health care education and, even though there is an increased need for educators, the true number of medical educators has been in relative decline for over a decade. PURPOSE In this paper, we focus on the role of doctors as medical educators. We reflect on the culture in which medical education and training are delivered, the challenges faced, and their origins and sustaining factors. We propose a re-framing of this culture by applying Maslow's principles of the hierarchy of needs to medical educators, not only as individuals but as a specialist group and to the system in which this group works, to instigate actionable change and promote self-actualization for medical educators. DISCUSSION Promoting and supporting the work of doctors who are educators is critically important. Despite financial investment in some practice areas, overall funding for and the number of medical educators continues to decline. Continuing Professional Development (CPD) schemes such as those offered by specialised medical education associations are welcomed, but without time, funding and a supportive culture from key stakeholders, medical educators cannot thrive and reach their potential. CONCLUSION We need to revolutionise the culture in which medical education is practised, where medical educators are valued and commensurately rewarded as a diverse group of specialists who have an essential role in training the health care workforce to support the delivery of excellent, inclusive health care for patients. By reimagining the challenges faced as a hierarchy we show that until the fundamental needs of value, funding and time are realised, it will remain challenging to instigate the essential change that is needed.
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Affiliation(s)
- Sarah Allsop
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | - Lindsey Pope
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
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Rieser R, Weil B, Jenni N, Brodmann Maeder M. Initiative for the implementation of planetary health in postgraduate medical training and continuing medical education in Switzerland. GMS J Med Educ 2023; 40:Doc26. [PMID: 37377574 PMCID: PMC10291353 DOI: 10.3205/zma001608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 08/10/2022] [Accepted: 09/01/2022] [Indexed: 06/29/2023]
Abstract
The Swiss Medical Association FMH drew up the strategy "Planetary health - Strategy on the courses of action on climate change for the medical profession in Switzerland" in collaboration with the Swiss Institute for Medical Education SIME, the umbrella organisations and students. On 7 October 2021, the strategy was approved by the Swiss Medical Chamber with a budget of over CHF 380,000 (approx € 365,000). The first step in implementation involved setting up an advisory group which will tackle the concrete implementation of the strategy. This article provides an insight into the current state of work on the project with a focus on the measures in the areas of postgraduate medical training and continuing medical education. It is a work in progress.
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Affiliation(s)
- Robin Rieser
- Swiss Medical Association FMH, Bern, Switzerland
| | - Barbara Weil
- Swiss Medical Association FMH, Bern, Switzerland
| | - Nadja Jenni
- Swiss Institute for Medical Education SIME, Bern, Switzerland
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Bogarin R, Elizondo L, Kalaitzoglou E, Popovic J, Rogol A, Richmond E, Chanoine JP, Lopez-Pedrosa JM, Ruiz Salazar F, Vuguin P. Bringing the Pediatric Endocrine Spanish Speaking Community Together: First Virtual Pediatric Endocrine Meeting in Low- and Middle-Income Countries in Central and South America. Interact J Med Res 2023; 12:e41353. [PMID: 37155229 PMCID: PMC10203921 DOI: 10.2196/41353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Pediatric endocrinology is a specialty that is struggling worldwide to maintain adequately trained professionals. Pediatric endocrine care in Central America and Caribbean countries is often performed by pediatricians or adult endocrinologists due to the limited number of pediatric endocrinologists. These health care providers are seldom members of endocrine societies and frequently lack formal training in the field. OBJECTIVE In this study, we describe the scope of a virtual conference in pediatric endocrinology and diabetes targeted to low- and middle-income countries to provide equal opportunities for access to medical education for health care professionals. METHODS The virtual conference was sponsored by the Pediatric Endocrine Society (North America), Asociación Costarricense de Endocrinología (previously, Asociación Nacional Pro Estudio de la Diabetes, Endocrinología y Metabolismo), and Asociacion Centroamericana y del Caribe de Endocrinologia Pediátrica. The conference was free to participants and comprised 23 sessions that were either synchronous with ability for real-time interactive sessions or asynchronous sessions, where content was available online to access at their convenience. Topics included idiopathic short stature, polycystic ovarian syndrome, diabetes mellitus, telemedicine, Turner syndrome, congenital adrenal hyperplasia, obesity, central precocious puberty, and subclinical hypothyroidism. The participants were asked to evaluate the conference after its completion with a questionnaire. RESULTS A total of 8 speakers from Spain, Canada, Costa Rica, and the United States delivered the virtual event to 668 health care professionals from Guatemala, Venezuela, Dominican Republic, Costa Rica, Ecuador, Peru, Uruguay, Mexico, Honduras, Argentina, the United States, Bolivia, Chile, Panama, El Salvador, Nicaragua, Paraguay, Belize, Spain, and Colombia. Name, profession, and country were fully disclosed by 410 (61.4%) of the 668 health care professionals. The profession or level of training of participants were as follows: pediatric endocrinologists (n=129, 19.3%), pediatricians (n=116, 17.4%), general practitioners (n=77, 11.5%), adult endocrinologists (n=34, 5.1%), medical students (n=23, 3.4%), residents in various specialties (n=14, 2.1%), and others (n=17, 2.6%). A total of 23 sessions were offered, most of which were bilingual (Spanish and English). Feedback from the evaluation questionnaire indicated that the content of the conference was very relevant to the participants' professional practice. Additionally, the participants reported that they were very satisfied with the organization, the web-based platform, and the sessions of the conference. CONCLUSIONS Lack of accessibility to the latest and cutting-edge medical education in pediatric endocrinology and diabetes for medical professionals from low- and middle-income countries can be overcome with a virtual conference. Online availability, low cost, and easy-to-use technology were well received from the participants, who were overall very satisfied by the quality and the relevance of the sessions to their professional practice.
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Affiliation(s)
- Roberto Bogarin
- Costa Rica National Children´s Hospital, San Jose, Costa Rica
| | | | | | - Jadranka Popovic
- Pediatric Alliance Allegheny Health Network, Pittsburgh, PA, United States
| | - Alan Rogol
- University of Virginia, Charlottesville, VA, United States
| | - Erick Richmond
- Costa Rica National Children´s Hospital, San Jose, Costa Rica
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Paul P, Mahfoud ZR, Malik RA, Kaul R, Muffuh Navti P, Al-Sheikhly D, Chaari A. Knowledge, Awareness, and Attitude of Healthcare Stakeholders on Alzheimer's Disease and Dementia in Qatar. Int J Environ Res Public Health 2023; 20:4535. [PMID: 36901551 PMCID: PMC10002196 DOI: 10.3390/ijerph20054535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Dementia is characterized by progressive cognitive decline, memory impairment, and disability. Alzheimer's disease (AD) accounts for 60-70% of cases, followed by vascular and mixed dementia. Qatar and the Middle East are at increased risk owing to aging populations and high prevalence of vascular risk factors. Appropriate levels of knowledge, attitudes, and awareness amongst health care professionals (HCPs) are the need of the hour, but literature indicates that these proficiencies may be inadequate, outdated, or markedly heterogenous. In addition to a review of published quantitative surveys investigating similar questions in the Middle East, a pilot cross-sectional online needs-assessment survey was undertaken to gauge these parameters of dementia and AD among healthcare stakeholders in Qatar between 19 April and 16 May 2022. Overall, 229 responses were recorded between physicians (21%), nurses (21%), and medical students (25%), with two-thirds from Qatar. Over half the respondents reported that >10% of their patients were elderly (>60 years). Over 25% reported having contact with >50 patients with dementia or neurodegenerative disease annually. Over 70% had not undertake related education/training in the last 2 years. The knowledge of HCPs regarding dementia and AD was moderate (mean score of 5.3 ± 1.5 out of 7) and their awareness of recent advances in basic disease pathophysiology was lacking. Differences existed across professions and location of respondents. Our findings lay the groundwork for a call-to-action for healthcare institutions to improve dementia care within Qatar and the Middle East region.
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Affiliation(s)
| | - Ziyad Riyad Mahfoud
- Division of Medical Education, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, NY 10065, New York, USA
| | - Rayaz A. Malik
- Division of Medicine, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9NT, UK
- Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK
| | | | - Phyllis Muffuh Navti
- Division of Continuing Professional Development, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Deema Al-Sheikhly
- Division of Medical Education, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Continuing Professional Development, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Ali Chaari
- Premedical Division, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
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43
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Willemot L, Lee MJ, Mulford J. Introduction to surgical coaching. ANZ J Surg 2023; 93:487-492. [PMID: 36707460 DOI: 10.1111/ans.18287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/22/2022] [Accepted: 01/08/2023] [Indexed: 01/29/2023]
Abstract
Surgical coaching is a new approach to continuous professional development (CPD). Advocates claim that coaching improves surgical and non-technical skills, leading to enhanced performance and reduced stress and burnout. Widespread acceptance of coaching in the surgical community is limited due to a paucity of evidence, surgery-specific obstacles and lack of resources. This narrative review introduces what 'surgical coaching' is and describes its origins. Coaching techniques are based on live or video observation of procedures, followed by collaborative analysis, reflection and goal planning in a non-competitive setting aided by an expert, peer or lay coach. Technical skills improvements have been reported using coaching techniques, yet long-term influence on non-technical competencies, overall performance and surgeon wellbeing are largely hypothetical. There are clear potential benefits in the application of surgical coaching to daily surgical practice. However, significant knowledge gaps remain. Dedicated research into the short-term applicability and the long-term effects of surgical coaching are required.
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Affiliation(s)
- Laurent Willemot
- Launceston General Hospital, Launceston, Tasmania, Australia
- College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Matthew J Lee
- College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Jonathan Mulford
- Launceston General Hospital, Launceston, Tasmania, Australia
- College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
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44
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McKnight L, Schultz A, Vidic N, Palmer EE, Jaffe A. Learning to make a difference for chILD: Value creation through network collaboration and team science. Pediatr Pulmonol 2023. [PMID: 36855907 DOI: 10.1002/ppul.26377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/20/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023]
Abstract
Addressing the recognized challenges and inequalities in providing high quality healthcare for rare diseases such as children's interstitial lung disease (chILD) requires collaboration across institutional, geographical, discipline, and system boundaries. The Children's Interstitial Lung Disease Respiratory Network of Australia and New Zealand (chILDRANZ) is an example of a clinical network that brings together multidisciplinary health professionals for collaboration, peer learning, and advocacy with the goal of improving the diagnosis and management of this group of rare and ultra-rare conditions. This narrative review explores the multifaceted benefits arising from social learning spaces within rare disease clinical networks by applying the value creation framework. The operation of the chILDRANZ network is used as an example across the framework to highlight how value is generated, realized, and transferred within such collaborative clinical and research networks. The community of practice formed in the chILDRANZ multidisciplinary meetings provides a strong example of social learning that engages with the uncertainty inherent in rare disease diagnosis and management and pays attention to generate new knowledge and best practice to make a difference for children and families living with chILD. This review underscores international calls for further investment in, and support of, collaborative clinical networks and virtual centers of excellence for rare disease.
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Affiliation(s)
- Lauren McKnight
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Sydney, Kensington, New South Wales, Australia
| | - André Schultz
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.,Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Nada Vidic
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Sydney, Kensington, New South Wales, Australia
| | - Elizabeth E Palmer
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Sydney, Kensington, New South Wales, Australia.,Centre for Clinical Genetics, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Adam Jaffe
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Sydney, Kensington, New South Wales, Australia.,Respiratory Department, Sydney Children's Hospital, Randwick, New South Wales, Australia
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45
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Lavercombe M. Recommendations from the Medical Education Editor. Respirology 2023; 28:300-302. [PMID: 36852561 DOI: 10.1111/resp.14485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 03/01/2023]
Affiliation(s)
- Mark Lavercombe
- Department of Respiratory & Sleep Disorders Medicine, Western Health, Melbourne, Victoria, Australia.,Department of Medical Education, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
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46
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Jayas A, Andriole DA, Grbic D, Hu X, Dill M, Howley LD. Physicians' continuing medical education activities and satisfaction with their ability to stay current in medical information and practice: A cross-sectional study. Health Sci Rep 2023; 6:e1110. [PMID: 36789399 PMCID: PMC9918722 DOI: 10.1002/hsr2.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/09/2023] [Accepted: 01/31/2023] [Indexed: 02/13/2023] Open
Abstract
Background and Aims Little is known about physicians' approaches to continuing medical education (CME) for continuing professional development despite the rapid evolution of CME offerings. We sought to identify the extent to which demographic, career, and experiential CME-activity variables were independently associated with physicians' satisfaction with their ability to stay current on medical information and practice. Methods Using the 2019 Association of American Medical Colleges' National Sample Survey of Physicians data, we ran multivariable logistic regression models examining demographic, career, and experiential (participation in 11 CME activities in the past year) variables for their associations with physicians' satisfaction (satisfied vs. not satisfied/neutral) with their ability to stay current. Results Of 5926 respondents, 90% (5341/5926) were satisfied with their ability to stay current. Significant (each two-sided p < 0.05) predictors of respondents who were satisfied included (among others) a surgery specialty (vs. primary care; adjusted odds ratio [AOR] = 1.41, 95% confidence interval [CI] = 1.06-1.88), an academic affiliation (vs. none; AOR = 1.35, 95% CI = 1.10-1.66), and participation (vs. no participation) in each of professional meetings (AOR = 1.31, 95% CI = 1.07-1.60) and journal-based CME (AOR = 1.29, 95% CI = 1.07-1.56). Respondents who self-identified as a race/ethnicity underrepresented in medicine (vs. white; AOR = 0.68, 95% CI = 0.48-0.97) and were between ages 40 and 49 years (vs. 50-59; AOR = 0.74; 95% CI = 0.58-0.94) were less likely to be satisfied. Gender, board certification status, and medical degree type did not independently predict satisfaction (each p > 0.05). Conclusion We observed independent associations between physicians' satisfaction with their ability to stay current in medical information and practice and each specialty, academic affiliation, race/ethnicity, age, and CME activity type (for 2 of 11 examined). Findings may be relevant to organizations and institutions designing and implementing CME activities in the current context of COVID-19 pandemic-related in-person activity limitations and can inform targeted interventions addressing differences in the satisfaction we observed to better support physicians' CME.
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Affiliation(s)
- Amy Jayas
- Academic AffairsAssociation of American Medical CollegesWashingtonDistrict of ColumbiaUSA
| | - Dorothy A. Andriole
- Academic AffairsAssociation of American Medical CollegesWashingtonDistrict of ColumbiaUSA
| | - Douglas Grbic
- Academic AffairsAssociation of American Medical CollegesWashingtonDistrict of ColumbiaUSA
| | - Xiaochu Hu
- Academic AffairsAssociation of American Medical CollegesWashingtonDistrict of ColumbiaUSA
| | - Michael Dill
- Academic AffairsAssociation of American Medical CollegesWashingtonDistrict of ColumbiaUSA
| | - Lisa D. Howley
- Academic AffairsAssociation of American Medical CollegesWashingtonDistrict of ColumbiaUSA
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Williams BW, Welindt D. Assisting physicians who exhibit disruptive behavior: Understanding the costs, contributors, and corrections. Australas Psychiatry 2023; 31:132-135. [PMID: 36749186 DOI: 10.1177/10398562231156477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aim of this article is to discuss the etiology, prevalence, impact, and management of disruptive behavior in physicians. These various aspects will be examined at both the individual and system level, to provide appropriate perspective and detail effective approaches to address these behaviors. METHOD Clinical experience and review of the authors' and other researchers' findings provide consensus on numerous key aspects of physician disruptive behavior. RESULTS Physicians demonstrating disruptive behavior are often distressed. The behavior should be understood as arising from biopsychosocial contributors, knowledge gaps, insight, and systems factors. These contributors are inclusive and may interact with each other. CONCLUSIONS A comprehensive approach is required which can include assessment/reassessment tools, individualized programming (therapy, coaching, instruction), deliberate practice, medical follow-up, and system intervention. Complications include the diversity of disruptive behaviors, the many contributory factors therein, disagreement about methodology/measurement, and the role of the system.
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Affiliation(s)
- Betsy W Williams
- Clinical Program Director, Professional Renewal Center®, Lawrence, KS, USA.,Director of Education, Wales Behavioral Assessment, Lawrence, KS, USA; Clinical Associate Professor, Department of Psychiatry, School of Medicine, University of Kansas, Lawrence, KS, USA
| | - Dillon Welindt
- Department of Psychology, 3265University of Oregon, Eugene, OR, USA
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de Lusignan S, Ashraf M, Ferreira F, Tripathy M, Yonova I, Rafi I, Kassianos G, Joy M. Impact of General Practitioner Education on Acceptance of an Adjuvanted Seasonal Influenza Vaccine among Older Adults in England. Behav Sci (Basel) 2023; 13:bs13020130. [PMID: 36829359 PMCID: PMC9952828 DOI: 10.3390/bs13020130] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/06/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
Seasonal vaccination against influenza and in-pandemic COVID-19 vaccination are top public health priorities; vaccines are the primary means of reducing infections and also controlling pressures on health systems. During the 2018-2019 influenza season, we conducted a study of the knowledge, attitudes, and behaviours of 159 general practitioners (GPs) and 189 patients aged ≥65 years in England using a combination of qualitative and quantitative approaches to document beliefs about seasonal influenza and seasonal influenza vaccine. GPs were surveyed before and after a continuing medical education (CME) module on influenza disease and vaccination with an adjuvanted trivalent influenza vaccine (aTIV) designed for patients aged ≥65 years, and patients were surveyed before and after a routine visit with a GP who participated in the CME portion of the study. The CME course was associated with significantly increased GP confidence in their ability to address patients' questions and concerns about influenza disease and vaccination (p < 0.001). Patients reported significantly increased confidence in the effectiveness and safety of aTIV after meeting their GP. Overall, 82.2% of the study population were vaccinated against influenza (including 137 patients vaccinated during the GP visit and 15 patients who had been previously vaccinated), a rate higher than the English national average vaccine uptake of 72.0% that season. These findings support the value of GP-patient interactions to foster vaccine acceptance.
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Affiliation(s)
- Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
- Royal College of General Practitioners, Research and Surveillance Centre, London NW1 2FB, UK
- Correspondence: ; Tel.: +44-01865-617-283 (ext. 17-283)
| | | | - Filipa Ferreira
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Manasa Tripathy
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford GU2 7XH, UK
| | - Ivelina Yonova
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford GU2 7XH, UK
| | - Imran Rafi
- Royal College of General Practitioners, Research and Surveillance Centre, London NW1 2FB, UK
- Institute for Medical and Biomedical Education, St George’s University of London, London SW17 0RE, UK
| | - George Kassianos
- Royal College of General Practitioners, Research and Surveillance Centre, London NW1 2FB, UK
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
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Fiuzzi M. Outcomes and Observations of On-line CME Activities during the Pandemic. J CME 2023; 12:2167286. [PMID: 36969485 PMCID: PMC10031771 DOI: 10.1080/28338073.2023.2167286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic created an environment where the majority of continuing medical education (CME) and continuing professional development (CPD) activities needed to be delivered digitally. Producing digital materials for 16 separate learning activities (four learning journeys for each of four topic areas) in 2021 provided challenges and raised points of interest and discussion for a small, Italy-based provider of CME and CPD. This study presents outcome metrics from four live, interactive webinars. A variety of promotional efforts, including the strategic use of social media, generated interest and participation; feedback from the European Accreditation Council for Continuing Medical Education standard questionnaire to participants provided rates of satisfaction; subject knowledge and self-reported competence was measured by responses to pre- and post-event and follow-up (after 3 months) questionnaires. Post-event analysis of processes prompted introspection on the learning journey outcomes and methods of analysis. This paper discusses these observations, including potential innovations for future activities (e.g. reconfiguring the e-learning platform to capture time spent on learning activities), and also discusses issues in learner behaviour that impact CME provision and evaluation.
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Affiliation(s)
- Michela Fiuzzi
- Scientific Seminars International Foundation, Rome, Italy
- Scientific Seminars International Foundation, Via di Porta Pinciana, 6, 00185Rome, Italy
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50
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Winn AS, Huth K, Leichtner AM, Newman LR. Beyond the Workshop: Results From a Longitudinal, Interprofessional Teaching Certificate Program. J Med Educ Curric Dev 2023; 10:23821205231205433. [PMID: 37799299 PMCID: PMC10548803 DOI: 10.1177/23821205231205433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVES While most hospital-based, healthcare professionals are expected to teach and supervise, few receive training in education. We designed, implemented, and evaluated an interprofessional, hospital-based teaching certificate program based on experiential learning and reflective practice for healthcare professionals with little or no formal training in education. METHODS Participants attended educational seminars; incorporated new concepts, skills, and behaviors in their teaching; and submitted written reflections. Participants also met with an education coach, received feedback from a trained observer, and observed a "master teacher." We used descriptive statistics to analyze a survey distributed to the 2017-2019 cohort. We also analyzed written reflections to determine whether participants described a new teaching skill, concept, or behavior, and how they applied these to their teaching. RESULTS Survey completion rate was 15/20 (75%). Participants described feeling connected to an educator community, establishing educational alliances with senior educators, and learning teaching strategies from other certificate members outside their own profession. Participants indicated they are more likely to pursue educational innovation, leadership, and scholarship. In the reflections, 88% described incorporating a new concept in their teaching. CONCLUSION Participants in an interprofessional teaching certificate program engaged in a curriculum of professional development in education. Graduates of the program reported knowledge gain, behavior change, and establishment of educational alliances and a community of practice.
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Affiliation(s)
- Ariel S Winn
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kathleen Huth
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Alan M Leichtner
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Education, Boston Children's Hospital, Boston, MA, USA
| | - Lori R Newman
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Education, Boston Children's Hospital, Boston, MA, USA
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