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Huy NT, Chico RM, Huan VT, Shaikhkhalil HW, Uyen VNT, Qarawi ATA, Alhady STM, Vuong NL, Truong LV, Luu MN, Dumre SP, Imoto A, Lee PN, Tam DNH, Ng SJ, Hashan MR, Matsui M, Duc NTM, Karimzadeh S, Koonrungsesomboon N, Smith C, Cox S, Moji K, Hirayama K, Linh LK, Abbas KS, Dung TNT, Mohammed Ali AL-Ahdal T, Balogun EO, Duy NT, Mohamed Eltaras M, Huynh T, Hue NTL, Khue BD, Gad A, Tawfik GM, Kubota K, Nguyen HM, Pavlenko D, Trang VTT, Vu LT, Hai Yen T, Yen-Xuan NT, Trang LT, Dong V, Sharma A, Dat VQ, Soliman M, Abdul Aziz J, Shah J, Hung PDL, Jee YS, Phuong DTH, Quynh TTH, Giang HTN, Huynh VTN, Thi NA, Dhouibi N, Phan T, Duru V, Nam NH, Ghozy S. Awareness and preparedness of healthcare workers against the first wave of the COVID-19 pandemic: A cross-sectional survey across 57 countries. PLoS One 2021; 16:e0258348. [PMID: 34936646 PMCID: PMC8694437 DOI: 10.1371/journal.pone.0258348] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/24/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave. METHODS This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training. RESULTS We surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0-14.0) and the median awareness score was 29.6 (IQR = 26.6-32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p<0.001). Association rule mining suggests that nurses and doctors who had a 'great-extent-of-confidence' in handling suspected COVID-19 patients had participated in COVID-19 training courses. Male participants (mean difference = 0.34; 95% CI = 0.22, 0.46; p<0.001) and nurses (mean difference = 0.67; 95% CI = 0.53, 0.81; p<0.001) had higher preparedness scores compared to women participants and doctors. INTERPRETATION There was an unsurprising high level of awareness and preparedness among HCWs who participated in COVID-19 training courses. However, disparity existed along the lines of gender and type of HCW. It is unknown whether the difference in COVID-19 preparedness that we detected early in the pandemic may have translated into disproportionate SARS-CoV-2 burden of disease by gender or HCW type.
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Affiliation(s)
- Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- * E-mail: (NTH); (RMC)
| | - R. Matthew Chico
- Department of Disease Control, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail: (NTH); (RMC)
| | - Vuong Thanh Huan
- Faculty of Medicine, Pham Ngoc Thach University, Ho Chi Minh City, Vietnam
| | | | - Vuong Ngoc Thao Uyen
- School of Biotechnology, International University—Vietnam National University, Ho Chi Minh City, Vietnam
| | | | | | - Nguyen Lam Vuong
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Le Van Truong
- Traditional Medicine Hospital of Ministry of Public Security, Vietnam
| | - Mai Ngoc Luu
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Shyam Prakash Dumre
- Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Atsuko Imoto
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Peter N. Lee
- P.N. Lee Statistics and Computing Ltd., Sutton, United Kingdom
| | | | - Sze Jia Ng
- Hospital Enche’ Besar Hajjah Khalsom, Johor, Malaysia
| | - Mohammad Rashidul Hashan
- Government of the People’s Republic of Bangladesh—Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Mitsuaki Matsui
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Nguyen Tran Minh Duc
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Sedighe Karimzadeh
- School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Nut Koonrungsesomboon
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sharon Cox
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Kazuhiko Moji
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Kenji Hirayama
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Le Khac Linh
- VinUniversity, College of Health Sciences, Hanoi, Vietnam
| | | | - Tran Nu Thuy Dung
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tareq Mohammed Ali AL-Ahdal
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Ar-Ramtha, Jordan
| | - Emmanuel Oluwadare Balogun
- Department of Biochemistry and African Center of Excellence on Neglected Tropical Diseases and Forensic Biotechnology, Ahmadu Bello University, Zaria, Nigeria
| | - Nguyen The Duy
- Department of Gyn. Endocrinology and Reproductive Medicine, University Hospital Giessen and Marburg, Marburg, Germany
- Philipps University Marburg, Marburg, Germany
| | | | - Trang Huynh
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Bui Diem Khue
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | | | | | - Hoang-Minh Nguyen
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | | | - Le Thuong Vu
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tran Hai Yen
- School of Biotechnology, International University—Vietnam National University, Ho Chi Minh City, Vietnam
| | | | | | - Vinh Dong
- American University of the Caribbean, Cupe Coy, Saint Maarten, United States of America
| | - Akash Sharma
- University College of Medical Sciences & Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Vu Quoc Dat
- Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam
| | | | - Jeza Abdul Aziz
- Medical Laboratory Science, College of Health Science, University of Human Development, Kurdistan Region, Sulaimani, Iraq
- Baxshin Research Training Organization, Baxshin Hospital, Kurdistan Region, Sulaimani, Iraq
| | - Jaffer Shah
- Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Pham Dinh Long Hung
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Yap Siang Jee
- School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Dang Thuy Ha Phuong
- Center for Biomedical Research, Pham Ngoc Thach University of Medicine, Vietnam
| | | | - Hoang Thi Nam Giang
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine and Pharmacy, University of Da Nang, Da Nang, Vietnam
| | | | | | - Nacir Dhouibi
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Truc Phan
- Vinmec International Hospital, Hanoi, Vietnam
| | - Vincent Duru
- Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Nguyen Hai Nam
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sherief Ghozy
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Wang Y, Yang J, Ma H, Dong X, Xie G, Ye S, Du J. Application of telemedicine in the COVID-19 epidemic: An analysis of Gansu Province in China. PLoS One 2021; 16:e0249872. [PMID: 34347779 PMCID: PMC8336882 DOI: 10.1371/journal.pone.0249872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 03/27/2021] [Indexed: 12/16/2022] Open
Abstract
This paper analyzes the application of various telemedicine services in Gansu Province, China during the COVID-19 epidemic, and summarizes the experiences with these services. In addition, the satisfaction levels of patients and doctors with the application of telemedicine in COVID-19 were investigated, the deficiencies of telemedicine in Gansu were determined, and recommendations for modification were proposed. Coronavirus Disease 2019 (COVID-19) has broken out in China, and Gansu Province in Northwest of China has not been spared. To date, there are 91 local COVID-19 cases and 42 imported cases. 109 hospitals were selected as designated hospitals during the COVID-19 outbreak, and most of them were secondary hospitals. However, it was unsatisfactory that the ability of medical services is relatively low in most of secondary hospitals and primary hospitals. Therefore, we helped the secondary hospitals cope with COVID-19 by means of remote consultation, long-distance education, telemedicine question and answer (Q&A). Our practical experience shows that telemedicine can be widely used during the COVID-19 epidemic, especially in developing countries and areas with lagging medical standards.
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MESH Headings
- COVID-19/epidemiology
- COVID-19/therapy
- China/epidemiology
- Disease Outbreaks
- Education, Distance/organization & administration
- Education, Distance/statistics & numerical data
- Education, Medical, Continuing/methods
- Education, Medical, Continuing/organization & administration
- Education, Medical, Continuing/statistics & numerical data
- Education, Nursing, Continuing/methods
- Education, Nursing, Continuing/organization & administration
- Education, Nursing, Continuing/statistics & numerical data
- Epidemics
- Geography
- Health Services Accessibility/organization & administration
- Health Services Accessibility/statistics & numerical data
- Humans
- Physician-Patient Relations
- Remote Consultation/instrumentation
- Remote Consultation/methods
- Remote Consultation/organization & administration
- Remote Consultation/statistics & numerical data
- SARS-CoV-2/physiology
- Software
- Telemedicine/instrumentation
- Telemedicine/methods
- Telemedicine/organization & administration
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Affiliation(s)
- Yan Wang
- Department of Telemedicine Consultation Center, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Jie Yang
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu China
| | - Huijuan Ma
- Department of Telemedicine Consultation Center, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Xinchun Dong
- Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Guangmei Xie
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu China
- * E-mail:
| | - Songning Ye
- Department of Telemedicine Consultation Center, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Juan Du
- Department of Human Resources, Gansu Provincial Hospital, Lanzhou, Gansu, China
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Li KD, Hakam N, Sadighian MJ, Holler JT, Nabavizadeh B, Amend GM, Fang R, Meeks W, Makarov D, Breyer BN. Evaluating Quality Improvement and Patient Safety Amongst Practicing Urologists: Analysis of the 2018 American Urological Association Census. Urology 2021; 156:117-123. [PMID: 34331999 DOI: 10.1016/j.urology.2021.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/17/2021] [Accepted: 07/18/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe factors associated with Quality improvement and patient safety (QIPS) participation using 2018 American Urological Association Census data. QIPS have become increasingly important in medicine. However, studies about QIPS in urology suggest low levels of participation, with little known about factors predicting non-participation. METHODS Results from 2339 census respondents were weighted to estimate 12,660 practicing urologists in the United States. Our primary outcome was participation in QIPS. Predictor variables included demographics, practice setting, rurality, fellowship training, QIPS domains in practice, years in practice, and non-clinical/clinical workload. RESULTS QIPS participants and non-participants significantly differed in distributions of age (P = .0299), gender (P = .0013), practice setting (P <.0001), employment (employee vs partner vs owner vs combination; P <.0001), and fellowship training (P <.0001). QIPS participants reported fewer years in practice (21.3 vs 25.9, P = .018) and higher clinical (45.2 vs 39.2, P = .022) and non-clinical (8.76 vs 5.28, P = .002) work hours per week. Non-participation was associated with male gender (OR = 2.68, 95% CI 1.03-6.95) and Asian race (OR = 2.59, 95% CI 1.27-5.29) for quality programs and private practice settings (ORs = 8.72-27.8) for patient safety initiatives. CONCLUSION QIPS was associated with academic settings. Interventions to increase rates of quality and safety participation should target individual and system-level factors, respectively. Future work should discern barriers to QIPS engagement and its clinical benefits.
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Affiliation(s)
- Kevin D Li
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Nizar Hakam
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Michael J Sadighian
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Jordan T Holler
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Behnam Nabavizadeh
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Gregory M Amend
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Raymond Fang
- Department of Data Management and Statistical Analysis, American Urological Association, Linthicum, MD
| | - William Meeks
- Department of Data Management and Statistical Analysis, American Urological Association, Linthicum, MD
| | - Danil Makarov
- Population Health and Health Policy, New York University School of Medicine Veterans Affairs New York Harbor Healthcare System-Brooklyn, Brooklyn, NY
| | - Benjamin N Breyer
- Department of Urology, University of California San Francisco, San Francisco, CA; Department of Biostatistics and Epidemiology, University of California San Francisco, San Francisco, CA.
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O'Brien Pott M, Blanshan AS, Huneke KM, Baasch Thomas BL, Cook DA. What Influences Choice of Continuing Medical Education Modalities and Providers? A National Survey of U.S. Physicians, Nurse Practitioners, and Physician Assistants. Acad Med 2021; 96:93-100. [PMID: 32969838 DOI: 10.1097/acm.0000000000003758] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To explore what influences clinicians in selecting continuing medical education (CME) activities in the United States. METHOD In August 2018, the authors conducted an Internet-based national survey, sampling 100 respondents from each of 5 groups: family medicine physicians, internal medicine and hospitalist physicians, medicine specialist physicians, nurse practitioners, and physician assistants. In total, 1,895 clinicians were invited and 500 (26%) responded. Questions addressed the selection and anticipated use of CME delivery modalities and perceived characteristics of specific CME providers. Response formats used best-worst scaling or 5-point ordinal response options. RESULTS The factors identified as most important in selecting CME activities were topic (best-worst scaling net positivity 0.54), quality of content (0.51), availability of CME credit (0.43), and clinical practice focus (0.41), while referral frequency (-0.57) ranked lowest. The activities that the respondents anticipated using most in the future were live (mean 3.8 [1 = not likely, 5 = very likely]), online (mean 3.5), point-of-care (mean 3.5), and print-based (mean 3.5) activities. For online CME, the features of greatest appeal were that learning could be done when clinicians had time (mean 4.4), at their own pace (mean 4.2), and at lower cost (mean 4.2). For live CME, the features of greatest appeal were that the subject was best taught using this modality (mean 4.0), or the activity was located in a destination spot (mean 4.0) or a regional location (mean 3.9). When rating specific CME providers, most academic institutions received relatively high ratings for research focus and clinical practice focus, whereas commercial providers had slightly higher ratings for ease of access. Responses were generally similar across clinician types and age groups. CONCLUSIONS Physicians, nurse practitioners, and physician assistants are interested in using a variety of CME delivery modalities. Appealing features of online and live CME were different.
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Affiliation(s)
- Maureen O'Brien Pott
- M. O'Brien Pott is senior analyst, Planning Services, Mayo Clinic, Rochester, Minnesota
| | - Anissa S Blanshan
- A.S. Blanshan is senior marketing manager, Mayo Clinic, Rochester, Minnesota
| | - Kelly M Huneke
- K.M. Huneke is instructor, health care administration, and administrator, Center for Military Medicine and Mayo Clinic School of Continuous Professional Development, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - Barbara L Baasch Thomas
- B.L. Baasch Thomas is senior director of education and professional development, Mayo Clinic School of Continuous Professional Development, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - David A Cook
- D.A. Cook is professor of medicine and medical education and director, Section of Research and Data Analytics, Mayo Clinic School of Continuous Professional Development; director of education science, Office of Applied Scholarship and Education Science; and consultant, Division of General Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-2383-4633
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Alsaleem SA, Almoalwi NM, Siddiqui AF, Alsaleem MA, Alsamghan AS, Awadalla NJ, Mahfouz AA. Current Practices and Existing Gaps of Continuing Medical Education among Resident Physicians in Abha City, Saudi Arabia. Int J Environ Res Public Health 2020; 17:E8483. [PMID: 33207729 PMCID: PMC7696225 DOI: 10.3390/ijerph17228483] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 10/15/2020] [Revised: 11/13/2020] [Accepted: 11/14/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Continuing medical education (CME) is an everlasting process throughout the physician's working life. It helps to deliver better services for the patients. OBJECTIVES To explore CME among resident physicians in Abha City; their current practices, their opinions, and barriers faced. METHODS A cross-sectional study was conducted among resident physicians at the Ministry of Health hospitals in Abha City using a validated self-administered questionnaire. It included personal characteristics, current CME practices, satisfaction with CME, and barriers to attendance. RESULTS The present study included 300 residents from 15 training specialties. Their reported CME activities during the previous year were lectures and seminars (79.7%) followed by conferences (43.7%), case presentations (39.7%), workshops (34.0%), group discussion (29/7%), and journal clubs (27.3%). Astonishingly enough, very few (8%) attended online electronic CME activities. There were significant differences in CME satisfaction scores by different training specialties. Regarding residents' perceptions of the effectiveness of different CME activities (conferences/symposia, workshops/courses, and interdepartmental activities) the results showed that workshops and courses were significantly the most effective method compared to the other two methods in retention of knowledge, improving attitudes, improving clinical skills, improving managerial skills, and in improving practice behaviors. Barriers reported were being busy, lack of interest, high cost, and lack of suitable providers. CONCLUSION Based on the findings of this study, it is recommended that online learning be promoted as a CME format for trainees. There should be support of residents and clinicians through the provision of protected time for their CME activities outside their daily clinical commitments.
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Affiliation(s)
- Safar Abadi Alsaleem
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (S.A.A.); (A.F.S.); (M.A.A.); (A.S.A.); (N.J.A.)
| | | | - Aesha Farheen Siddiqui
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (S.A.A.); (A.F.S.); (M.A.A.); (A.S.A.); (N.J.A.)
| | - Mohammed Abadi Alsaleem
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (S.A.A.); (A.F.S.); (M.A.A.); (A.S.A.); (N.J.A.)
| | - Awad S. Alsamghan
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (S.A.A.); (A.F.S.); (M.A.A.); (A.S.A.); (N.J.A.)
| | - Nabil J. Awadalla
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (S.A.A.); (A.F.S.); (M.A.A.); (A.S.A.); (N.J.A.)
- Department of Community Medicine, College of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Ahmed A. Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (S.A.A.); (A.F.S.); (M.A.A.); (A.S.A.); (N.J.A.)
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria 21511, Egypt
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Chermak GD, Silva ME, Nye J, Hasbrouck J, Musiek FE. An Update on Professional Education and Clinical Practices in Central Auditory Processing. J Am Acad Audiol 2020; 18:428-52; quiz 455. [PMID: 17715652 DOI: 10.3766/jaaa.18.5.7] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Results of an online questionnaire probing audiologists' professional education and clinical practices in central auditory processing and its disorders are reported. Respondents demonstrated scant knowledge of the efficiency of central auditory tests and procedures; however, they were rather consistent in reporting more frequent use of tests and procedures they rated as more efficient. Many of the tests and procedures (including electrophysiologic measures) reported as most frequently used are among those cited in the literature as having good sensitivity and specificity. Respondents recognized the audiologist's treatment responsibilities in the areas of environmental accommodations and assistive listening devices; however, less than half of the respondents judged auditory training to fall within the audiologist's purview. Comparison with a similar study published in 1998 revealed an increase in respondents' academic preparation in (C)APD, with little change in clinical preparation, and use of a more efficient central auditory test battery. Se reportan los resultados de un cuestionario en línea indagando sobre la educación profesional y las prácticas clínicas de los audiólogos en cuanto al procesamiento auditivo (central) y sus trastornos. Aquellos que respondieron demostraron un débil conocimiento sobre la eficiencia de las pruebas y procedimientos auditivos centrales; sin embargo, fueron bastante consistentes en reportar un uso más frecuente de las pruebas y procedimientos que consideraban más eficientes. Muchas de las pruebas y procedimientos (incluyendo las mediciones electrofisiológicas) que se reportaron como más frecuentemente utilizadas, están entre las que se citan en la literatura como de mejor sensibibilidad y especificidad. Los que responsieron reconocieron las responsabilidades en cuanto a tratamiento por parte del audiólogo, en las áreas de adecuación ambiental y en el uso de dispositivos auditivos de apoyo. Sin embargo, menos de la mitad de los que respondieron consideraron que el entrenamiento auditivo estaba dentro de las ámbito del audiólogo. La comparación con un estudio similar publicado en 1998 reveló una mejoría en la preparación académica de los audiológos en (C)APD, con poco cambios en la preparación clínica, y en el uso de una batería mas eficiente de pruebas para audición central.
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Affiliation(s)
- Gail D Chermak
- Department of Speech and Hearing Sciences, Washington State University, Pullman, WA 99164-2420, USA.
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Armson H, Perrier L, Roder S, Shommu NS, Wakefield J, Shaw E, Zahorka S, Elmslie T, Lofft M. Assessing Unperceived Learning Needs in Continuing Medical Education for Primary Care Physicians: A Scoping Review. J Contin Educ Health Prof 2020; 40:257-267. [PMID: 33284177 DOI: 10.1097/ceh.0000000000000300] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Assessing needs before developing continuing medical education/continuing professional development (CME/CPD) programs is a crucial step in the education process. A previous systematic literature review described a lack of objective evaluation for learning needs assessments in primary care physicians. This scoping review updates the literature on uses of objective evaluations to assess physicians' unperceived learning needs in CME/CPD. Identifying and understanding these approaches can inform the development of educational programs that are relevant to clinical practice and patient care. The study objectives were to (1) scope the literature since the last systematic review published in 1999; (2) conduct a comprehensive search for studies and reports that explore innovative tools and approaches to identify physicians' unperceived learning needs; (3) summarize, compare, and classify the identified approaches; and (4) map any gaps in the literature to identify future areas of research. METHODS A scoping review was used to "map" the literature on current knowledge regarding approaches to unperceived needs assessment using conceptual frameworks for planning and assessing CME/CPD activities. RESULTS Two prominent gaps were identified: (1) performance-based assessment strategies are highly recommended in nonresearch articles yet have low levels of implementation in published studies and (2) analysis of secondary data through patient input or environmental scanning is emphasized in grey literature implementation strategies more so than in peer-reviewed theoretical and research articles. DISCUSSION Future evaluations should continue to incorporate multiple strategies and focus on making unperceived needs assessments actionable by describing strategies for resource management.
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Affiliation(s)
- Heather Armson
- Dr. Armson: Assistant Dean, Continuing Medical Education and Professional Development and Professor, Department of Family Medicine, University of Calgary; Research Director, The Foundation for Medical Practice Education, McMaster University. Dr. Perrier: Research Data Management Librarian, University of Toronto Libraries, University of Toronto. Dr. Roder: Research Program Coordinator, The Foundation for Medical Practice Education, McMaster University. Dr. Shommu: Research Coordinator, Department of Medicine, Cumming School of Medicine, University of Calgary. Dr. Wakefield: Professor Emeritus, Department of Family Medicine, McMaster University; Senior Editor, Module Development, The Foundation for Medical Practice Education, McMaster University. Dr. Shaw: Professor; Associate Chair of Education, Department of Family Medicine; Director, Module Development, The Foundation for Medical Practice Education, McMaster University. Ms. Zahorka: Education Coordinator, The Foundation for Medical Practice Education, McMaster University. Dr. Elmslie: Professor Emeritus, Department of Family Medicine, University of Ottawa; Executive Director, The Foundation for Medical Practice Education, McMaster University. Ms. Lofft: Research Assistant, The Foundation for Medical Practice Education, McMaster University
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Movsisyan NK, Petrosyan V, Abelyan G, Sochor O, Baghdasaryan S, Etter JF. Learning to assist smokers through encounters with standardized patients: An innovative training for physicians in an Eastern European country. PLoS One 2019; 14:e0222813. [PMID: 31557211 PMCID: PMC6762076 DOI: 10.1371/journal.pone.0222813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/06/2019] [Indexed: 11/19/2022] Open
Abstract
Objectives A lack of physician training is a major obstacle for effective tobacco dependence treatment. This study assessed the feasibility of an active learning training program and its effects on smoking cessation counselling skills of medical residents in Armenia, an Eastern European country with high smoking prevalence. Study design The study used a pre-post assessment of smoking cessation counselling activities and a course evaluation survey to assess the feasibility of the intervention in a different environment. Methods We adapted an active learning training model developed in Switzerland. Residents were trained in Yerevan, Armenia, using video-taped counselling sessions, role plays, standardized patients (actors), group discussions and immediate feedback. The training evaluation was done using a semi-structured anonymous questionnaire. The study assessed the physicians’ self-reported smoking cessation counselling activities before and 6 months after the training. A non-parametric Mann-Whitney test was used to assess pre-post differences in physicians’ counselling skills measured on ordinal scale. Results Of the 37 residents trained, 75% were female, 89% aged 20–29 years and 83% were never-smokers. Twenty-eight trainees (76%) returned the course evaluation survey and 32 (86%) answered a questionnaire on skills self-assessment at 6 months follow-up. The majority agreed the course was successful in achieving its learning objectives (64%-96%) and increased their confidence in assisting their patients to quit (74%). After 6 months, the physicians were more likely than at baseline to adhere to evidence-based counselling strategies, including assessing the smoking status and dependence and matching the advice to the patient motivation. The training did not, however, improve the prescription of tobacco dependence medications. Conclusions Six months after the training, several self-reported smoking cessation counselling activities had significantly improved compared to baseline. This training model is acceptable for medical residents in Yerevan, Armenia and offers a promising approach in addressing the lack of physician counselling skills in similar settings and populations.
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Affiliation(s)
- Narine K. Movsisyan
- American University of Armenia, Gerald and Patricia Turpanjian School of Public Health, Yerevan, Armenia
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
- * E-mail:
| | - Varduhi Petrosyan
- American University of Armenia, Gerald and Patricia Turpanjian School of Public Health, Yerevan, Armenia
| | - Gohar Abelyan
- American University of Armenia, Gerald and Patricia Turpanjian School of Public Health, Yerevan, Armenia
| | - Ondrej Sochor
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Satenik Baghdasaryan
- Yerevan State Medical University, Department of Postgraduate and Continuing Medical Education, Yerevan, Armenia
| | - Jean-François Etter
- Institute of Global Health, Faculty of Medicine, University of Geneva, Campus Biotech, Geneva, Switzerland
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Anschuetz L, Huwendiek S, Stricker D, Yacoub A, Wimmer W, Caversaccio M. Assessment of Middle Ear Anatomy Teaching Methodologies Using Microscopy versus Endoscopy: A Randomized Comparative Study. Anat Sci Educ 2019; 12:507-517. [PMID: 30430760 DOI: 10.1002/ase.1837] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 02/19/2018] [Revised: 09/26/2018] [Accepted: 09/28/2018] [Indexed: 06/09/2023]
Abstract
Teaching methodologies for the anatomy of the middle ear have not been investigated greatly due to the middle ear's highly complex structure and hidden location inside of the temporal bone. The aim of this randomized study was to quantitatively compare the suitability of using microscope- and endoscope-based methods for teaching the anatomy of the middle ear. We hypothesize that the endoscopic approach will be more efficient compared to the microscopic approach. To answer the study questions, 33 sixth-year medical students, residents and otorhinolaryngology specialists were randomized either into the endoscopy or the microscopy group. Their anatomical knowledge was assessed using a structured anatomical knowledge test before and after each session. Each participant received tutoring on a human cadaveric specimen using one of the two methods. They then performed a hands-on dissection. After 2-4 weeks, the same educational curriculum was repeated using the other technique. The mean gains in anatomical knowledge for the specialists, residents, and medical students were +19.0%, +34.6%, and +23.4%, respectively. Multivariate analyses identified a statistically significant increase in performance for the endoscopic method compared to the microscopic technique (P < 0.001). For the recall of anatomical structures during dissection, the endoscopic method outperformed the microscopic technique independently of the randomization or the prior training level of the attendees (P < 0.001). In conclusion, the endoscopic approach to middle ear anatomy education is associated to an improved gain in knowledge as compared to the microscopic approach. The participants subjectively preferred the endoscope for educational purposes.
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MESH Headings
- Adult
- Anatomy/education
- Cadaver
- Curriculum
- Dissection
- Ear, Middle/anatomy & histology
- Ear, Middle/diagnostic imaging
- Education, Medical, Continuing/methods
- Education, Medical, Continuing/statistics & numerical data
- Education, Medical, Undergraduate/methods
- Education, Medical, Undergraduate/statistics & numerical data
- Educational Measurement/statistics & numerical data
- Endoscopy
- Female
- Humans
- Internship and Residency/methods
- Internship and Residency/statistics & numerical data
- Male
- Mental Recall
- Microscopy
- Middle Aged
- Program Evaluation
- Random Allocation
- Students, Medical/statistics & numerical data
- Surgeons/education
- Surgeons/statistics & numerical data
- Teaching
- Young Adult
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Affiliation(s)
- Lukas Anschuetz
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | - Sören Huwendiek
- Institute of Medical Education, University of Bern, Bern, Switzerland
| | - Daniel Stricker
- Institute of Medical Education, University of Bern, Bern, Switzerland
| | - Abraam Yacoub
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | - Wilhelm Wimmer
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland
| | - Marco Caversaccio
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland
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10
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Abstract
OBJECTIVES To describe the nature, frequency and content of non-vitamin K oral anticoagulant (NOAC)-related events for healthcare professionals sponsored by the manufacturers of the NOACs in Australia. A secondary objective is to compare these data to the rate of dispensing of the NOACs in Australia. DESIGN AND SETTING This cross-sectional study examined consolidated data from publicly available Australian pharmaceutical industry transparency reports from October 2011 to September 2015 on NOAC-related educational events. Data from April 2011 to June 2016 on NOAC dispensing, subsidised under Australia's Pharmaceutical Benefits Scheme (PBS), were obtained from the Department of Health and the Department of Human Services. MAIN OUTCOME MEASURES Characteristics of NOAC-related educational events including costs (in Australian dollars, $A), numbers of events, information on healthcare professional attendees and content of events; and NOAC dispensing rates. RESULTS During the study period, there were 2797 NOAC-related events, costing manufacturers a total of $A10 578 745. Total expenditure for meals and beverages at all events was $A4 238 962. Events were predominantly attended by general practitioners (42%, 1174/2797), cardiologists (35%, 977/2797) and haematologists (23%, 635/2797). About 48% (1347/2797) of events were held in non-clinical settings, mainly restaurants, bars and cafes. Around 55% (1551/2797) of events consisted of either conferences, meetings or seminars. The analysis of the content presented at two events detected promotion of NOACs for unapproved indications, an emphasis on a favourable benefit/harm profile, and that all speakers had close ties with the manufacturers of the NOACs. Following PBS listings relevant to each NOAC, the numbers of events related to that NOAC and the prescribing of that NOAC increased. CONCLUSIONS Our findings suggest that the substantial investment in NOAC-related events made by four pharmaceutical companies had a promotional purpose. Healthcare professionals should seek independent information on newly subsidised medicines from, for example, government agencies or drug bulletins.
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Affiliation(s)
- Behrad Behdarvand
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Emily A Karanges
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lisa Bero
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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11
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Dowling S, Last J, Finnegan H, O'Connor K, Cullen W. What are the current 'top five' perceived educational needs of Irish general practitioners? Ir J Med Sci 2019; 189:381-388. [PMID: 31190220 DOI: 10.1007/s11845-019-02047-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 04/10/2019] [Accepted: 06/04/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Doctors' continuing medical educational and professional development (CME and CPD) needs are known to be strongly influenced by national and local contextual characteristics. A crucial step in the development of effective education and training programmes is the assessment of learner needs. METHODS A national needs assessment was conducted among general practitioners (GPs) in the Republic of Ireland who attended continuing medical education small group learning meetings (CME-SGL) in late 2017. Doctors completed a self-administered anonymous three-page questionnaire which gathered demographic data and asked them to choose their 'top five' perceived educational needs from separate lists of topics for CME and CPD. RESULTS There were 1669 responses (98% of monthly attendance). The topics most commonly identified as a priority for further CME were prescribing (updates/therapeutics), elderly medicine, management of common chronic conditions, dermatology, and patient safety/medical error. The most commonly selected CPD topics were applying evidence-based guidelines to practice, appraising performance/conducting practice audits, coping with change, and managing risk and legal medicine. There was no difference between urban and rural practice settings regarding the most commonly chosen topics in each category; however, more rural GPs selected pre-hospital/emergency care as one of their 'top five'. CONCLUSION Our findings identified priority areas where CME and CPD for GPs in Ireland should focus. The topics selected may reflect the changing nature of general practice, which increasingly requires delivery of care to an ageing population with more multi-morbidity and chronic disease management, while trying to apply evidence-based medicine and consider patient safety issues. CME/CPD programmes need to adapt accordingly.
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Affiliation(s)
- Stephanie Dowling
- University College Dublin School of Medicine, Health Sciences Centre, UCD, Dublin, Ireland.
- Cappoquin Health Centre, West Waterford, Ireland.
| | - Jason Last
- University College Dublin School of Medicine, Health Sciences Centre, UCD, Dublin, Ireland
| | - Henry Finnegan
- Irish College of General Practice National CME Director, Irish College of General Practice, Dublin, Ireland
| | | | - Walter Cullen
- University College Dublin School of Medicine, Health Sciences Centre, UCD, Dublin, Ireland
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12
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Bustraan J, Dijkhuizen K, Velthuis S, van der Post R, Driessen E, van Lith JMM, de Beaufort AJ. Why do trainees leave hospital-based specialty training? A nationwide survey study investigating factors involved in attrition and subsequent career choices in the Netherlands. BMJ Open 2019; 9:e028631. [PMID: 31175199 PMCID: PMC6589009 DOI: 10.1136/bmjopen-2018-028631] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To gain insight into factors involved in attrition from hospital-based medical specialty training and future career plans of trainees who prematurely left their specialty training programme. DESIGN Nationwide online survey study. SETTING Postgraduate education of all hospital-based specialties in the Netherlands. PARTICIPANTS 174 trainees who prematurely left hospital-based medical specialty training between January 2014 and September 2017. MAIN OUTCOME MEASURES Factors involved in trainees' decisions to leave specialty training and their subsequent career plans. RESULTS The response rate was 38%. Of the responders, 25% left their programme in the first training year, 50% in year 2-3 and 25% in year 4-6. The most frequently reported factors involved in attrition were: work-life balance, job content, workload and specialty culture. Of the leaving trainees, 66% switched to another specialty training programme, of whom two-thirds chose a non-hospital-based training programme. Twelve per cent continued their career in a non-clinical role and the remainder had no specific plans yet. CONCLUSIONS This study provides insight in factors involved in attrition and in future career paths. Based on our findings, possible interventions to reduce attrition are: (1) enable candidates to develop a realistic view on job characteristics and demands, prior to application; (2) provide individual guidance during specialty training, with emphasis on work-life balance and fit with specialty.
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Affiliation(s)
- Jacqueline Bustraan
- Centre for Innovation in Medical Education, Leiden University Medical Centre, Leiden, The Netherlands
| | - Kirsten Dijkhuizen
- Centre for Innovation in Medical Education, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Sophie Velthuis
- Centre for Innovation in Medical Education, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Erik Driessen
- Department of Education Development and Research, Maastricht University, Maastricht, The Netherlands
| | - Jan M M van Lith
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Arnout Jan de Beaufort
- Centre for Innovation in Medical Education, Leiden University Medical Centre, Leiden, The Netherlands
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13
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Wu S, Li R, Su W, Ruan Y, Chen M, Khan MS. Is knowledge retained by healthcare providers after training? A pragmatic evaluation of drug-resistant tuberculosis management in China. BMJ Open 2019; 9:e024196. [PMID: 30904847 PMCID: PMC6475142 DOI: 10.1136/bmjopen-2018-024196] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 12/11/2018] [Accepted: 01/21/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Considering the urgent need of training to improve standardised management of drug-resistant infectious disease and the lack of evidence on the impact of training, this study evaluates whether training participants' knowledge on multidrug-resistant tuberculosis (MDR-TB) is improved immediately and a year after training. SETTING AND PARTICIPANTS The study involved 91 MDR-TB healthcare providers (HCPs), including clinical doctors, nurses and CDC staff, who attended a new MDR-TB HCP training programme in Liaoning and Jiangxi provinces, China. MAIN OUTCOME MEASURES A phone-based assessment of participants' long-term retention of knowledge about MDR-TB management was conducted in July 2017, approximately 1 year after training. The proportion of correct responses in the long-term knowledge assessment was compared with a pretraining test and an immediate post-training test using a χ2 test. Factors influencing participants' performance in the long-term knowledge assessment were analysed using linear regression. RESULTS Across both provinces, knowledge of definitions of drug-resistant TB, standardised MDR-TB case detection protocols and laboratory diagnosis was improved 1 year after the training by 14.5% (p=0.037), 32.4% (p<0.001) and 31% (p<0.001) relative to pretraining. However, compared with immediately after training, the knowledge of the three topics declined by 26.5% (p=0.003), 19.8% (p=0.018) and 52.7% (p<0.001) respectively in Jiangxi, while no significant decline was observed in Liaoning. Additionally, we found that obtaining a higher score in the long-term knowledge assessment was associated with longer years of clinical experience (coefficient=0.51; 95 CI% 0.02 to 0.99; p=0.041) and attending training in Liaoning (coefficient=0.50; 95% CI 0.14 to 0.85; p=0.007). CONCLUSION Our study, the first to assess knowledge retention of MDR-TB HCPs 1 year after training, showed an overall positive long-term impact of lecture-style group training on participants' knowledge. Knowledge decline 1 year after training was observed in one province, Jiangxi, and this may be partly addressed by targeted support to HCPs with fewer years of clinical experience.
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Affiliation(s)
- Shishi Wu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Renzhong Li
- National Center for Tuberculosis Control and Prevention, China CDC, Beijing, China
| | - Wei Su
- National Center for Tuberculosis Control and Prevention, China CDC, Beijing, China
| | - Yunzhou Ruan
- National Center for Tuberculosis Control and Prevention, China CDC, Beijing, China
| | - Mingting Chen
- National Center for Tuberculosis Control and Prevention, China CDC, Beijing, China
| | - Mishal S Khan
- Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, London, UK
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14
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Berlingo L, Girault A, Azria E, Goffinet F, Le Ray C. Women and academic careers in obstetrics and gynaecology: aspirations and obstacles among postgraduate trainees - a mixed-methods study. BJOG 2019; 126:770-777. [PMID: 30506800 DOI: 10.1111/1471-0528.15574] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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] [Accepted: 11/02/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the relationship between gender and a career in academic medicine. DESIGN Mixed-methods study. SETTING Obstetrics-gynaecology postgraduate training programme in Paris, France. SAMPLE Postgraduate trainees in obstetrics-gynaecology (n = 204). METHODS Statistical analysis of quantitative survey data, thematic analysis of qualitative interview data and integrative analysis. MAIN OUTCOME MEASURES Women's aspirations and obstacles related to their decision about a career in academic medicine. RESULTS A career in academic medicine was envisaged by 13% of the women residents and 27% of the men (P = 0.01). Women reported receiving advice from a mentor less often than men (38.8% versus 52.9%, P = 0.002). Overall, 40.6% of women and 2.9% of men reported experiencing gender discrimination (P < 0.001). In response to the question 'Do you have doubts about your ability to pursue or succeed at an academic career?', 62.4% of the women and only 17.7% of the men answered yes (P < 0.001). The global analysis identified the following obstacles: persistent gender stereotypes that produce everyday sexism, lack of identification with male role models, lack of mentors, perceived discrimination, an ideal of professional excellence that is difficult to attain, constraining professional organisational norms, inequality between men and women in the domestic and family spheres, and finally self-censorship and important doubts about their ability to combine a demanding career and a fulfilling personal life. CONCLUSIONS Women reported the desire to follow a career in academic medicine half as often as men. Improving the presence and visibility of role models for residents and combating workplace discrimination will address some of the barriers to women choosing a career in academic medicine. TWEETABLE ABSTRACT Women obstetric trainees in France are only half as likely as men to envisage following an academic path.
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Affiliation(s)
- L Berlingo
- Port Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, DHU Risks in Pregnancy, Paris, France
- Paris Descartes University, Paris, France
| | - A Girault
- Port Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, DHU Risks in Pregnancy, Paris, France
- Paris Descartes University, Paris, France
- Inserm UMR 1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris-Descartes University, Paris, France
| | - E Azria
- Paris Descartes University, Paris, France
- Inserm UMR 1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris-Descartes University, Paris, France
- Maternity Unit Notre Dame de Bon Secours, Paris Saint Joseph Hospital, Paris, France
- DHU Risks in Pregnancy, Paris, France
| | - F Goffinet
- Port Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, DHU Risks in Pregnancy, Paris, France
- Paris Descartes University, Paris, France
- Inserm UMR 1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris-Descartes University, Paris, France
| | - C Le Ray
- Port Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, DHU Risks in Pregnancy, Paris, France
- Paris Descartes University, Paris, France
- Inserm UMR 1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris-Descartes University, Paris, France
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Abstract
A survey was posted to all general practitioner anaesthetists in Australia who are currently involved in the Joint Consultative Committee on Anaesthesia (JCCA) accreditation process known as the Maintenance of Professional Standards program (MOPS). The survey was intended to gain information regarding accreditation, continuing medical education, caseloads, on call, work practices, attitudes and future work plans. The response rate was 70% (168/240). The majority of respondents worked in a rural location (73%) where there were no specialist anaesthetists (74%). Of the respondents, 89 were category A accredited, but only 15% had this based on completion of the Advanced Rural Skills Curriculum Statement in Anaesthesia (ARSCSA) and examination. The mean number of sessions in anaesthesia worked per week was 2.8 (SD 2.2). Of the respondents, 69% administered more than 150 anaesthetics per year: 28% were on call more than 10 times per month. General surgery, gastrointestinal endoscopy, obstetrics, gynaecology and orthopaedics were the most common specialties for which anaesthesia was provided. Eight percent of respondents stated that sedation comprised 81–100% of their caseload: 92% used propofol as part of their usual intravenous sedation technique: 90% provided anaesthesia for paediatric patients with a mean minimum age of 4.1 years (SD 3.4): 64% provided epidural anaesthesia/analgesia. The majority stated that specialist anaesthetists and hospital administrations were helpful and supportive. Eighty-two percent planned to continue or increase their current anaesthetic workload over the next five years. The JCCA MOPS program appears to provide a satisfactory pathway for training, accreditation and on-going education of general practitioner anaesthetists.
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Affiliation(s)
- M J Davie
- Department of Anaesthesia, Logan Hospital, Brisbane, Queensland, Australia
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Raieli V, Correnti E, Sandullo A, Romano M, Marchese F, Loiacono C, Brighina F. Effectiveness of a digital platform for sharing knowledge on headache management: a two-year experience. Funct Neurol 2019; 33:51-55. [PMID: 29633697 PMCID: PMC5901942 DOI: 10.11138/fneur/2018.33.1.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
It is crucial that all headache specialists receive adequate training. Considering the unsatisfactory results obtained with standard updating courses and the growing need for continuing professional education, a digital platform was developed as a training tool. The platform has been active since 1 October 2014. It is readily accessible to doctors by free registration. Users have access to all the material available on the platform, which includes scientific articles, e-books, presentations and images. Users can share their own material and clinical cases directly. At the time of this study, the platform had 37 users. In the second year following its launch 316 files were downloaded and five discussions were started. These saw 22 contributions. Fifteen of the 37 members did not perform any action on the platform. In total, 74 files were uploaded in the second year of activity, but 90% of the contributions came from a very small group of users. There were no significant differences in use of the platform between members of the Italian Society for the Study of Headache and other specialists. Even though the platform appears to be an easily accessible, interactive and inexpensive instrument, the higher number of downloads than uploads suggests that it is used passively.
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Affiliation(s)
| | | | | | - Marcello Romano
- Neurology Dept.- Cervello, Villa Sofia Ospedali Riuniti, Palermo, Italy
| | | | | | - Filippo Brighina
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Italy
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17
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Kuruvilla A, Jacob KS. Reimagining Psychiatric Education for Physicians. Natl Med J India 2019; 32:1-4. [PMID: 31823929 DOI: 10.4103/0970-258x.272083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Anju Kuruvilla
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | - K S Jacob
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
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Tam YS, Kumar CM, Au Eong KG, Yip CC, Cheng J. Trends in Cataract Surgery Technique and Anaesthesia Preferences in Singapore: A 2016 Survey. Ann Acad Med Singap 2018; 47:390-393. [PMID: 30324968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Yong Seng Tam
- Medical School, The University of Sheffield, United Kingdom
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Schütze H, Shell A, Brodaty H. Development, implementation and evaluation of Australia's first national continuing medical education program for the timely diagnosis and management of dementia in general practice. BMC Med Educ 2018; 18:194. [PMID: 30097036 PMCID: PMC6086051 DOI: 10.1186/s12909-018-1295-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 07/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Dementia is the second leading cause of death in Australia. Over half of patients with dementia are undiagnosed in primary care. This paper describes the development, implementation and initial evaluation of the first national continuing medical education program on the timely diagnosis and management of dementia in general practice in Australia. METHODS Continuing medical education workshops were developed and run in 16 urban and rural locations across Australia (12 were delivered as small group workshops, four as large groups), and via online modules. Two train-the-trainer workshops were held. The target audience was general practitioners, however, international medical graduates, GP registrars, other doctors, primary care nurses and other health professionals were also welcome. Self-complete questionnaires were used for the evaluation. RESULTS Of 1236 people (GPs, other doctors, nurses and other health professionals) who participated in the program, 609 completed the full program (small group workshops (282), large group workshops (75), online modules (252)); and 627 elected to undertake one or more individual submodules (large group workshops (444), online program (183)). Of those who completed the full program as a small group workshop, 14 undertook the additional Train-the-trainer program. 76% of participants felt that their learning needs were entirely met and 78% felt the program was entirely relevant to their practice. CONCLUSION Continuing medical education programs are an effective method to deliver education to GPs. A combination of face-to-face and online delivery modes increases reach to primary care providers. Train-the-trainer sessions and online continuing medical education programs promote long-term delivery sustainability. Further research is required to determine the long-term knowledge translation effects of the program.
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Affiliation(s)
- Heike Schütze
- School of Health and Society, University of Wollongong, Wollongong, NSW 2522 Australia
| | - Allan Shell
- Dementia Centre for Research Collaboration, UNSW Australia, Level 3, AGSM Building, Sydney, 2052 Australia
| | - Henry Brodaty
- Dementia Centre for Research Collaboration, UNSW Australia, Level 3, AGSM Building, Sydney, 2052 Australia
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20
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Jones AT, Barnhart BJ, Durning SJ, Lipner RS. The Association of Changing Practice Settings on Maintenance of Certification Exam Outcomes: A Comparative Study of General Internists Over Time. Acad Med 2018; 93:756-762. [PMID: 29040158 DOI: 10.1097/acm.0000000000002028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE To investigate how changing to or from solo practice settings relates to maintenance of certification (MOC) exam performance. METHOD The authors conducted a retrospective analysis of exam pass/fail outcomes for 7,112 physicians who successfully completed their initial MOC cycle from 2000 to 2004. Initial physician MOC practice characteristics records, demographic information, and exam performance were linked with exam pass/fail outcomes from their second MOC cycle from 2006 to 2014 (5,215 physicians after attrition). Exam pass/fail outcomes for physicians' second MOC cycle were compared among four groups: those who remained in group practice across both MOC cycles, those who changed from group to solo practice, those who changed from solo to group practice, and those who remained in solo practice across both MOC cycles. RESULTS Physicians who changed from solo to group practice performed significantly better than those who remained in solo practice (odds ratio [OR] = 1.67; 95% confidence interval [CI] = 1.11, 2.51; P = .027). Conversely, physicians changing from group to solo practice performed significantly worse than physicians staying in group practice (OR = 0.60; 95% CI = 0.45, 0.80; P = .002). Meanwhile, physicians who changed from solo to group practice performed similarly to physicians remaining in group practice (OR = 0.95; 95% CI = 0.67, 1.35; P = 0.76). CONCLUSIONS Changes in solo/group practice status were associated with second-cycle MOC exam performance. This study provides evidence that the context in which a physician practices may have an impact on their MOC exam performance.
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Affiliation(s)
- Andrew T Jones
- A.T. Jones is director of psychometrics, American Board of Surgery, Philadelphia, Pennsylvania. B.J. Barnhart is research associate, American Board of Internal Medicine, Philadelphia, Pennsylvania. S.J. Durning is professor of medicine and pathology, Department of Medicine, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland. R.S. Lipner is senior vice president, Assessment and Research, American Board of Internal Medicine, Philadelphia, Pennsylvania
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Auerbach SR, Everitt MD, Butts RJ, Rosenthal DN, Law YM. The Pediatric Heart Failure Workforce: An International, Multicenter Survey. Pediatr Cardiol 2018; 39:307-314. [PMID: 29147800 DOI: 10.1007/s00246-017-1756-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 02/20/2017] [Accepted: 10/24/2017] [Indexed: 11/25/2022]
Abstract
Our objective was to understand the scope of pediatric heart failure (HF) and the current staffing environment of HF programs. An online survey was distributed to members of the Pediatric Heart Transplant Study and the Pediatric Council of the International Society for Heart and Lung Transplantation. All participants received the primary 23-question survey. Additionally, HF program directors received a 32-question supplemental survey. Of 235 invitations sent, there were 69 (29%) primary surveys and 34 program director surveys completed (24 U.S. programs, 9 outside non-U.S., and one non-specified location). A formal HF program was reported by 88% of directors. There were 150 [IQR 50-200] outpatients/institution and 40% [25-50] of patients had congenital heart disease. Inpatient HF census was 3 [2-4] patients. Most programs (70%) used a consulting service model to provide HF specialty care, while only 10 (30%) utilized an inpatient HF service. Inpatient HF service programs had a higher daily inpatient census versus consult service model programs (4 [3-7] vs. 2 [1-4], respectively; p = 0.022) and had a higher number of full-time equivalents dedicated to HF (5.5 [2-7] vs. 2.5 [1-4], respectively; p = 0.024). Only 47% of programs report a general fellowship rotation devoted to HF. Advanced practice providers (APP) were utilized in 15 programs, nurse coordinators in 2, and both in 3. Most HF programs are formalized, utilize APP, and have inadequate HF staffing to utilize a separate inpatient HF service. Exposure of general pediatric cardiology fellows to HF care is variable between institutions.
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Affiliation(s)
- Scott R Auerbach
- Division of Cardiology, Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado Heart Institute, Aurora, CO, USA.
| | - Melanie D Everitt
- Division of Cardiology, Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado Heart Institute, Aurora, CO, USA
| | - Ryan J Butts
- Division of Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - David N Rosenthal
- Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Palo Alto, CA, USA
| | - Yuk M Law
- Division of Cardiology, Department of Pediatrics, Children's Hospital & Regional Medical Center, University of Washington, Seattle, WA, USA
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Schrier MW, Rougas SC, Schrier EW, Elisseou S, Warrie S. Intimate Partner Violence Screening and Counseling: An Introductory Session for Health Care Professionals. MedEdPORTAL 2017; 13:10622. [PMID: 30800823 PMCID: PMC6338198 DOI: 10.15766/mep_2374-8265.10622] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
INTRODUCTION Intimate partner violence is a serious public health concern in the United States. Despite recommendations that physicians should routinely screen their patients, research has shown that lack of specific training has resulted in many health care professionals feeling unable to adequately perform this difficult but vital task. Though many educational resources exist to teach intimate partner violence screening, they often lack specific guidance on how to navigate this difficult conversation. In addition, they often lack formal teaching on how to counsel and refer patients who are victims of intimate partner violence. METHODS This unique module, intended for a small-group setting of four to eight students, contains an intimate partner violence checklist with sample language that covers both screening and counseling using a motivational interviewing framework. Additional materials include a checklist companion for tips on how to navigate the conversation, two cases for role-play, a facilitator guide, and an objective structured clinical encounter case and assessment rubric. RESULTS This module was given to 260 second-year medical students at the Warren Alpert Medical School between 2015 and 2017 and was rated highly by almost 90% of students. DISCUSSION After completing this module, learners will be able to appropriately screen for intimate partner violence as well as counsel and refer patients who have screened positive. By implementing this module, educators can increase the number of health care professionals able to broach this difficult conversation with patients who may be in need of help and may otherwise go unaided.
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Affiliation(s)
- Madeleine W. Schrier
- Resident Physician in Pediatrics, Warren Alpert Medical School of Brown University
| | - Steven C. Rougas
- Assistant Professor of Emergency Medicine and Medical Science, Warren Alpert Medical School of Brown University
- Corresponding author:
| | - Ellen W. Schrier
- Clinical Social Worker and Family Therapist, Private Practice in Monterey County, CA
| | - Sadie Elisseou
- Assistant Professor of Medicine, Warren Alpert Medical School of Brown University
| | - Sarita Warrie
- Assistant Professor of Medicine and Medical Science, Warren Alpert Medical School of Brown University
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Kizawa Y, Yamamoto R. [Achievement and Future Direction of the PEACE Project - A National Education Project for Palliative Care Education]. Gan To Kagaku Ryoho 2017; 44:541-544. [PMID: 28790252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Although palliative care is assuming an increasingly important role in patient care, most physicians did not learn to provide palliative care during their medical training. To address these serious deficiencies in physician training in palliative care, government decided to provide basic palliative education program for all practicing cancer doctors as a national policy namely Palliative care Emphasis program on symptom management and Assessment for Continuous medical Education(PEACE). The program was 2-days workshop based on adult learning theory and focusing on symptom management and communication. In this 9 years, 4,888 educational workshop has been held, and 93,250 physicians were trained. In prospective observational study, both knowledges and difficulties practicing palliative care were significantly improved. In 2017, the new palliative care education program will be launched including combined program of e-learning and workshop to provide tailor made education based on learner's readiness and educational needs in palliative care.
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Affiliation(s)
- Yoshiyuki Kizawa
- Dept. of Palliative Medicine, Kobe University School of Medicine
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Maher B, Faruqui A, Horgan M, Bergin C, Tuathaigh CO, Bennett D. Continuing professional development and Irish hospital doctors: a survey of current use and future needs. Clin Med (Lond) 2017; 17:307-315. [PMID: 28765405 PMCID: PMC6297636 DOI: 10.7861/clinmedicine.17-4-307] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 11/27/2022]
Abstract
Doctors rate clinical relevance and applicability as the most important determinants of continuing professional development (CPD) course selection. This study examined patterns of current CPD practice and perceived CPD needs among hospital doctors in Ireland across various clinical specialties. A cross-sectional survey was administered to doctors, focusing on the areas of training needs analysis, CPD course content and preferred course format. In total, 547 doctors identified doctor-patient communication as the skill ranked highest for importance and level of current performance. Workload/time organisation and stress management were areas where a skills deficiency was identified. Non-clinical CPD topics, including resilience training, management and communication skills, were preferred areas for future CPD offerings. All respondents favoured interactive, hands-on sessions. CPD course completion and preference patterns differed significantly across clinical specialties. These results highlight the importance of considering the individual needs and preferences of clinicians across clinical specialties to facilitate more effective CPD programmes.
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Affiliation(s)
| | | | - Mary Horgan
- Cork University Hospital, dean of the School of Medicine, University College Cork, Cork, Ireland and president, Royal College of Physicians in Ireland, Dublin, Ireland
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Aghajafari F, Tapley A, Sylvester S, Davey AR, Morgan S, Henderson KM, van Driel ML, Spike NA, Kerr RH, Catzikiris NF, Mulquiney KJ, Magin PJ. Procedural skills of Australian general practice registrars: A cross-sectional analysis. Aust Fam Physician 2017; 46:429-434. [PMID: 28609601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Procedural skills are an essential component of general practice vocational training. The aim of this study was to investigate the type, frequency and rural or urban associations of procedures performed by general practice registrars, and to establish levels of concordance of procedures performed with a core list of recommended procedural skills in general practice training. METHODS A cross-sectional analysis of a cohort study of registrars' consultations between 2010 and 2016 was undertaken. Registrars record 60 consecutive consultations during each six-month training term. The outcome was any procedure performed. RESULTS In 182,782 consultations, 19,411 procedures were performed. Procedures (except Papanicolaou [Pap] tests) were performed more often in rural than urban areas. Registrars commonly sought help from supervisors for more complex procedures. The majority of procedures recommended as essential in registrar training were infrequently performed. DISCUSSION Registrars have low exposure to many relevant clinical procedures. There may be a need for greater use of laboratory-based training and/or to review the expectations of the scope of procedural skills in general practice.
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Anderson K, Accurso EC, Kinasz KR, Le Grange D. Residents' and Fellows' Knowledge and Attitudes About Eating Disorders at an Academic Medical Center. Acad Psychiatry 2017; 41:381-384. [PMID: 27882518 PMCID: PMC7219944 DOI: 10.1007/s40596-016-0578-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 05/25/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This study examined physician residents' and fellows' knowledge of eating disorders and their attitudes toward patients with eating disorders. METHODS Eighty physicians across disciplines completed a survey. The response rate for this survey across disciplines was 64.5 %. RESULTS Participants demonstrated limited knowledge of eating disorders and reported minimal comfort levels treating patients with eating disorders. Psychiatry discipline (p = 0.002), eating disorder experience (p = 0.010), and having ≥4 eating disorder-continuing medical education credits (p = 0.037) predicted better knowledge of anorexia nervosa but not bulimia nervosa. Psychiatry residents (p = 0.041), and those who had treated at least one eating disorder patient (p = 0.006), reported significantly greater comfort treating patients with eating disorders. CONCLUSION These results suggest that residents and fellows from this sample may benefit from training to increase awareness and confidence necessary to treat patients with eating disorders. Sufficient knowledge and comfort are critical since physicians are often the first health care provider to have contact with patients who have undiagnosed eating disorders.
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Barth KS, Ball S, Adams RS, Nikitin R, Wooten NR, Qureshi ZP, Larson MJ. Development and Feasibility of an Academic Detailing Intervention to Improve Prescription Drug Monitoring Program Use Among Physicians. J Contin Educ Health Prof 2017; 37:98-105. [PMID: 28562498 PMCID: PMC5521811 DOI: 10.1097/ceh.0000000000000149] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
INTRODUCTION South Carolina (SC) ranks 10th in opioid prescriptions per capita-33% higher than the national average. SC is also home to a large military and veteran population, and prescription opioid use for chronic pain is alarmingly common among veterans, especially those returning from Afghanistan and Iraq. This article describes the background and development of an academic detailing (AD) educational intervention to improve use of a Prescription Drug Monitoring Program among SC physicians who serve military members and veterans. The aim of this intervention was to improve safe opioid prescribing practices and prevent prescription opioid misuse among this high-risk population. METHODS A multidisciplinary study team of physicians, pharmacists, psychologists, epidemiologists, and representatives from the SC's Prescription Monitoring Program used the Medical Research Council complex interventions framework to guide the development of the educational intervention. The theoretical and modeling phases of the AD intervention development are described and preliminary evidence of feasibility and acceptability is provided. RESULTS Ninety-three physicians consented to the study from 2 practice sites. Eighty-seven AD visits were completed, and 59 one-month follow-up surveys were received. Participants rated the AD intervention high in helpfulness of information, intention to use information, and overall satisfaction with the intervention. The component of the intervention felt to be most helpful was the AD visit itself. Characteristics of the participants and the intervention, as well as anticipated barriers to behavior change are detailed. DISCUSSION Preliminary results support the feasibility of AD delivery to veteran and community patient settings, the feasibility of facilitating Prescription Drug Monitoring Program registration during an AD visit, and that AD visits were generally found satisfying to participants and helpful in improving knowledge and confidence about safe opioid prescribing practices. The component of the intervention felt to be most helpful to the participants was the actual AD visit, and most participants rated their intentions high to use the information and tools from the visit. Intervention key messages, preliminary outcome measures, and successes and challenges in developing and delivering this intervention are discussed to advance best practices in developing educational interventions in this important area of public health.
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Affiliation(s)
- Kelly S Barth
- Barth: Associate Professor, Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC. Ball: Research Assistant Professor, Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, Charleston, SC. Adams: Scientist, Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA. Nikitin: Research Associate, Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA. Wooten: Assistant Professor, College of Social Work, University of South Carolina, and Chair, Military Specialization, Lieutenant Colonel, Army National Guard. Qureshi: Assistant Professor, Department of Health Services Policy and Management, University of South Carolina, Columbia, SC, and Adjunct Professor, Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, Columbia, SC. Larson: Senior Scientist and Lecturer, Heller School for Social Policy and Management, Brandeis University, Waltham, MA
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Bailey MA, Smith AC, Fitzgerald A, Taylor E. Delivery of child development services by videoconferencing: A review of four years’ experience in Queensland. J Telemed Telecare 2016; 11 Suppl 2:S1-3. [PMID: 16375781 DOI: 10.1258/135763305775124939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In 2001 the Child Development Unit (CDU) in Brisbane piloted a series of monthly multidisciplinary case discussions via videoconference in the area of child development. During 2001 two sessions were provided; during 2004 there were 40. The substantial growth in 2004 was due to the expansion of child development services to include special interest group meetings and multipoint case conference meetings. In 2004, a total of 49 h of videoconferencing was conducted. The average session length was 75 min. Education and training sessions were delivered to 32 hospitals and health centres in Queensland and northern New South Wales. The maximum number of sites involved during a single videoconference was 25. The average number of attendees for each videoconference was five per site, including allied health staff, nurses and paediatricians. The delivery of child development services via videoconference has been shown to be useful in Queensland, especially for allied health staff working in regional and remote areas. The growth of the programme indicates its acceptance as a mainstream child development service in Queensland.
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Affiliation(s)
- Maggie A Bailey
- Child Development Unit, Community Child Health Service, Royal Children's Hospital and Health Service District, Brisbane, Australia.
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Lund O, Andersen B, Christensen MK. Old habits die hard: a case study on how new ways of teaching colonoscopy affect the habitus of experienced clinicians. Int J Med Educ 2016; 7:297-308. [PMID: 27643986 PMCID: PMC5056026 DOI: 10.5116/ijme.57d5.5693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/20/2016] [Accepted: 09/11/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The purpose of this study is to explore the habitual constraints and opportunities that affect how experienced clinicians learn new skills and, in particular, how new ways of teaching can influence these. METHODS We conducted a case study based on a specialized training program for colonoscopy services in Denmark. Data was obtained from a short-term ethnographic fieldwork and in-depth interviews during this program. Participants were 12 experienced colonoscopists and three expert colonoscopy trainers from Denmark and UK. The analysis of data involved categorization, inductive coding, and theoretical reading inspired by sociological theory. RESULTS The experienced clinicians' responsiveness to training was shaped by an underlying logic of colonoscopy practice that was characterized by tacit skills, routine work, lower status, skepticism and self-protectiveness. In order to overcome these habitual constraints, the trainers applied a pedagogical approach based on four methods: 1) intellectualization: 'academization' of skills and competencies, 2) sensing and scaffolding: hands-on experiences and learning by doing, 3) asymmetry: accentuating the authority and respect of the trainer, and 4) relation-building: building relationship and engagement between trainer and clinician. This multi-dimensional approach to teaching enabled the trainers to affect the clinicians' logic of practice and to create buy-in (so-called illusio). CONCLUSIONS Clinical skills include socially constructed behaviors and unconscious competences which affect experienced clinicians' responsiveness to continuing medical education. This study suggests four educational strategies that may help trainers to establish new logics of practice in experienced clinicians and to improve the clinicians' conscious competence.
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Affiliation(s)
- Ole Lund
- Centre for Health Sciences Education, Aarhus University, Denmark
| | - Berit Andersen
- Department of Public Health Programmes, Regional Hospital of Randers, Denmark
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Mi M, Halalau A. A pilot study exploring the relationship between lifelong learning and factors associated with evidence-based medicine. Int J Med Educ 2016; 7:214-9. [PMID: 27372836 PMCID: PMC4939218 DOI: 10.5116/ijme.576f.a2ca] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 06/26/2016] [Accepted: 02/25/2016] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To explore possible relationships between residents' lifelong learning orientation, skills in practicing evidence-based medicine (EBM), and perceptions of the environment for learning and practicing EBM. METHODS This was a pilot study with a cross-sectional survey design. Out of 60 residents in a medical residency program, 29 participated in the study. Data were collected using a survey that comprised three sections: the JeffSPLL Scale, EBM Environment Scale, and an EBM skill questionnaire. Data were analyzed using SPSS and were reported with descriptive and inferential statistics (mean, standard deviation, Pearson's correlation, and a two-sample t-test). RESULTS Mean scores on the JeffSPLL Scale were significantly correlated with perceptions of the EBM Scale and use of EBM resources to keep up to date or solve a specific patient care problem. There was a significant correlation between mean scores on the EBM Scale and hours per week spent in reading medical literature to solve a patient care problem. Two-sample t-tests show that residents with previous training in research methods had significantly higher scores on the JeffSPLL Scale (p=0.04), EBM Scale (p=0.006), and self-efficacy scale (p =0.024). CONCLUSIONS Given the fact that physicians are expected to be lifelong learners over the course of their professional career, developing residents' EBM skills and creating interventions to improve specific areas in the EBM environment would likely foster residents' lifelong learning orientation.
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Affiliation(s)
- Misa Mi
- Department of Biomedical Sciences, Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Alexandra Halalau
- Department of Internal Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
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Chandramani S, Challenor R, Mehta S. A survey of study leave entitlement in 2002 amongst non-consultant career grade doctors in genitourinary medicine. Int J STD AIDS 2016; 15:26-8. [PMID: 14769167 DOI: 10.1258/095646204322637218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Non-consultant career grade (NCCG) doctors perform a significant proportion of the clinical work in genitourinary medicine (GUM) and it is essential that their training and educational needs are met. Seven hundred questionnaires were posted to NCCGs in the UK to investigate whether employing trusts supported the educational needs of NCCG doctors by granting/funding study leave. A summary of the 220 replies (31% response) is presented. One hundred and twenty (55%) were not granted study leave to attend the 2002 national GUM NCCG conference. Study leave was less likely to be granted to those who held posts as clinical assistant or hospital practitioner and to those doctors who were working three or fewer sessions per week in GUM. It appears from our survey that many NCCG doctors who are seeing a significant proportion of the clinical workload in GUM are not supported by their employing trusts to keep up to date.
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Affiliation(s)
- Shamala Chandramani
- Genitourinary Medicine Department, Manor Hospital, Moat Road, Walsall, WS2 9PS, UK.
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Mejia R, Pérez Stable EJ, Kaplan CP, Gregorich SE, Livaudais-Toman J, Peña L, Alderete M, Schoj V, Alderete E. Effectiveness of an Intervention to Teach Physicians How to Assist Patients to Quit Smoking in Argentina. Nicotine Tob Res 2016; 18:1101-9. [PMID: 26175459 PMCID: PMC5815630 DOI: 10.1093/ntr/ntv153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 07/07/2015] [Indexed: 11/14/2022]
Abstract
INTRODUCTION We evaluated an intervention to teach physicians how to help their smoking patients quit compared to usual care in Argentina. METHODS Physicians were recruited from six clinical systems and randomized to intervention (didactic curriculum in two 3-hour sessions) or usual care. Smoking patients who saw participating physicians within 30 days of the intervention (index clinical visit) were randomly sampled and interviewed by telephone with follow-up surveys at months 6 and 12 after the index clinical visit. Outcomes were tobacco abstinence (main), quit attempt in the past month, use of medications to quit smoking, and cigarettes per day. Repeated measures on the same participants were accommodated via generalized linear mixed models. RESULTS Two hundred fifty-four physicians were randomized; average age 44.5 years, 53% women and 12% smoked. Of 1378 smoking patients surveyed, 81% were women and 45% had more than 12 years of education. At 1 month, most patients (77%) reported daily smoking, 20% smoked some days and 3% had quit. Mean cigarettes smoked per day was 12.9 (SD = 8.8) and 49% were ready to quit within the year. Intention-to-treat analyses did not show significant group differences in quit rates at 12 months when assuming outcome response was missing at random (23% vs. 24.1%, P = .435). Using missing=smoking imputation rule, quit rates were not different at 12 months (15.6% vs. 16.4% P = .729). Motivated smokers were more likely to quit at 6 months (17.7% vs. 9.6%, P = .03). CONCLUSIONS Training in tobacco cessation for physicians did not improve abstinence among their unselected smoking patients.
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Affiliation(s)
- Raul Mejia
- Department of Medicine, Centro de Estudios de Estado y Sociedad (CEDES), Argentina, Buenos Aires, Argentina; Department of Medicine, Program in General Internal Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Eliseo J Pérez Stable
- Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, UCSF, San Francisco, CA;
| | - Celia P Kaplan
- Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, UCSF, San Francisco, CA
| | - Steven E Gregorich
- Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, UCSF, San Francisco, CA
| | - Jennifer Livaudais-Toman
- Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, UCSF, San Francisco, CA
| | - Lorena Peña
- Department of Medicine, Centro de Estudios de Estado y Sociedad (CEDES), Argentina, Buenos Aires, Argentina
| | - Mariela Alderete
- Fundacion Interamericana del Corazón Argentina, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Jujuy, Jujuy, Argentina
| | - Veronica Schoj
- Fundacion Interamericana del Corazón Argentina, Buenos Aires, Argentina
| | - Ethel Alderete
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Jujuy, Jujuy, Argentina
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Abstract
AbstractBackground:The growing science and technology of various neurosurgical areas fosters subspecialization. The transmission of this expanding knowledge base to the neurosurgical resident becomes an increasing challenge. A survey of neurosurgical residency program directors was undertaken to evaluate their response to the budding subspecialization of spine surgery within general neurosurgery.Methods:A survey requesting background data, educational infrastructure and prevailing opinion was distributed to all 13 neurosurgical program directors in Canada. The responses were tabulated and results recorded. It is upon these results that conclusions and proposed directions are based.Results/Conclusions:The current practice of the overwhelming majority of Canadian academic neurosurgical centers is to have neurosurgical spinal subspecialists working under the umbrella of the general neurosurgical division. A large percentage of neurosurgical program directors in Canada believe that the management of spinal disease, including both intradural procedures and instrumentation, is and should remain an integral part of general neurosurgical training. A consensus statement regarding the requirements of neurosurgical training in spinal disorders is the expressed desire of almost all program directors. A proposed direction and resolution is discussed.
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MESH Headings
- Canada
- Data Collection
- Education, Medical
- Education, Medical, Continuing/organization & administration
- Education, Medical, Continuing/statistics & numerical data
- Education, Medical, Graduate/organization & administration
- Education, Medical, Graduate/statistics & numerical data
- Faculty, Medical
- Humans
- Internship and Residency/organization & administration
- Internship and Residency/statistics & numerical data
- Medicine/statistics & numerical data
- Neurology/education
- Neurology/statistics & numerical data
- Neurosurgery/education
- Neurosurgery/statistics & numerical data
- Neurosurgical Procedures/education
- Neurosurgical Procedures/statistics & numerical data
- Orthopedics/education
- Orthopedics/statistics & numerical data
- Specialization
- Spinal Cord/surgery
- Spinal Cord Diseases/surgery
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MacWalter G, McKay J, Bowie P. Utilisation of internet resources for continuing professional development: a cross-sectional survey of general practitioners in Scotland. BMC Med Educ 2016; 16:24. [PMID: 26791566 PMCID: PMC4721189 DOI: 10.1186/s12909-016-0540-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 07/22/2015] [Accepted: 01/07/2016] [Indexed: 05/18/2023]
Abstract
BACKGROUND Participation in continuing professional development (CPD) is a professional and regulatory expectation of general practitioners (GPs). Traditionally, CPD activity was undertaken face-to-face in educational settings, but internet based formats have found increasing favour. The need for doctors to use the internet for service and educational purposes is growing, particularly in support of specialty training and appraisal. We aimed to determine how GPs in Scotland utilise online resources in support of their CPD. This involved identifying which resources are used and how frequently, along with their preferences as to how and why they access these resources. METHODS A cross sectional study was undertaken using an online questionnaire to survey general practitioners across Scotland. Data were subjected to descriptive analysis and differences in attitudinal responses between groups and Fischer's exact tests were calculated. RESULTS Three hundred and eighty-three GP responses were received, with the majority being female (n = 232, 60.6%) and GP partners (n = 236, 61.6%). The majority used the internet on three or more working days per week or more frequently (n = 361, 94.3%) with the three most common reasons being to obtain information for a patient (n = 358, 93.5%), answering a clinical question (n = 357, 93.2%) and CPD purposes (n = 308, 80.4%). Of 37 online resources used by respondents, the top five were SIGN Guidelines (n = 303, 79.3%), BMJ Learning (n = 279, 73.0%), NICE Guidelines (n = 255, 66.8%), GP Notebook (n = 243, 63.6%) and Google (n = 234, 61.3%). Low use of social media such as Facebook (n = 11, 2.9%) and Twitter (n = 11, 2.9%) was reported for CPD. A majority agreed that 'reading information online' (95.0%) and 'completing online learning modules' (87.4%) were the most valued online activities. Slow internet connections (n = 240, 62.7%), website access restrictions (n = 177, 46.2%) and difficulties logging into online CPD resources (n = 163, 42.6%) were reported barriers. Significant response differences (P < 0.05) were found between groups based on high volume online usage, gender and age. CONCLUSIONS The majority of respondents had positive attitudes to using online resources for continuing professional development, and a preference for evidence-based and peer reviewed online resources. Information technology (IT) difficulties remain a barrier to effective utilisation. The findings have implications for future planning and design of online resources and IT infrastructure.
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Affiliation(s)
- Gordon MacWalter
- NHS Education for Scotland, 2 Central Quay, 89 Hydepark Street, Glasgow, G3 8BW, UK
| | - John McKay
- NHS Education for Scotland, 2 Central Quay, 89 Hydepark Street, Glasgow, G3 8BW, UK
| | - Paul Bowie
- NHS Education for Scotland, 2 Central Quay, 89 Hydepark Street, Glasgow, G3 8BW, UK.
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
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Nosulya EV, Kosyakov SY, Kim IA, Piskunov GZ. [The remote post-graduate education in otorhinolaryngology: the first results and further prospects]. Vestn Otorinolaringol 2016; 81:84-86. [PMID: 26977576 DOI: 10.17116/otorino201681184-86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The objective of the present work was the retrospective analysis of the efficiency of two courses of remote education of otorhinolaryngologists in the real-time mode based on the results of the on-line questionnaire study. We analyzed the data obtained during the implementation of the pilot project of the remote post-graduate education at the Department of Otorhinolaryngology,Russian Medical Academy of Post-Graduate Education making use of the independent Internet resource for the professional training of otorhinolaryngologists. The two programs of remote education realized in 2012 and 2013 involved 7.9% of all otorhinolaryngologists practicing in the Russian Federation. The fraction of those who passed through all stages of the learning process increased almost two-fold, that is from 10% in 2012 up to 19% in 2013. About 14% of the participants made themselves familiar with all program modules; this result is in agreement with the data obtained in mass on-line remote teaching of the non-medical audience. It is concluded that the results of the present study provide a basis for the elaboration of the remote education programs for the training of specialists not only in otorhinolaryngology but also in other fields of medicine.
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Affiliation(s)
- E V Nosulya
- Russian Medical Academy of Post-Graduate Education, Russian Ministry of Health, Moscow, Russia, 125367
| | - S Ya Kosyakov
- Russian Medical Academy of Post-Graduate Education, Russian Ministry of Health, Moscow, Russia, 125367
| | - I A Kim
- Russian Medical Academy of Post-Graduate Education, Russian Ministry of Health, Moscow, Russia, 125367
| | - G Z Piskunov
- Russian Medical Academy of Post-Graduate Education, Russian Ministry of Health, Moscow, Russia, 125367
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Li H, Wang Z, Jiang N, Liu Y, Wen D. Lifelong learning of Chinese rural physicians: preliminary psychometrics and influencing factors. BMC Med Educ 2015; 15:192. [PMID: 26519057 PMCID: PMC4628275 DOI: 10.1186/s12909-015-0460-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 05/06/2015] [Accepted: 10/09/2015] [Indexed: 05/11/2023]
Abstract
BACKGROUND There are more than 4.9 million rural health workers undertaking the health care need of rural population of over 629 million in China. The lifelong learning of physicians is vital in maintaining up-to-date and qualified health care, but rural physicians in many developing countries lack adequate medical professional developments. There has also been no empirical research focused on the lifelong learning of rural physician populations. The purpose of this study was to investigate the primary levels of lifelong learning of the rural physicians and to analyze group differences. METHODS We conducted a cross-sectional study on 1197 rural physicians using the Jefferson Scale of Physician Lifelong Learning (JSPLL). Cronbach's α coefficient, exploratory factor analysis, independent sample t-test, and one-way ANOVA followed by Student-Newman-Keuls test were performed to analyze the data. RESULTS For Chinese rural physicians, the JSPLL was reliable (Cronbach's α coefficient = 0.872) and valid, with exploratory factor analysis fitting a 3-factor model and accounting for a total of 60.46 % of the variance. The mean lifelong learning score was 45.56. Rural physicians generally performed worse in the technical skills in seeking information domain. Rural physicians with 21-30 working years have a lower score of lifelong learning (P < 0.05) than other phases of working years. Career satisfaction and professional titles had a significantly positive influence on physicians' orientation towards lifelong learning (P < 0.05). The overall lifelong learning scores of physicians who received more training after completion of medical school were higher than those with less additional post-medical school training (P <0.05). CONCLUSIONS The JSPLL is effective for the Chinese rural physician population. In order to cope with impacting factors on rural physicians' lifelong learning, the results of the study reinforced the importance of continuing medical education and career satisfaction for lifelong learning and the need for medical schools and hospitals to provide reasonable strategies and necessary support for rural physicians with different amounts of working years. Providing rural physicians more educational opportunities and helping them access educational resources may be an effective strategy for improving their orientation to lifelong learning.
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Affiliation(s)
- Honghe Li
- School of Public Health, China Medical University, Shenyang, Liaoning Province, China.
- Research Center for Medical Education, China Medical University, Shenyang, Liaoning Province, China.
| | - Ziwei Wang
- School of Public Health, China Medical University, Shenyang, Liaoning Province, China.
- Research Center for Medical Education, China Medical University, Shenyang, Liaoning Province, China.
| | - Nan Jiang
- Research Center for Medical Education, China Medical University, Shenyang, Liaoning Province, China.
| | - Yang Liu
- School of Public Health, China Medical University, Shenyang, Liaoning Province, China.
| | - Deliang Wen
- School of Public Health, Dalian Medical University, Dalian, Liaoning Province, China.
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Lörincz BB, Busch CJ, Möckelmann N, Knecht R. Initial learning curve of single-incision transaxillary robotic hemi- and total thyroidectomy--A single team experience from Europe. Int J Surg 2015; 18:118-22. [PMID: 25917203 DOI: 10.1016/j.ijsu.2015.04.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 11/11/2014] [Revised: 04/09/2015] [Accepted: 04/19/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The primary advantage of robotic thyroidectomy is to avoid a neck scar. On the other hand, this sophisticated technique implies some potential risks otherwise not associated with conventional thyroidectomy, increased costs, and prolonged operating times. With all these factors being an important issue, we analysed the data of our initial European series in order to understand the nature of the learning curve for this technique. METHODS Ten patients underwent transaxillary robotic thyroidectomy for benign disease, performed consistently by the same surgeon with the same team, within a timeframe of 12 months. There were four total thyroidectomies and six hemithyroidectomies. Operating times broken down into creating the working space, docking the robot, and console work (including wound closure), were prospectively recorded and evaluated. RESULTS By the end of the initial learning curve comprising ten patients, the total operating time for a robotic hemithyroidectomy and for a total thyroidectomy has decreased by 49% to 190 min, and by 31% to 229 min, respectively. Intraoperative complications were successfully managed without conversion to open access surgery. CONCLUSION The learning curve for transaxillary robotic thyroidectomy is rather steep; reasonable progress in terms of operating times can be achieved within the first ten cases. Consistency in the team and careful patient selection are paramount factors for success.
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Affiliation(s)
- Balazs B Lörincz
- Head and Neck Cancer Center of the Hubertus Wald University Cancer Center Hamburg, Dept. of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany.
| | - Chia-Jung Busch
- Head and Neck Cancer Center of the Hubertus Wald University Cancer Center Hamburg, Dept. of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
| | - Nikolaus Möckelmann
- Head and Neck Cancer Center of the Hubertus Wald University Cancer Center Hamburg, Dept. of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
| | - Rainald Knecht
- Head and Neck Cancer Center of the Hubertus Wald University Cancer Center Hamburg, Dept. of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany.
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Porter JE, Cooper SJ, Taylor B. Family presence during resuscitation (FPDR): A survey of emergency personnel in Victoria, Australia. ACTA ACUST UNITED AC 2015; 18:98-105. [PMID: 25655467 DOI: 10.1016/j.aenj.2014.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 10/15/2013] [Revised: 12/24/2014] [Accepted: 12/24/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Family presence during resuscitation (FPDR) has been endorsed internationally by resuscitation councils since the year 2000; however, the extent to which FPDR is practiced in emergency settings requires further investigation. METHODS Emergency personnel (n=347) from 18 participating emergency departments across the state of Victoria, Australia completed a 10-page questionnaire, which was designed to develop an understanding of the current practice and implementation of FPDR and to ascertain the differences in practice between adult and paediatric resuscitations. RESULTS Emergency personnel update their adult and paediatric advanced life support qualifications annually with 87% of nurses and 65% of doctors completing adult life support and 72% of nurses and 49% of doctors completing paediatric advanced life support training. The majority of nursing staff reported support for FPDR (83%) with over 70% indicating that it is apart of their current practice. There was strong agreement from both nurses (79%) and doctors (77%) that the family have the right to be present. A family support person was deemed as essential by nurses (92%) and doctors (89%) when allowing family to be present. A factor analysis was conducted on participant statements, revealing four codes; impact on professional practice and performance, personnel beliefs about FPDR, professional satisfaction and the importance of a support person and saying goodbye. CONCLUSION A family support person was highlighted as essential to the successful implementation of FPDR, together with the development of a comprehensive training the education program for emergency personnel. FPDR continues to be a significant issue and further investigation into FPDR practice and implementation in the ED is warranted.
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Affiliation(s)
- Joanne E Porter
- School of Nursing, Midwifery and Healthcare, Federation University, Churchill, Victoria, Australia.
| | - Simon J Cooper
- School of Nursing and Midwifery, Monash University, Berwick, Victoria, Australia; University of Brighton, UK
| | - Beverley Taylor
- School of Nursing, Midwifery and Healthcare, Federation University, Churchill, Victoria, Australia
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Carrera RM, Cendoroglo M, Gonçales PDS, Marques FRB, Sardenberg C, Glezer M, dos Santos OFP, Rizzo LV, Lottenberg CL, Schvartsman C. Association between participation and compliance with Continuing Medical Education and care production by physicians: a cross-sectional study. Einstein (Sao Paulo) 2015; 13:1-6. [PMID: 25807247 PMCID: PMC4977592 DOI: 10.1590/s1679-45082015ao3189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 10/30/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Physician participation in Continuing Medical Education programs may be influenced by a number of factors. To evaluate the factors associated with compliance with the Continuing Medical Education requirements at a private hospital, we investigated whether physicians' activity, measured by volumes of admissions and procedures, was associated with obtaining 40 Continuing Medical Education credits (40 hours of activities) in a 12-month cycle. METHODS In an exclusive and non-mandatory Continuing Medical Education program, we collected physicians' numbers of hospital admissions and numbers of surgical procedures performed. We also analyzed data on physicians' time since graduation, age, and gender. RESULTS A total of 3,809 credentialed, free-standing, private practice physicians were evaluated. Univariate analysis showed that the Continuing Medical Education requirements were more likely to be achieved by male physicians (odds ratio 1.251; p=0.009) and who had a higher number of hospital admissions (odds ratio 1.022; p<0.001). Multivariate analysis showed that age and number of hospital admissions were associated with achievement of the Continuing Medical Education requirements. Each hospital admission increased the chance of achieving the requirements by 0.4%. Among physicians who performed surgical procedures, multivariate analysis showed that male physicians were 1.3 time more likely to achieve the Continuing Medical Education requirements than female physicians. Each surgical procedure performed increased the chance of achieving the requirements by 1.4%. CONCLUSION The numbers of admissions and number of surgical procedures performed by physicians at our hospital were associated with the likelihood of meeting the Continuing Medical Education requirements. These findings help to shed new light on our Continuing Medical Education program.
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Affiliation(s)
| | | | | | | | | | - Milton Glezer
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Margolis A, Gonzalez-Martinez F, Noboa O, Abbud-Filho M, Lorier L, Nin M, Silvariño R, García S, Pefaur J, Greloni GC, Noronha IL, Lopez A, Ribeiro-Alves MA, Tanús R, Fernández-Cean J. Online Continuing Medical Education for the Latin American Nephrology Community. Stud Health Technol Inform 2015; 216:372-375. [PMID: 26262074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A continuing medical education (CME) course was implemented for Latin American nephrologists in 2013. The topic was Immunopathology in native and transplanted kidneys. The course was given in Spanish and Portuguese. The activities included a distance education seven-week asynchronous online modality with multiple educational strategies. Thirty hours of study workload were estimated to complete the course. Four hundred and ninety-eight physicians coming from 18 countries registered for the course; 442 of them participated in it. Of those who participated, 51% received a certificate of completion and 29% a certificate of participation. Sixty-five percent of registrants participated in the case discussions. Eighty-six percent were very satisfied and 13% were satisfied. Lack of time to devote to the course was the main limitation expressed (62%), while Internet access or difficulties in the use of technology were considered by only 12 and 6% of participants, respectively. There was a significant increase in knowledge between before and after the course; the average grade increased from 64 to 83%. In conclusion, technology-enabled education demonstrated potential to become an instrument for Latin American nephrologists.
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Affiliation(s)
| | | | - Oscar Noboa
- Nephrology Department, Universidad de la República, Uruguay
| | | | | | - Marcelo Nin
- Nephrology Department, Universidad de la República, Uruguay
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Planquette B, Maurice D, Peron J, Mourin G, Ferre A, Sanchez O, Meyer G. Knowledge of the diagnostic algorithm for pulmonary embolism in primary care. Eur J Intern Med 2015; 26:18-22. [PMID: 25498510 DOI: 10.1016/j.ejim.2014.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 07/22/2014] [Revised: 11/18/2014] [Accepted: 11/21/2014] [Indexed: 01/21/2023]
Abstract
BACKGROUND Diagnostic algorithms for pulmonary embolism (PE) have been validated in patients attending hospital emergency departments. However, general practitioners (GPs) are often the professionals of first resort for the majority of non-critical cases of PE. AIM To evaluate the knowledge of the diagnostic algorithm for PE among GPs in France. DESIGN AND SETTING Questionnaire-based survey of GPs with a private practice. METHOD All GPs in the study area were sent a questionnaire including several questions on the diagnosis of PE and two clinical cases scenario with suspected PE. Factors associated with knowledge of the diagnostic algorithm were analysed by univariate and multivariate analyses. RESULTS Five-hundred and eight questionnaires were distributed and 155 (30.5%) were available for analysis. Only 55% of the GPs did know about clinical scores for the assessment of clinical probability of PE and 42% of the GPs were aware that clinical probability is needed to interpret the result of D-dimer testing. Forty GPs (26%) gave valid responses to both clinical cases, 54 GPs (35%) had one valid case out of the two and 61 (39%) gave invalid responses to both clinical cases. Participation in specific training on PE was significantly associated with valid responses to the two clinical cases in multivariate analysis (p<0.017). CONCLUSION The majority of GPs were unaware of the diagnostic algorithm for PE. Clinical probability was rarely assessed and knowledge about D-dimers was poor. Specific training on PE and greater awareness of clinical probability scores may promote knowledge of PE algorithm diagnosis.
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Affiliation(s)
- B Planquette
- Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; ISERM U970-PARCC, Paris, France.
| | - D Maurice
- Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - J Peron
- Hospices Civils de Lyon, Service de Biostatistique, F-69003 Lyon, France; CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France; Université de Lyon, F-69622, Lyon, France
| | - G Mourin
- Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France
| | - A Ferre
- Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France
| | - O Sanchez
- Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; ISERM U970-PARCC, Paris, France
| | - G Meyer
- Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; ISERM U970-PARCC, Paris, France
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Abstract
A 12-month pilot was carried out on assessments for learning and assessments of learning as part of workplace-based assessments in postgraduate medical education. This was carried out in three regions and core medical trainees and higher specialty medical trainees participated. Focus groups and questionnaires were utilised to investigate the trainees' and trainers' experiences and perceptions of assessments for learning. The study demonstrated that the trainees and trainers perceived the newly introduced assessments for learning--supervised learning events (SLEs)--as learning tools. However, SLEs were often undertaken with no previous organisation and with no direct observation, regardless of the underlying purposes and methods of the WPBAs. There was a lack of, or delayed or non-specific, feedback following SLEs, which would have impeded its educational value. Trainee and trainer disengagement was one of the contributing factors. These findings are valuable in informing and facilitating future successful implementation of assessments for learning.
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Wenghofer EF, Marlow B, Campbell C, Carter L, Kam S, McCauley W, Hill L. The relationship between physician participation in continuing professional development programs and physician in-practice peer assessments. Acad Med 2014; 89:920-927. [PMID: 24871244 DOI: 10.1097/acm.0000000000000243] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To investigate the relationship between physicians' performance, as evaluated through in-practice peer assessments, and their participation in continuing professional development (CPD). METHOD The authors examined the predictive effects of participating in the CPD programs of the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada one year before in-practice peer assessments conducted by the medical regulatory authority in Ontario, Canada, in 2008-2009. Two multivariate logistic regression models were used to determine whether physicians who reported participating in any CPD and group-based, assessment-based, and/or self-directed CPD activities were more or less likely to receive satisfactory assessments than physicians who had not. All models were adjusted for the effects of sex, age, specialty certification, practice location, number of patient visits per week, hours worked per week, and international medical graduate status. RESULTS A total of 617 physicians were included in the study. Analysis revealed that physicians who reported participating in any CPD activities were significantly more likely (odds ratio [OR] = 2.5; P = .021) to have satisfactory assessments than those who had not. In addition, physicians participating in group-based CPD activities were more likely to have satisfactory assessments than those who did not (OR = 2.4; P = .016). CONCLUSIONS There is encouraging evidence supporting a positive predictive association between participating in CPD and performance on in-practice peer assessments. The findings have potential implications for policies which require physicians to participate in programs of lifelong learning.
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Affiliation(s)
- Elizabeth F Wenghofer
- Dr. Wenghofer is associate professor, School of Rural and Northern Health, and Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada. Dr. Marlow is assistant professor, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. Dr. Campbell is director of professional affairs, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada, and associate professor, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. Dr. Carter is director, Centre for Flexible Learning, Nipissing University, North Bay, Ontario, Canada, and professor, Northern Ontario School of Medicine, Sudbury, Ontario, Canada. Ms. Kam is a PhD student, School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada. Dr. McCauley is medical advisor, Quality Management Division, College of Physicians and Surgeons of Ontario, Toronto, Ontario, Canada, and associate professor, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada. Ms. Hill is former manager, Continuing Professional Development, College of Family Physicians of Canada, Mississauga, Ontario, Canada
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Chalouhi GE, Salomon LJ, Fontanges M, Althuser M, Haddad G, Scemama O, Chabot JM, Duyme M, Fries N. Formative assessment based on an audit and feedback improves nuchal translucency ultrasound image quality. J Ultrasound Med 2013; 32:1601-1605. [PMID: 23980221 DOI: 10.7863/ultra.32.9.1601] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES The purpose of this work was to study the impact of an audit and feedback on the quality of routine first-trimester nuchal transparency ultrasound images. METHODS Eighty-eight sonographers were each sent 2 different series of 30 consecutive nuchal translucency images at a mean interval of 3 months to a dedicated, protected server for remote double-blind independent analysis based on the new Collège Français d'Echographie Foetale/Centre National de la Recherche Scientifique image-scoring method (https://www.cfef.org/evaluation/ISMCFEFCNRS.pdf). The sonographers were classified as low (score below the median) or high (score above the median) scorers for each series. Before their second evaluation, 73 of the 88 sonographers received a feedback report on their first series of images, whereas the other 15 participants received no feedback. The baseline characteristics of the participants who did and did not receive feedback were comparable. RESULTS Participants who received feedback increased their average score significantly, from a mean ± SD of 11.1 ± 1.3 to 13.4 ± 1.4 among low scorers (P < .00001) and from 15.1 ± 1.2 to 16.0 ± 1.4 among high scorers (P < .001), whereas no significant change was seen among participants who received no feedback (low scorers, 10.9 ± 1.5 to 12.1 ± 2.0; P = .11; high scorers, 14.7 ± 1.3 to 14.6 ± 1.3; P = .99). The proportion of satisfactory images increased by 48% among low scorers who received feedback. CONCLUSIONS Formative assessment based on a moderately intensive audit and feedback is feasible and effective for improving the quality of routine first-trimester nuchal transparency ultrasound images.
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Affiliation(s)
- Gihad E Chalouhi
- Department of Obstetrics and Fetal Medicine, Paris Descartes University, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants-Malades, Paris, France
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Khanal S, Ibrahim MIBM, Shankar PR, Palaian S, Mishra P. Evaluation of academic detailing programme on childhood diarrhoea management by primary healthcare providers in Banke district of Nepal. J Health Popul Nutr 2013; 31:231-242. [PMID: 23930342 PMCID: PMC3702345 DOI: 10.3329/jhpn.v31i2.16388] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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] [Indexed: 06/02/2023]
Abstract
Academic detailing is rarely practised in developing countries. A randomized control trial on healthcare service was conducted to evaluate the impact of academic detailing programme on the adherence of primary healthcare providers in Banke district, Nepal, to childhood diarrhoea treatment guidelines recommended by World Health Organization/United Nations Children's Fund (WHO/UNICEF). The participants (N=209) were systematically divided into control and intervention groups. Four different academic detailing sessions on childhood diarrhoea management were given to participants in the intervention group. At baseline, 6% of the participants in the control and 8.3% in the intervention group were adhering to the treatment guidelines which significantly (p < 0.05) increased among participants in the intervention (65.1%) than in the control group (16.0%) at the first follow-up. At the second follow-up, 69.7% of participants in the intervention group were adhering to the guidelines, which was significantly (p < 0.05) greater than those in the control group (19.0%). Data also showed significant improvement in prescribing pattern of the participants in the intervention group compared to the control group. Therefore, academic detailing can be used for promoting adherence to treatment guidelines in developing countries, like Nepal.
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Affiliation(s)
- Saval Khanal
- Department of Pharmacy, Sunsari Technical College, Dharan, Nepal; 2College of Pharmacy, Qatar University, Doha, Qatar.
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Uchida M. [Career planning for explanation of clinical test results and program of inspections: developing medical technologists for team medical care]. Rinsho Byori 2013; 61:353-359. [PMID: 23855193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Current medical care is subdivided according to medical advances, and sophistication and new techniques are necessary. In this setting, doctors and nurses have been explaining to and consulting patients about their medical examinations; however, in recent years, medical technologists have performed these duties at the start of the team's medical care. Therefore, we think it is possible for patients to receive clear and convincing explanations. Most patients cannot understand their examination data, which are written using numbers and charts, etc. Recently, the Nagano Medical Technologist Society has been developing technologists who could explain examination results to patients. This development training included hospitality and communication. The certificate of completion will be issued in March when the program starts.
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Affiliation(s)
- Misuko Uchida
- Department of Clinical Laboratory, JA Nagano Azumi General Hospital, Kitaazumi gun, Nagano-pref. 399 8695, Japan.
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Kok R, Hoving JL, Smits PBA, Ketelaar SM, van Dijk FJH, Verbeek JH. A clinically integrated post-graduate training programme in evidence-based medicine versus 'no intervention' for improving disability evaluations: a cluster randomised clinical trial. PLoS One 2013; 8:e57256. [PMID: 23469188 PMCID: PMC3585805 DOI: 10.1371/journal.pone.0057256] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 01/20/2013] [Indexed: 11/29/2022] Open
Abstract
Background Although several studies have shown that teaching EBM is effective in improving knowledge, at present, there is no convincing evidence that teaching EBM also changes professional behaviour in practice. Therefore, the primary aim of this study was to evaluate the effectiveness of a clinically integrated post-graduate training programme in EBM on evidence-based disability evaluation. Methods and Findings In a cluster randomised controlled trial, fifty-four case-based learning groups consisting of 132 physicians and 1680 patients were randomly assigned to the intervention or control groups. A clinically integrated, post-graduate, 5-day training programme in evidence-based medicine, consisting of (home) assignments, peer teaching, interactive training in searching databases, lectures and brainstorming sessions was provided to the intervention group. The control group received no training. The primary outcome was evidence-based disability evaluation, as indicated by the frequency in use of evidence of sufficient quality in disability evaluation reports. There are no general EBM behaviour outcome measures available. Therefore, we followed general guidelines for constructing performance indicators and defined an a priori cut-off for determination of sufficient quality as recommended for evaluating EB training. Physicians trained in EBM performed more evidence-based disability evaluations compared to physicians in the control group (difference in absolute proportion 9.7%, 95% CI 3.5 to 15.9). The primary outcome differences between groups remained significant after both cluster-adjusted analysis and additional sensitivity analyses accounting for subjects lost to follow-up. Conclusions A EBM programme successfully improved the use of evidence in a non-hospital based medical specialty. Our findings support the general recommendations to use multiple educational methods to change physician behaviour. In addition, it appeared important that the professional context of the intervention was very supportive in the sense that searches in databases, using and applying guidelines and other forms of evidence are considered standard practice and are encouraged by colleagues and management.
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Affiliation(s)
- Rob Kok
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands.
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Borbolla D, Gorman P, Del Fiol G, Mohan V, Hersh W, Otero C, Luna D, Gonzalez Bernaldo De Quiros F. Physicians perceptions of an educational support system integrated into an electronic health record. Stud Health Technol Inform 2013; 186:125-129. [PMID: 23542982 PMCID: PMC3745779] [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: 06/02/2023]
Abstract
The purpose of this study is to determine the perceptions by physicians of an educational system integrated into an electronic health record (EHR). Traditional approaches to continuous medical education (CME) have not shown improvement in patient health care outcomes. Hospital Italiano de Buenos Aires (HIBA) has implemented a system that embeds information pearls into the EHR, providing learning opportunities that are integrated into the patient care process. This study explores the acceptability and general perceptions of the system by physicians when they are in the consulting room. We interviewed 12 physicians after one or two weeks of using this CME system and we performed a thematic analysis of these interviews. The themes that emerged were use and ease of use of the system; value physicians gave to the system; educational impact on physicians; respect for the individual learning styles; content available in the system; and barriers that were present or absent for using the CME system. We found that the integrated CME system developed at HIBA was well accepted and perceived as useful and easy to use. Future work will involve modifications to the system interface, expansion of the content offered and further evaluation.
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Affiliation(s)
- Damian Borbolla
- Hospital Italiano de Buenos Aires, Buenos Aires City, Argentina.
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Campbell CM, Parboosingh J. The Royal College experience and plans for the maintenance of certification program. J Contin Educ Health Prof 2013; 33 Suppl 1:S36-S47. [PMID: 24347151 DOI: 10.1002/chp.21205] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The Royal College of Physicians and Surgeons of Canada, in 2001, implemented a mandatory maintenance of certification (MOC) program that is required for fellows to maintain membership and fellowship. Participation in the MOC program is one of the recognized pathways approved by provincial medical regulatory authorities in Canada by which specialists can demonstrate their commitment to continued competent performance in practice. This article traces the historical beginnings of the MOC program, highlighting the educational foundation and scientific evidence that influenced its philosophy, goals, and strategic priorities. The MOC program has evolved into a complex system of continuing professional development to facilitate and enable a "cultural shift'' in how we conceptualize and support the continuing professional development (CPD) of specialists. The MOC program is an educational strategy that supports a learning culture where specialists are able to design, implement and document their accomplishments from multiple learning activities to build evidence-informed practices. In the future, the MOC Program must evolve from assisting fellows to use effective educational resources "for credit" to enable fellows, leveraging a competency-based CPD model, to demonstrate their capacity to continuously improve practice. This will require innovative methods to capture learning and practice improvements in real time, integrate learning during the delivery of health care, expand automation of reporting strategies, and facilitate new sociocultural methods of emergent learning and practice change. Collectively, these directions will require a research agenda that will generate evidence for how transformative cultural change in continuing professional education of the profession can be realized.
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Affiliation(s)
- Craig M Campbell
- Director, Continuing Professional Development, The Royal College of Physicians and Surgeons of Canada; Associate Professor of Medicine, University of Ottawa, Faculty of Medicine.
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Hellgren MI, Sjöström M, Eckner J, Gjessing K, Jennersjö P. [Continuing education in general practice has improved. The national research school in general practice can provide a boost for primary care research]. Lakartidningen 2012; 109:1619-1620. [PMID: 23077772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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