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Nasri N, Xu W, Jamaludin KA, Mohamad Nasri N. Socio-culturally responsive medical professionalism and ethics education: A curriculum co-creation approach. Med Educ Online 2024; 29:2303209. [PMID: 38194435 PMCID: PMC10778402 DOI: 10.1080/10872981.2024.2303209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/04/2024] [Indexed: 01/11/2024]
Abstract
Medical professionalism and ethics (MPE) are critical components influencing how medical practitioners provide patients with the highest standard of care. As a result, a structured attempt has been undertaken to enhance the content and teaching delivery of the medical professionalism and ethics education (MPEE) in the undergraduate medical curriculum. Guided by Vygotsky's sociocultural learning theory, Harre and Van Langenhove's positioning theory and Taba's principles of curriculum development, a curriculum co-creation project was organized with the aim of developing a socio-culturally responsive MPEE. A total of fifteen medical students agreed to participate in the project where they co-created MPE curriculum with a medical educator over the course of three months. Upon completion of the project, a co-created, socio-culturally responsive MPE curriculum was presented. The thematic analysis revealed positive changes in the participants' attitudes, skills, and behaviors towards co-creating the MPE curriculum. They also reported feeling a sense of fulfilment after having a transformative experience as curriculum co-creators and after receiving positive feedback from the faculty, staff, and other students on the co-created MPE curriculum. The project's success demonstrates the importance of curriculum co-creation as a strategy to promote co-creation efforts among students and educators in developing a socio-culturally responsive curriculum. The project's framework and practical recommendations can be adopted by other medical educators and faculties to encourage students' participation and their role on curriculum development using the co-creation approach.
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Affiliation(s)
- Nurfarahin Nasri
- Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Wenwen Xu
- Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
- Faculty of Aviation, Chengdu College of University of Electronic Science and Technology of China, Chengdu, China
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Blaszczak J, Wiener S, Plegue M, Shumer D, Shatzer J, Hernandez A. Evaluating the effectiveness of an online curriculum on caring for transgender and nonbinary patients. Med Educ Online 2024; 29:2311481. [PMID: 38320110 PMCID: PMC10848997 DOI: 10.1080/10872981.2024.2311481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/24/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND AND OBJECTIVES It is well established that provider lack of knowledge in the field of transgender and nonbinary health is as ignificant barrier to care and that training in this area is lacking. This study examined how family medicine residents' self-confidence and medical knowledge in providing gender-affirming care changed after completing a novel, online curriculum on transgender and nonbinary care. METHODS Thirty-nine family medicine residents were invited to complete the curriculum. Change inself-confidence was determined by the difference in scores on a Likert scale on a pre- and post-survey. Change in medical knowledge was assessed by examining the difference between pre- and post-test scores on a novel multiple-choice examination. RESULTS Only 7% of current residents agreed that their current training is adequate in order to provide comprehensive primary care to transgender and nonbinary people. After completion of the curriculum, 100% of participants felt at least somewhat confident providing primary care to transgender and nonbinary people, including hormone therapy. Average medical knowledge post-test scores trended higher than the pre-test results (mean (SD) at pre = 11.2 (1.4) vs post = 14.6 (2.8)). CONCLUSIONS An online, self-directed curriculum on caring for transgender and nonbinary patients in the primary care setting, including management of gender-affirming hormone therapy, has the potential to increase confidence and knowledge in this field, decreasing barriers to care for this population.
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Affiliation(s)
- Julie Blaszczak
- Department of Family Medicine University of Michigan, Ann Arbor, MI, USA
| | - Sara Wiener
- Department of Organizational Learning University of Michigan, Ann Arbor, MI, USA
| | - Melissa Plegue
- Department of Family Medicine University of Michigan, Ann Arbor, MI, USA
| | - Dan Shumer
- Department of Pediatric Endocrinology University of Michigan, Ann Arbor, MI, USA
| | - John Shatzer
- School of Education Johns Hopkins, Baltimore, MD, USA
| | - Anita Hernandez
- Department of Family Medicine University of Michigan, Ann Arbor, MI, USA
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3
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Ho JW, Cerier EJ, Diaz CM, Hu YY, Tatebe LC, Alam HB, Johnson JK, Halverson AL. Residents Need a Dynamic Approach to Leadership Education: A Qualitative Study. J Surg Educ 2024; 81:794-803. [PMID: 38664171 DOI: 10.1016/j.jsurg.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/22/2024] [Accepted: 03/02/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE Leadership is an essential skill for surgeons, but it is not systematically taught in residency. The objective of this study was to explore the current experiences, motivators, and perspectives on leadership training of general surgery residents. DESIGN/SETTING/PARTICIPANTS Semi-structured focus groups were conducted with 20 general surgery residents at an academic training program. Six in-person sessions (one for each postgraduate year and research) were recorded, transcribed, and de-identified. Data were inductively coded by 2 independent researchers and analyzed thematically. Discrepancies were discussed and resolved through consensus. RESULTS Participants described developing their leadership skills prior to residency through formal (e.g., job and military) and informal (e.g., extracurricular) experiences. Most reported that leadership development during residency occurred informally (e.g., emulating mentors, trial-and-error). Evolving responsibilities and expectations shaped residents' leadership values: junior residents focused on student and task management and adaptation to new teams; mid-level residents emphasized emotional intelligence and delivery of resident feedback; and senior residents stressed team engagement, inspiring the team, and teaching/mentoring. Major transition periods between residency levels were identified as critical times for leadership training as they allow for self-reflection, motivating residents to participate in a leadership curriculum. Employing level appropriate and immediately applicable content during this time would encourage curriculum attendance and prepare residents for new roles. CONCLUSIONS There is a lack of formal leadership training in general surgery residency. There is an opportunity to design and implement leadership training that engages surgical residents with level-relevant content and strategies. Transition periods offer optimal timing for maximal curricula uptake.
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Affiliation(s)
- Jessie W Ho
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
| | - Emily J Cerier
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Carmen M Diaz
- Kellogg School of Management, Northwestern University, Chicago, Illinois
| | - Yue-Yung Hu
- Northwestern Quality Improvement, Research, and Education in Surgery (NQUIRES) Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Leah C Tatebe
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Hasan B Alam
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Julie K Johnson
- Northwestern Quality Improvement, Research, and Education in Surgery (NQUIRES) Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amy L Halverson
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
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Abstract
Engagement with medical education podcasts among health professions learners has been increasing steadily over the last several years. Prior '12 Tips' publications have focused on helping medical educators create and publish their own podcasts. However, there is a gap in available resources to help educators incorporate an already existing and growing library of medical education podcasts into their curriculum rather than create their own. In this paper, the authors provide medical educators '12 Tips' on how to integrate podcasts into their teaching sessions grounded in fundamental principles of curriculum development, cognitive science, and accessibility.
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Affiliation(s)
- Charlotte Chaiklin
- Assistant Professor of Medicine, Division of General Internal Medicine, University of Florida, FL, USA
| | - Joshua Onyango
- Assistant Professor of Medicine, Division of General Internal Medicine, Vanderbilt University Medical Center, TN, USA
| | - Molly Heublein
- Associate Professor of Medicine, UCSF Department of General Internal Medicine, CA, USA
| | - Katherine Gielissen
- Assistant Professor of Medicine and Pediatrics, Emory University School of Medicine, GA, USA
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5
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Cary MP, De Gagne JC, Kauschinger ED, Carter BM. Advancing Health Equity Through Artificial Intelligence: An Educational Framework for Preparing Nurses in Clinical Practice and Research. Creat Nurs 2024; 30:154-164. [PMID: 38689433 DOI: 10.1177/10784535241249193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
The integration of artificial intelligence (AI) into health care offers the potential to enhance patient care, improve diagnostic precision, and broaden access to health-care services. Nurses, positioned at the forefront of patient care, play a pivotal role in utilizing AI to foster a more efficient and equitable health-care system. However, to fulfil this role, nurses will require education that prepares them with the necessary skills and knowledge for the effective and ethical application of AI. This article proposes a framework for nurses which includes AI principles, skills, competencies, and curriculum development focused on the practical use of AI, with an emphasis on care that aims to achieve health equity. By adopting this educational framework, nurses will be prepared to make substantial contributions to reducing health disparities and fostering a health-care system that is more efficient and equitable.
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Affiliation(s)
- Michael P Cary
- Duke University School of Nursing, Durham, NC, USA
- Duke University School of Medicine, Durham, NC, USA
- Duke AI Health, Durham, NC, USA
- American Association of Colleges of Nursing, Durham, NC, USA
| | - Jennie C De Gagne
- Duke University School of Nursing, Durham, NC, USA
- Duke University School of Medicine, Durham, NC, USA
- Duke AI Health, Durham, NC, USA
- American Association of Colleges of Nursing, Durham, NC, USA
| | - Elaine D Kauschinger
- Duke University School of Nursing, Durham, NC, USA
- Duke University School of Medicine, Durham, NC, USA
- Duke AI Health, Durham, NC, USA
- American Association of Colleges of Nursing, Durham, NC, USA
| | - Brigit M Carter
- Duke University School of Nursing, Durham, NC, USA
- Duke University School of Medicine, Durham, NC, USA
- Duke AI Health, Durham, NC, USA
- American Association of Colleges of Nursing, Durham, NC, USA
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Phillips A, Srinivas A, Prentoska I, O'Dea M, Kustrup M, Hurley S, Bruno S, Nguyen V, Lai PK. Teaching biologics design using molecular modeling and simulations. Biochem Mol Biol Educ 2024; 52:299-310. [PMID: 38197506 DOI: 10.1002/bmb.21813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 11/30/2023] [Accepted: 12/30/2023] [Indexed: 01/11/2024]
Abstract
Teaching chemistry and biology students about biologics design remains challenging despite its increasing importance in pharmaceutical development. Monoclonal antibodies, commonly called mAbs, are the most popular biologics. They have been developed into drugs to treat various diseases in the past decades. Multiple challenges exist for designing proper formulations to stabilize mAbs, such as preventing aggregation and mitigating viscosity. Molecular modeling and simulations can improve pharmaceutical products by examining the interactions between mAbs and other compounds, such as excipients. To introduce students to biopharmaceuticals, eight students at the Stevens Institute of Technology participated in a semester-long course to learn the challenges of pharmaceutical development and different computational skills to study biologics design. The students started with a limited background in this field. Throughout one semester, they were introduced to various literature and software tools for modeling antibodies and studying their interactions with excipients. This paper aims to develop a course structure to be replicated at other universities and institutions to teach biopharmaceutical development to students.
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Affiliation(s)
- Andrew Phillips
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Anusha Srinivas
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Ilina Prentoska
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Margaret O'Dea
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Matthew Kustrup
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Sarah Hurley
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Savannah Bruno
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Vy Nguyen
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Pin-Kuang Lai
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey, USA
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Collier-Sewell F, Monteux S. What is the purpose of nurse education (and what should it be)? Nurs Inq 2024:e12640. [PMID: 38685718 DOI: 10.1111/nin.12640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/18/2024] [Accepted: 03/24/2024] [Indexed: 05/02/2024]
Abstract
Can we take the purpose of nurse education for granted, and, more importantly, should we? That is the issue at stake in this paper. The question of purpose is conspicuously absent in the nursing literature; our aim here is to urge that it not be overlooked by demonstrating its importance to the future of nursing. We approach the question of nurse education's purpose in concrete and speculative terms through two distinct yet interrelated questions: what is the purpose of nurse education? and what should it be? Amidst the complexity and uncertainty of our time, we cast doubt on the adequacy of manualised and regulated approaches-ubiquitous in nurse education-to prepare nurses who can meet the challenges of contemporary practice. We also assert that transgressive approaches to education, as the antithesis of manualisation, reach the same impasse by (over)predetermining what the educational 'output' will be. To move beyond this impasse, we draw on the theory of Gert Biesta and Ron Barnett to contrast cultivation and existential-type education. In so doing, we do not seek to provide 'answers' to nurse education's purpose but, rather, raise the profile of what we believe is a right and proper question for the discipline to grapple with.
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Affiliation(s)
- Freya Collier-Sewell
- Centre for Culture, Media and Society, Sheffield Hallam University, Sheffield, UK
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8
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Parsons K, Strout K, Winn C, Therrien-Genest M, Yerxa K, McNamara J. Development of Master Chef: A Curriculum to Promote Nutrition and Mindful Eating among College Students. Int J Environ Res Public Health 2024; 21:487. [PMID: 38673398 PMCID: PMC11050589 DOI: 10.3390/ijerph21040487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/12/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024]
Abstract
Research suggests that success in improving undergraduates' diet quality can benefit from a multifaceted approach, incorporating nutrition education, mindful eating, and culinary skill-building. The current study aimed (1) to review the development of Master Chef, a mindful eating curriculum, and (2) assess its feasibility through an online expert review. Expert reviewers were recruited through an online mindful eating course. Survey questions included both Likert-style and open-ended questions. Quantitative survey data were analyzed using descriptive statistics. Two independent researchers coded qualitative data, which then underwent inductive thematic analysis. Reviewers (N = 7) were experts in the fields of nutrition, psychology, and mindful eating. Master Chef's overall feasibility was rated highly. The overall curriculum was perceived positively. However, it was recommended that the program include more mindfulness. Master Chef was identified as a feasible program for improving the health behaviors of college students. Pilot dissemination and analysis will be necessary to assess the program's effectiveness in supporting disease prevention among undergraduates.
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Affiliation(s)
- Kayla Parsons
- School of Food and Agriculture, University of Maine, Orono, ME 04469, USA; (K.P.); (C.W.); (M.T.-G.); (K.Y.)
| | - Kelley Strout
- School of Nursing, University of Maine, Orono, ME 04469, USA;
| | - Caitlyn Winn
- School of Food and Agriculture, University of Maine, Orono, ME 04469, USA; (K.P.); (C.W.); (M.T.-G.); (K.Y.)
| | - Mona Therrien-Genest
- School of Food and Agriculture, University of Maine, Orono, ME 04469, USA; (K.P.); (C.W.); (M.T.-G.); (K.Y.)
| | - Kate Yerxa
- School of Food and Agriculture, University of Maine, Orono, ME 04469, USA; (K.P.); (C.W.); (M.T.-G.); (K.Y.)
| | - Jade McNamara
- School of Food and Agriculture, University of Maine, Orono, ME 04469, USA; (K.P.); (C.W.); (M.T.-G.); (K.Y.)
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Yu E, Coffey C. Prehospital mass casualty incident triage simulation builds knowledge and confidence in medical trainees. AEM Educ Train 2024; 8:e10962. [PMID: 38525360 PMCID: PMC10955617 DOI: 10.1002/aet2.10962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/09/2024] [Accepted: 01/30/2024] [Indexed: 03/26/2024]
Abstract
Background Mass casualty incident (MCI) triage simulation is an increasingly useful tool for teaching triage systems to medical students, trainees, and hospital staff. MCI simulation in the prehospital setting has not yet been studied in this population. Objectives/Aims We aimed to assess the effectiveness of a prehospital MCI simulation in medical students, residents, and fellows. Our primary outcome was knowledge of the components of the triage algorithms used in MCI response. Our secondary outcome was each participant's confidence level if required to assist with or lead a MCI response. Methods This was an observational study with pre-post surveys. We recruited 30 medical students, 14 emergency medicine (EM) residents, and four pediatric EM fellows to fill out a survey before and after a 3-h simulation session practicing the START and JumpSTART algorithms on two prehospital MCI scenarios. Results Overall, all groups demonstrated significant improvement in knowledge of triage colors, information needed to assign a triage color, pediatric airway management during a MCI, and indications for breaths-first CPR. They also demonstrated significant increase in confidence both in assisting with and in leading a MCI response. Conclusions Simulated practice triaging patients in prehospital MCI scenarios improves knowledge of triage algorithms and increases confidence in assisting with or leading a MCI response in medical trainees.
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Affiliation(s)
- Elaine Yu
- Department of Emergency MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Christanne Coffey
- Department of Emergency MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
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Carson RA, Sobolewski B, Bowen F. Evaluating a Health Equity Podcast for Provider Practice Change: A Cross-sectional Study. J Pediatr Health Care 2024; 38:194-202. [PMID: 38429031 DOI: 10.1016/j.pedhc.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/24/2023] [Accepted: 11/18/2023] [Indexed: 03/03/2024]
Abstract
INTRODUCTION Podcasts are effective tools for disseminating health education. This study aimed to disseminate a health equity curriculum on best practices. METHOD A cross-sectional descriptive study was conducted as part of the Health Equity in Pediatrics podcast series between May and June 2023. Listeners were surveyed following each episode, and both quantitative and qualitative responses of voluntary respondents were analyzed. RESULTS Episodes were downloaded 4,095 times. Survey respondents (n = 66) reported increased knowledge and intended practice change inspired by the podcast. Qualitative responses included themes surrounding knowledge, appreciation, and practice change. DISCUSSION Podcasts are easily disseminated to wide audiences and can improve health equity knowledge while inspiring practice change. This style can help listeners identify practices that suggest implicit bias and implement more equitable best practices. Future research should examine implicit bias training and standardization of health equity education using podcasts.
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11
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Ohta R, Maejima S, Sano C. Applying Advanced Practice Nurses in Rural Japan: A Mixed-Methods Perspective. Cureus 2024; 16:e57015. [PMID: 38681408 PMCID: PMC11046255 DOI: 10.7759/cureus.57015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Rural hospitals, particularly those in geographically isolated regions like Shimane Prefecture, Japan, face significant healthcare delivery challenges. These include limited resources, an aging population, and a scarcity of healthcare professionals. Advanced practice nurses (APNs) have emerged as pivotal in addressing these gaps, offering specialized patient assessment, diagnosis, and management skills. This study aimed to evaluate the demand for APNs in rural community hospitals, focusing on the specific educational needs and clinical competencies required to improve healthcare outcomes in these settings. Method Employing a mixed-methods approach, this research combined qualitative insights from stakeholder interviews with quantitative data analysis of electronic health records (EHRs) at Unnan City Hospital. This sequential exploratory design aimed to capture comprehensive educational needs and outcomes, integrating the depth of qualitative data with the breadth of quantitative evidence to tailor a curriculum for APNs in rural healthcare contexts. Results The study revealed a critical demand for APNs skilled in managing common medical issues in rural settings, such as infections, circulatory failures, and respiratory problems. Stakeholder interviews highlighted the necessity for a curriculum that enhances clinical competencies and emphasizes soft skills like communication and leadership. An analysis of EHRs identified 21 specific diseases across six categories, underlining the importance of targeted education on these prevalent conditions. Conclusion The findings underscore the urgent need for specialized education programs for APNs in rural hospitals to address these communities' unique healthcare challenges. Developing a curriculum that focuses on clinical and soft skills essential for rural healthcare delivery can significantly enhance the quality of care. This study advocates for implementing such tailored educational programs to empower APNs, thereby contributing to healthcare equity and improving patient outcomes in rural settings.
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Affiliation(s)
| | | | - Chiaki Sano
- Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN
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Tolchin DW, Ankam NS, Rydberg L. Twelve tips for including disability education in undergraduate medical education. Med Teach 2024:1-8. [PMID: 38386799 DOI: 10.1080/0142159x.2024.2317913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
Disability is a large and growing minority population worldwide. People with disabilities continue to experience health and healthcare disparities. Despite multiple calls to action to provide disability education within undergraduate medical education as a strategy to mitigate ongoing inequities, robust disability education is not routinely provided across medical schools. This article provides twelve tips that any medical school faculty can utilize to integrate meaningful disability education within existing core medical education.
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Affiliation(s)
- Dorothy W Tolchin
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Spauling Rehabilitation Hospital, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, MassGeneral Brigham, Boston, Massachusetts, USA
| | - Nethra S Ankam
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Leslie Rydberg
- Shirley Ryan AbilityLab, Chicago, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Tingelhoff PD, Hufert F, Kiessling C, Otto B. Infection prevention in medical education - results of a descriptive cross-sectional study in Germany. GMS J Med Educ 2024; 41:Doc4. [PMID: 38504860 PMCID: PMC10946213 DOI: 10.3205/zma001659] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 09/02/2023] [Accepted: 11/22/2023] [Indexed: 03/21/2024]
Abstract
Objective The aim of the study was to assess the current curricular status of content on infection prevention in hospitals during medical education prior to the development of a serious game on infection prevention in hospitals. In addition, the data collected was to be contrasted with the training for a specialist nurse in hygiene and infection prevention (FKHI). Methodology In an online survey, persons in charge of medical degree programs and continuing education centers for FKHI, SkillsLabs and professional associations in Germany were asked to answer 28 questions on framework conditions, teaching, examinations, and gamification. Results Data was collected for 22 medical degree programs and 5 FKHI continuing education centers. Due to the low response rate, the data for the FKHI was only analyzed in summary form. On average, 13.5 teaching units (median) are available in medical studies. Six degree programs have a longitudinal curriculum. In 7 of the 22 degree programs, teaching is based on the National Competency-Based Learning Objectives Catalogue (NKLM). Almost all locations teach this content in lectures (n=18) and/or in internships (n=13). Teaching and examinations are most common in the third year of study (n=12). In addition to practical OSCE examinations (n=5), written (n=12) and computer-based (n=8) examinations are used in particular. Gamification is known as a didactic approach to some extent but is not used for teaching infection prevention. Conclusions Infection prevention in hospitals is given relatively low priority in medical education. Teaching and examinations are based on traditional knowledge-oriented formats, although practical teaching and practical examinations are established at some locations. In contrast to the FKHI, learning objectives currently appear to be less standardized. Further interprofessional development of teaching would be desirable in the future.
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Affiliation(s)
- Paul-Dierk Tingelhoff
- Witten/Herdecke University, Faculty of Medicine, Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
| | - Frank Hufert
- Brandenburg Medical School Theodor Fontane Senftenberg, Institute of Microbiology and Virology, Senftenberg, Germany
| | - Claudia Kiessling
- Witten/Herdecke University, Faculty of Medicine, Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
| | - Bertram Otto
- Witten/Herdecke University, Faculty of Medicine, Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
- Klinikum Ernst von Bergmann, Clinic for Gastroenterology, Hepatology, Infectiology and Rheumatology, Klinikum Potsdam, Germany
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14
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Spearin TA, Ayers CL. Instructional strategies and challenges for implementing teledentistry in dental hygiene curricula: A qualitative study. J Dent Educ 2024. [PMID: 38356361 DOI: 10.1002/jdd.13495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/11/2023] [Accepted: 01/13/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE/OBJECTIVES Research has documented the implementation of telecommunications and virtual technology use in health care disciplines to expand accessibility. Despite the current trend of digital innovations in healthcare systems, telehealth technology is not readily adopted in the dental hygiene profession yet. Currently, no standardized educational framework exists in dental hygiene curricula to prepare professionals with the technical skill set and professional knowledge necessary for telehealth applications. The aims and objectives of this research were (1) to investigate existing dental hygiene educators' pedagogical frameworks for incorporating telehealth technology into dental hygiene curricula, (2) explore these educators' instructional strategies for teaching telehealth technology, and (3) examine the theoretical implications and practical outcomes of teaching telehealth technology for professional development and transferrable work-force ready skills. METHODS A nine-item, open-ended, semi-structured interview guide was prepared and approved by the Institutional Review Board (IRB) in January 2023 to qualitatively investigate accredited entry-level dental hygiene programs in the United States. Thematic interpretational analysis was conducted using NVivo software. RESULTS A total of 54 of the 328 dental hygiene programs volunteered for participation. Thirteen full-time and part-time dental hygiene educators met inclusion criteria. The core salient themes identified included (a) curriculum mapping, (b) technology integration, (c) professional collaboration, and (d) supplemental skill set. CONCLUSIONS These findings provide guidance to dental hygiene programs for bridging the teledentistry knowledge gap in curriculum development. Incorporating telehealth applications into dental hygiene curricula prepares future dental hygienists with the specialized training needed to function as a member of contemporary health care teams addressing access to care.
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Affiliation(s)
| | - Candace L Ayers
- College of Graduate Health Sciences, A.T. Still University, Kirksville, Missouri, USA
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15
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Guilding C, White PJ, Cunningham M, Kelly-Laubscher R, Koenig J, Babey AM, Tucker S, Kelly JP, Gorman L, Aronsson P, Hawes M, Ngo SNT, Mifsud J, Werners AH, Hinton T, Khan F, Aljofan M, Angelo T. Defining and unpacking the core concepts of pharmacology: A global initiative. Br J Pharmacol 2024; 181:375-392. [PMID: 37605852 DOI: 10.1111/bph.16222] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 04/04/2023] [Revised: 07/11/2023] [Accepted: 08/08/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND AND PURPOSE Development of core concepts in disciplines such as biochemistry, microbiology and physiology have transformed teaching. They provide the foundation for the development of teaching resources for global educators, as well as valid and reliable approaches to assessment. An international research consensus recently identified 25 core concepts of pharmacology. The current study aimed to define and unpack these concepts. EXPERIMENTAL APPROACH A two-phase, iterative approach, involving 60 international pharmacology education experts, was used. The first phase involved drafting definitions for core concepts and identifying key sub-concepts via a series of online meetings and asynchronous work. These were refined in the second phase, through a 2-day hybrid workshop followed by a further series of online meetings and asynchronous work. KEY RESULTS The project produced consensus definitions for a final list of 24 core concepts and 103 sub-concepts of pharmacology. The iterative, discursive methodology resulted in modification of concepts from the original study, including change of 'drug-receptor interaction' to 'drug-target interaction' and the change of the core concept 'agonists and antagonists' to sub-concepts of drug-target interaction. CONCLUSIONS AND IMPLICATIONS Definitions and sub-concepts of 24 core concepts provide an evidence-based foundation for pharmacology curricula development and evaluation. The next steps for this project include the development of a concept inventory to assess acquisition of concepts, as well as the development of case studies and educational resources to support teaching by the global pharmacology community, and student learning of the most critical and fundamental concepts of the discipline.
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Affiliation(s)
- Clare Guilding
- School of Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Paul J White
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Margaret Cunningham
- Strathclyde Institute for Pharmacy and Biomedical Sciences (SIPBS), University of Strathclyde, Glasgow, UK
| | - Roisin Kelly-Laubscher
- Department of Pharmacology and Therapeutics, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Jennifer Koenig
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Anna-Marie Babey
- Faculty of Medicine and Health, University of New England, Armidale, New South Wales, Australia
| | - Steve Tucker
- School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
| | - John P Kelly
- Department of Pharmacology and Therapeutics, School of Medicine, University of Galway, Galway, Ireland
| | - Laurel Gorman
- Department of Medical Education, University of Central Florida College of Medicine, Orlando, Florida, USA
- Department of Biomedical Education, Temple University, Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Patrik Aronsson
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Martin Hawes
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, UK
| | - Suong N T Ngo
- School of Animal and Veterinary Science, Faculty of Sciences, Engineering and Technology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Janet Mifsud
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Arend H Werners
- School of Veterinary Medicine, St. George's University, True Blue, Grenada
| | - Tina Hinton
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Fouzia Khan
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Mohamad Aljofan
- Department of Biomedical Science, School of Medicine Nazarbayev University, Astana, Kazakhstan
| | - Tom Angelo
- University of North Carolina, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
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16
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Chennupati A, Qalib J, Jama AM, Ali YA, Abib AM, Ibrahim NA, Rees J, Read C, Bradley D, Patel L. Development of Somaliland national harmonised medical curriculum. Med Teach 2024:1-4. [PMID: 38270187 DOI: 10.1080/0142159x.2023.2289841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 11/28/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND AND OBJECTIVES The rational for the Somaliland national harmonised curriculum (NHC) was driven by shared concern about the quality of medical education. PROCESS The Ministry of Education and Science and the Ministry of Health Development produced a Medical Education Policy 2018. Policy objectives included the development of the NHC and accreditation for medical schools that met the standards of the World Federation for Medical Education (WFME). Two bodies were asked to oversee these aims: the National Health Professions' Commission (NHPC) and the National Commission of Higher Education (NCHE). Between 2018 and 2020, a collaborative approach between the Somaliland government, medical school stakeholders, King's Global Health Partnership's (KGHP) volunteers and the Tropical Health Education Trust (THET) team was used to design the 6-years NHC. The NHC structure, content and delivery were grounded by WFME standards, health needs of the local population, student focused and active learning methods, and feasibility of implementation in medical schools. OUTCOMES The NHC comprises details about the educational outcomes, curriculum model and framework, educational principles, instructional and learning methods, core as well as optional content, and assessment strategy. CONCLUSIONS The approach used to develop the NHC ensured it is bespoken for Somaliland. Ongoing evaluation of patient and population needs, each medical school's review of programme implementation and outcomes will inform continuous revision and renewal.
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Affiliation(s)
| | - Jinaw Qalib
- College of Medicine and Health Sciences, University of Hargeisa, Somaliland
| | | | | | | | | | - John Rees
- Medical Education, King's College London School of Medicine, London, United Kingdom of Great Britain and Northern Ireland
| | - Cathy Read
- King's Somaliland Partnership Lead, King's College, London, United Kingdom of Great Britain and Northern Ireland
| | - Don Bradley
- Staff Development, Manchester Medical School, The University of Manchester, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Leena Patel
- Department of Medical Education, Division of Medical Education, The University of Manchester, Manchester, United Kingdom of Great Britain and Northern Ireland
- Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, UK
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17
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Norris-Parish SL, Leggette HR, Pesl Murphrey T, Parrella JA, Richburg A, Herring AD. Beefing up communication skills of upper-level animal science students. Transl Anim Sci 2024; 8:txae007. [PMID: 38313224 PMCID: PMC10836500 DOI: 10.1093/tas/txae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 01/11/2024] [Indexed: 02/06/2024] Open
Abstract
Animal scientists face an increasing need to communicate with the lay public because of the public's interest in the origin and production of animal-sourced foods. Consumers' increased interest infers a critical need for effective communication skills among animal science graduates. Effective communication skills are mandatory if students are to explain scientific information and mitigate misinformation about livestock production. The purpose of our study was to investigate the communication styles and communication effectiveness of upper-level animal science students enrolled in a beef cattle production and management course at Texas A&M University across five semesters (N = 241; spring 2018 = 61, summer 2018 = 15, Fall 2018 = 54, spring 2019 = 55, and fall 2019 = 56). Male animal science students (n = 25; 32.9%) preferred assertive and direct communication (a driver communication style) and female students (n = 32; 19.4%) preferred collaborative and accommodating communication (an amiable communication style). Students were moderately experienced with beef cattle production (M = 3.09, SD = 1.07) before enrolling in the course; however, former beef cattle experiences did not influence their preferred communication style [F(10, 230) = 0.36, P = 0.96]. Researchers also observed students' communication skills during an end-of-semester beef cattle production and management project presentation and identified strengths and weaknesses. Students demonstrated strong, in-depth animal industry knowledge, an ability to connect beef production techniques to management success, and critical thinking skills when answering questions. Oral communication skills warranting improvement included integrating visual aids and/or visual slides to support findings, using improved stage presence and confidence, and sharing responsibilities when presenting as a team. Finally, completion of a supplemental communication training module, intended to develop oral communication skills, significantly improved [F(1, 55) = 4.16, P = 0.046] students' beef cattle production and management project presentation scores. As students become aware of their communication preferences and tendencies, they become equipped to adjust their communication practices and techniques when needed. Through this study, we gained insight into students' communication tendencies and skills, which can be used to provide curricular recommendations and enhance students' workforce readiness.
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Affiliation(s)
- Shannon L Norris-Parish
- Department of Agricultural and Extension Education, New Mexico State University, Las Cruces, NM 88003, USA
| | - Holli R Leggette
- Department of Agricultural Leadership, Education and Communications, Texas A&M University, College Station, TX 77843, USA
| | - Theresa Pesl Murphrey
- Department of Agricultural Leadership, Education and Communications, Texas A&M University, College Station, TX 77843, USA
| | - Jean A Parrella
- Department of Agricultural, Leadership, and Community Education, Virginia Tech, Blacksburg, VA 24060, USA
| | - Audra Richburg
- Department of Agricultural Leadership, Education and Communications, Texas A&M University, College Station, TX 77843, USA
| | - Andy D Herring
- Department of Agricultural Leadership, Education and Communications, Texas A&M University, College Station, TX 77843, USA
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18
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Lesselroth B, Monkman H, Palmer R, Kuziemsky C, Liew A, Foulks K, Kelly D, Wolfinbarger A, Wen F, Kollaja L, Ijams S, Homco J. Assessing Telemedicine Competencies: Developing and Validating Learner Measures for Simulation-Based Telemedicine Training. AMIA Annu Symp Proc 2024; 2023:474-483. [PMID: 38222442 PMCID: PMC10785836] [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] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
In 2021, the Association of American Medical Colleges published Telehealth Competencies Across the Learning Continuum, a roadmap for designing telemedicine curricula and evaluating learners. While this document advances educators' shared understanding of telemedicine's core content and performance expectations, it does not include turn-key-ready evaluation instruments. At the University of Oklahoma School of Community Medicine, we developed a year-long telemedicine curriculum for third-year medical and second-year physician assistant students. We used the AAMC framework to create program objectives and instructional simulations. We designed and piloted an assessment rubric for eight AAMC competencies to accompany the simulations. In this monograph, we describe the rubric development, scores for students participating in simulations, and results comparing inter-rater reliability between faculty and standardized patient evaluators. Our preliminary work suggests that our rubric provides a practical method for evaluating learners by faculty during telemedicine simulations. We also identified opportunities for additional reliability and validity testing.
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Affiliation(s)
- Blake Lesselroth
- University of Oklahoma-Tulsa, School of Community Medicine, Tulsa, Oklahoma, USA
| | - Helen Monkman
- University of Oklahoma-Tulsa, School of Community Medicine, Tulsa, Oklahoma, USA
| | | | - Craig Kuziemsky
- MacEwan University, Office of Research Services, Edmonton, Alberta, Canada
| | - Andrew Liew
- University of Oklahoma-Tulsa, School of Community Medicine, Tulsa, Oklahoma, USA
| | - Kristin Foulks
- University of Oklahoma-Tulsa, School of Community Medicine, Tulsa, Oklahoma, USA
| | - Deirdra Kelly
- University of Oklahoma-Tulsa, School of Community Medicine, Tulsa, Oklahoma, USA
| | - Ainsly Wolfinbarger
- University of Oklahoma-Tulsa, School of Community Medicine, Tulsa, Oklahoma, USA
| | - Frances Wen
- University of Oklahoma-Tulsa, School of Community Medicine, Tulsa, Oklahoma, USA
| | - Liz Kollaja
- University of Oklahoma-Tulsa, School of Community Medicine, Tulsa, Oklahoma, USA
| | - Shannon Ijams
- University of Oklahoma-Tulsa, School of Community Medicine, Tulsa, Oklahoma, USA
| | - Juell Homco
- University of Oklahoma-Tulsa, School of Community Medicine, Tulsa, Oklahoma, USA
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Heidemann LA, Rustici M, Buckvar-Keltz L, Anderson A, Plant J, Morgan HK, Goforth J, Atkins KM. Transition to Residency Courses: Recommendations for Creation and Implementation. J Med Educ Curric Dev 2024; 11:23821205231225009. [PMID: 38304278 PMCID: PMC10832425 DOI: 10.1177/23821205231225009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/19/2023] [Indexed: 02/03/2024]
Abstract
Transition to Residency (TTR) courses help ease the critical transition from medical school to residency, yet there is little guidance for developing and running these courses. In this perspective, the authors use their expertise as well as a review of the literature to provide guidance and review possible solutions to challenges unique to these courses. TTR courses should be specialty-specific, allow for flexibility, and utilize active learning techniques. A needs assessment can help guide course content, which should focus on what is necessary to be ready for day one of residency. The use of residents in course planning and delivery can help create a sense of community and ensure that content is practical. While course assessments are largely formative, instructors should anticipate the need for remediation, especially for skills likely to be performed with limited supervision during residency. Additionally, TTR courses should incorporate learner self-assessment and goal setting; this may be valuable information to share with learners' future residency programs. Lastly, TTR courses should undergo continuous quality improvement based on course evaluations and surveys. These recommendations are essential for effective TTR course implementation and improvement.
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Affiliation(s)
| | | | | | - Andrea Anderson
- George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | | | | | - Jon Goforth
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Katharyn M. Atkins
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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20
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Khalili J, Jeong J, Tibbe TD, Sim MS, Yoo SM. A Novel Curriculum for Internal Medicine Residents to Care for High-Need, High-Cost Patients. J Med Educ Curric Dev 2024; 11:23821205241246889. [PMID: 38617120 PMCID: PMC11015748 DOI: 10.1177/23821205241246889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/26/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVES High-need, high-cost (HNHC) patients represent a small proportion of patients in the US, but result in disproportionately higher healthcare utilization. Teaching Internal Medicine (IM) resident trainees to provide high value care for HNHC patients is critical. We sought to improve resident attitudes and increase clinical skills associated with treating HNHC patients by creating a curriculum that leveraged the UCLA Extensivist Program, a patient-centered medical home for HNHC patients. METHODS We developed a curriculum for PGY-2 and PGY-3 IM residents centered on caring for HNHC patients over the course of 6, 4h sessions during 1 academic year. Participants completed pre- and post-intervention surveys assessing self-rated attitudes and skills associated with caring for an HNHC patient population. RESULTS Twenty-one IM residents completed the curriculum and 41 were in the control group. There were no statistically significant differences in assessed attitudes and skills, but there were trends of improvement, including a decrease in participants who agreed or strongly agreed they felt overwhelmed when seeing patients for posthospital discharge follow up (45.0% pre- to 41.7% post-intervention) and an increase in participants who agreed or strongly agreed they have the skills to successfully transition HNHC patients between inpatient and ambulatory settings (20.0% pre- to 33.3% post-intervention). Participants reported better understanding of resources available to HNHC patients, effective coordination of transitions of care, and comprehensive assessment of social determinants of health. CONCLUSION A curriculum to improve resident attitudes and skills associated with caring for HNHC patients was successfully implemented in an IM program at a large academic medical center. The curriculum may be adapted for other training programs; long-term training woven throughout training may be important to significantly improve resident education on how to care for HNHC patients.
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Affiliation(s)
- Joshua Khalili
- Division of General Internal Medicine, Department of Medicine, UCLA, Los Angeles, CA, USA
| | - Jiyeon Jeong
- Division of General Internal Medicine, Department of Medicine, UCLA, Los Angeles, CA, USA
| | - Tristan D Tibbe
- Statistics Core, Department of Medicine, UCLA, Los Angeles, CA, USA
| | - Myung-Shin Sim
- Statistics Core, Department of Medicine, UCLA, Los Angeles, CA, USA
| | - Sun M Yoo
- Division of General Internal Medicine, Department of Medicine, UCLA, Los Angeles, CA, USA
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21
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Khoury JA, Assani D, Vandette MP, Denis-LeBlanc M, Burnier I, Fotsing S. Medical Students' Perception of Telesimulation Training: A Qualitative Analysis. J Med Educ Curric Dev 2024; 11:23821205241247371. [PMID: 38633450 PMCID: PMC11022672 DOI: 10.1177/23821205241247371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES Over the past 2 decades, simulation-based learning has become an essential part of medical training. Simulated clinics have proven to be effective for training medical students. Even so, this learning method presents organizational and financial challenges that limit its dissemination to all medical students, especially since the COVID-19 pandemic. Simulated teleconsultation retains the advantages of interactive simulated clinics while offering concrete solutions to the challenges faced. The project aims to explore students' perspectives on simulated teleconsultation training compared to simulated clinics in person. METHODS Ten pre-clerkship students in the Faculty of Medicine at the University of Ottawa participated in interviews following in-person and teleconsultation simulated clinic sessions. The interview guide was developed based on previous work. The questions asked concerned experience with teleconsultation, interaction with the tutor and patient, practical or logistical obstacles, educational value and feasibility. The authors evaluated the results using a thematic analysis. RESULTS The interview analysis showed that the tutor feedback received during the simulated teleconsultation was comparable to that received after the in-person simulated clinic. Although most of the students enjoy teleconsultation, they raised the challenge of carrying out physical examinations and creating a personal connection with the tutor/patient. CONCLUSION Given the circumstances of the pandemic and students' comfort with technology, the new generation of medical students seems prepared to embrace teleconsultation. The themes identified in the analysis will enable the necessary adjustments to be made in order to optimize their teleconsultation training, an inextricable step in promoting the active offer of healthcare services.
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Affiliation(s)
- Jo-Ann Khoury
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Dourra Assani
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Manon Denis-LeBlanc
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Institut du Savoir Montfort, Ottawa, Canada
| | - Isabelle Burnier
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Institut du Savoir Montfort, Ottawa, Canada
| | - Salomon Fotsing
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Institut du Savoir Montfort, Ottawa, Canada
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22
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Knapke J, Marcum M, Mendell A, Ryan P. Development of an undergraduate certificate in clinical and translational science: improving competence of the clinical research workforce. Front Pharmacol 2023; 14:1294534. [PMID: 38125884 PMCID: PMC10731045 DOI: 10.3389/fphar.2023.1294534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction: Academic research centers often struggle to recruit and retain a well-trained and diverse clinical and translational science (CTS) workforce. In particular, the clinical research professional (CRP) career pathway is not well known to undergraduate students and other individuals outside of academic medicine despite being a potential career route. To address these workforce challenges, the CRP Task Force at the University of Cincinnati (UC) aims to train a competent and diverse CRP workforce through targeted educational programming in the UC undergraduate population. Methods: Using a six-step curriculum development process that included: 1) performing a needs assessment, 2) determining content, 3) writing goals and objectives, 4) selecting the educational strategies, 5) implementing the curriculum, and 6) evaluating the curriculum, we designed an undergraduate certificate program in CTS. Results: The needs assessment included both internal and external data gathering to inform curriculum development and program decisions. Content was determined using the Core Competency Framework for the Clinical Research Professional Version 3.1., and program learning outcomes were written with both the competency framework and local workforce needs in mind. Educational strategies were selected based on optimization of available resources and local expertise with an emphasis on interactive didactics complemented by experiential learning. Implementation is underway and evaluation will follow once students begin enrolling. Discussion: By educating an undergraduate student population about CTS methods and career opportunities, we anticipate increased numbers of well-qualified, diverse applicants who pursue CRP careers locally and regionally.
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Affiliation(s)
- Jacqueline Knapke
- Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH, United States
- Center for Clinical and Translational Science and Training, University of Cincinnati, Cincinnati, OH, United States
| | - Michelle Marcum
- Cancer Center, University of Cincinnati, Cincinnati, OH, United States
| | - Angela Mendell
- Center for Clinical and Translational Science and Training, University of Cincinnati, Cincinnati, OH, United States
| | - Patrick Ryan
- Center for Clinical and Translational Science and Training, University of Cincinnati, Cincinnati, OH, United States
- Department of Pediatrics, Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center/University of Cincinnati, Cincinnati, OH, United States
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23
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Bunin J, Scott JM, Landoll R, Servey JT, Konopasky A. Making allyship visible: evaluation of a faculty development DEI curriculum. Med Educ Online 2023; 28:2241182. [PMID: 37519051 PMCID: PMC10392238 DOI: 10.1080/10872981.2023.2241182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Undergraduate medical learners from historically marginalized groups face significant barriers, which was made concrete at our institution when a student presented her research indicating that Black students felt unsure about which faculty members to approach. To better support our students, we used Kern's model for curriculum development and a critical pedagogy approach to create a Faculty Allyship Curriculum (FAC). A total of 790 individuals attended 90 workshops across 16 months and 20 individuals have completed the FAC. A majority of participants reported they felt at least moderately confident in their ability to teach learners who are underrepresented in medicine, mentor learners who are different than they are, and teach allyship topics. An informal content analysis of open-ended responses indicated changes in awareness, attitude, insight, and use of language and being more likely to display advocacy. For others considering creating a similar program, partnering with an existing program allows for rapid implementation and reach to a wide audience. We also recommend: beginning with a coalition of willing learners to quickly build community and culture change; ensuring that the curriculum supports ongoing personal commitment and change for the learners; and supporting facilitators in modeling imperfection and upstanding, 'calling in' rather than 'calling out' learners.
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Affiliation(s)
- Jessica Bunin
- Dean's Office, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jonathan M Scott
- Dean's Office, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Ryan Landoll
- Dean's Office, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jessica T Servey
- Dean's Office, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Abigail Konopasky
- Department of Medical Education, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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Lynn TM, D’urzo KA, Vaughan-Ogunlusi O, Wiesendanger K, Colbert-Kaip S, Capcara A, Chen S, Sreenan S, Brennan MP. The impact of a student-led anti-racism programme on medical students' perceptions and awareness of racial bias in medicine and confidence to advocate against racism. Med Educ Online 2023; 28:2176802. [PMID: 36787247 PMCID: PMC9930825 DOI: 10.1080/10872981.2023.2176802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/30/2022] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Systemic racism impacts personal and community health; however, education regarding its role in perpetuating healthcare inequity remains limited in medical curricula. This study implemented and evaluated the impact of a student-led anti-racism programme on medical students' perceptions of racial bias in medicine, awareness of, and confidence to advocate against racism in medicine. METHOD A total of 543 early stage medical students were invited to participate in the programme. Participants were assigned readings and videos exploring racial injustice in medicine and attended a virtual small-group discussion facilitated by faculty and students. Online surveys were used to collect pre- and post-programme data using Likert scales for response items. Open-ended questions were independently reviewed by three authors using reflexive thematic analysis. RESULTS Sixty-three early-stage medical students enrolled in the programme, of which 42 completed the pre-programme survey. There was a 76% (n = 32) response rate for the post-programme survey. The majority of students (60%, n = 25) had no previous education about racism in medicine. From pre- to post-programme, there was a significant change in students' perceived definition of race from genetic, biological, geographical, and cultural factors to socio-political factors (P < 0.0001). Significant increases in almost all factors assessing student awareness of racism and confidence to advocate against racism were observed. Student-identified barriers to discussing racism included lack of education and lived experience, fear of starting conflict and offending others. All survey respondents would recommend this programme to peers and 69% (n = 32) engaged in further topical self-directed education. CONCLUSION This simple and reproducible programme improved awareness and confidence to advocate against racism in medicine and resulted in a change in opinion regarding race-based medical practice. These findings are in line with best practice towards addressing racial bias in medicine, decolonizing medical curricula and strengthening anti-racism teaching of future physicians.
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Affiliation(s)
- Thérése M. Lynn
- Graduate Entry Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Katrina A. D’urzo
- Graduate Entry Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Kathryn Wiesendanger
- Graduate Entry Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Sarah Colbert-Kaip
- Graduate Entry Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Austin Capcara
- Graduate Entry Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Sarah Chen
- Graduate Entry Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Seamus Sreenan
- Graduate Entry Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Endocrinology, Connolly Hospital, Dublin, Ireland
| | - Marian P. Brennan
- Graduate Entry Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- School of Pharmacy and Biomedical Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Segon A, Sharma-Segon Y. The Impact of Asking Medical Students What They Want to Learn on Student Participation in Lectures. Cureus 2023; 15:e50970. [PMID: 38259417 PMCID: PMC10800295 DOI: 10.7759/cureus.50970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The General Internal Medicine Acting Internship (GIM AI) at our school is a compulsory, one-month-long experience. Morning report-style case-based discussions were conducted on a weekly basis as part of the acting internship and were poorly attended. We sought to redesign our academic half day didactic curriculum and increase voluntary student attendance by allowing students to actively participate in determining the content of the acting internship academic half day. INTERVENTION Prior to the beginning of the acting internship, students were sent an email survey listing seven inpatient topics to rank on a scale of 1-5 (1=not at all interested, 5=very interested). Based on student feedback, one additional topic was added: antibiotic use for common inpatient diagnoses. Topics that received the highest score were selected for topic-based sessions. A total of 32 teaching sessions were conducted over eight months. Twenty-four of these sessions were topic-based and the remainder were case-based. Student attendance at these sessions was voluntary. KEY RESULTS Case-based discussions had the lowest preference ranking (n=94, mean=2.9), while cross-cover-based discussions (n=94, mean=4.3, p=0.001) and antibiotic use (n=52, mean=4.3, p=0.001) received the highest scores. Thirty-four percent (41/120) of possible learners attended case-based discussions, while 78% (281/360) of possible learners attended topic-based sessions (p<0.001). Learners reported a statistically significant improvement in comfort level in recognizing and managing 73% of sub-topics (29 out of 41) covered in topic-based sessions. CONCLUSIONS A learner-centered approach to curriculum design led to robust student engagement in our acting internship academic half day. Fourth-year students prefer specific topic-based teaching sessions over case-based, morning report-style sessions.
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Affiliation(s)
- Ankur Segon
- Medicine, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Yogita Sharma-Segon
- Medicine, University of Texas Health Science Center at San Antonio, San Antonio, USA
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Luo OD, Londono CA, Prince N, Iny E, Warnock T, Cropper K, Girgis S, Walker C. The Climate Wise slides: An evaluation of planetary health lecture slides for medical education. Med Teach 2023; 45:1346-1348. [PMID: 37751514 DOI: 10.1080/0142159x.2023.2262126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
EDUCATIONAL CHALLENGE There is an urgent need for innovations in planetary health medical education. Physicians must be prepared to provide high-value, low-carbon healthcare for patients increasingly impacted by the health consequences of climate change. PROPOSED SOLUTION The Climate Wise slides, an evidence-based, open-access pedagogical tool that provides didactic planetary health medical education organized by medical subspecialty, was developed and evaluated by a virtual lecture session that presented a subset of the slides to N = 75 Canadian medical students. Each participant completed a questionnaire before and after the Climate Wise virtual lecture that included multiple choice questions to assess their planetary health knowledge and a rating of their interest in including the Climate Wise slides in medical curricula. LESSONS LEARNED Participants showed significantly improved planetary health knowledge scores (p < 0.0001) and increased interest in including the Climate Wise slides in medical curricula (p < 0.001) after the virtual Climate Wise lecture session. This study demonstrates that the Climate Wise slides are a valuable pedagogical tool to advance planetary health medical education. NEXT STEPS Future directions include evaluating faculty perspectives on the Climate Wise slides, learning outcomes of the slides implemented longitudinally in medical curricula, and developing higher-order problem-based and simulation-based planetary health medical education resources. Given the urgent need for planetary health medical education, we recommend the global sharing of teaching resources to facilitate the rapid upscaling of validated pedagogical tools internationally.
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Affiliation(s)
- Owen Dan Luo
- Department of Medicine, McGill University, Montreal, Québec, Canada
| | | | - Nicole Prince
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Ericka Iny
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Québec, Canada
| | - Tyler Warnock
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kayla Cropper
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - Sam Girgis
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - Celia Walker
- Department of Medicine, University of Alberta, Yellowknife, Northwest Territories, Canada
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Chan CA, Cabaniss P, Morford KL, Martino S, Martin A, Windish DM. Medical improvisation-based motivational interviewing for internal medicine residents: Mixed-methods evaluation of a novel course. Med Teach 2023; 45:1411-1418. [PMID: 37378496 DOI: 10.1080/0142159x.2023.2225725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
PURPOSE Develop and assess a novel medical improvisation-based motivational interviewing (MI) curriculum for residents. MATERIALS AND METHODS A 6-h medical improv-based MI curriculum occurred in 2022 for internal medicine residents. A mixed-methods evaluation included: pre- and post-role plays using the Motivational Interviewing Treatment Integrity Score (MITI) to assess MI competency, a post-course survey assessing confidence, and focus groups to understand learning through improvisation. RESULTS Participants increased their confidence in applying MI skills after the curriculum in responding to a patient's argument against change (29% pre vs. 72% post, p < 0.001), eliciting change talk (21% vs. 86%, p < 0.001), and providing information in an MI-centric way (39% vs. 86%, p < 0.001). All role-play participants achieved at least beginning proficiency on MITI technical and relational global summary scores post-course. MI-adherent behaviors increased, and MI-non-adherent behaviors decreased in post-course role plays. Themes on learning through improvisation included: (1) improvisation can enhance the learning of MI skills, (2) using non-medical scenarios in improvisation exercises has benefits, and (3) trying improvisation had positive effects on the learning environment. DISCUSSION A medical improvisation-based course is a promising, engaging way to teach residents MI skills and can improve competence and confidence with MI.
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Affiliation(s)
- Carolyn A Chan
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Kenneth L Morford
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Steve Martino
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Donna M Windish
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Engel KG, Millham LRI, Yeh IM, Malecha PW, Brizzi K, Schwartz AW, Tolchin DW. Assessing the Impact of a Hospice and Palliative Medicine Mentored Clinical Shadowing Experience for First-Year Medical and Dental Students: A Pilot Study. Am J Hosp Palliat Care 2023:10499091231214787. [PMID: 37950642 DOI: 10.1177/10499091231214787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2023] Open
Abstract
Background: All physicians encounter patients with serious illness. Medical students recognize the value of hospice and palliative medicine (HPM) and desire more knowledge and skills in this area. However, both pre-clinical and clinical HPM content are underrepresented within medical school curricula. Objectives: To conduct a pilot study examining the impact of a novel required HPM clinical experience on pre-clinical medical and dental students' learning through mixed methods evaluation of student responses. Design: Students completed a two-part electronic survey following a half-day HPM mentored clinical shadowing experience (HPM-MCSE) which included an introductory session, a faculty-mentored shadowing experience and a debriefing session. Setting/subjects: 163 first-year students at Harvard Medical School in Boston, Massachusetts, USA in 2022. Measurements: The survey collected demographic information and student responses to both closed-ended (Likert-scale) and open-ended prompts. Data were analyzed quantitatively using descriptive statistics and qualitatively using constant comparative methodology. Results: 127 medical and dental students responded (78% response rate). Qualitative analysis yielded three overarching themes: acquisition of knowledge about operational dimensions of HPM, acquisition of knowledge about psychosocial dimensions of HPM, and personal impact including an awareness of discordance between expectations and lived experience of HPM practice. Of the 109 students who completed the entire survey, 67% indicated that this experience increased their interest in palliative care and 98% reported an increase in their understanding of how palliative care enhances patient care. Conclusions: Early clinical exposure to HPM for first year students stimulates multi-dimensional learning about HPM and evokes personal reflection about serious illness care.
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Affiliation(s)
- Kirsten G Engel
- Harvard Medical School, Boston, MA, USA
- Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Lucia R I Millham
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Irene M Yeh
- Harvard Medical School, Boston, MA, USA
- Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Patrick W Malecha
- Harvard Medical School, Boston, MA, USA
- Section of Palliative Care, Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Kate Brizzi
- Harvard Medical School, Boston, MA, USA
- Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Andrea Wershof Schwartz
- Harvard Medical School, Boston, MA, USA
- New England Geriatrics Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA
- Division of Aging, Brigham and Women's Hospital, Boston, MA, USA
| | - Dorothy W Tolchin
- Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA, USA
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Wasson MK, Luther VP, Armstrong WS, Schwartz BS, Shnekendorf R, Logan A, Bennani K, Spicer JO. Skills, Not Just Knowledge: Infectious Diseases Fellows' Recommendations Regarding Antimicrobial Stewardship Training. Clin Infect Dis 2023; 77:1265-1272. [PMID: 37310036 DOI: 10.1093/cid/ciad358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/23/2023] [Accepted: 06/08/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Antimicrobial stewardship (AS) is an important topic in infectious diseases (ID) training, yet many ID fellowships lack formal training, and little is known about fellows' learning preferences. METHODS We conducted 24 in-depth interviews with ID fellows across the United States during 2018 and 2019 to explore their experiences with and preferences for AS education during fellowship. Interviews were transcribed, deidentified, and analyzed to identify themes. RESULTS Fellows had variable exposure to AS before and during fellowship, which impacted their knowledge about and attitude toward stewardship as a career; however, all fellows expressed the importance of learning general stewardship principles during fellowship. Some fellows' training included mandatory stewardship lectures and/or rotations, but most fellows felt their primary stewardship learning occurred through informal experiences in the clinical setting, such as holding the antimicrobial approval pager. Fellows expressed a preference for a standardized, structured curriculum that included in-person practical, interactive discussions with multidisciplinary faculty along with the opportunity to practice and apply their skills; however, they emphasized that time needed to be set aside for those educational activities. Although they wanted to learn the evidence and rationale for stewardship recommendations, they especially wanted training in and feedback on how to communicate stewardship recommendations to other health professionals, particularly in the setting of conflict. CONCLUSIONS ID fellows believe that standardized AS curricula should be included in their fellowship training, and they prefer structured, practical, and interactive learning experiences.
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Affiliation(s)
- Megan K Wasson
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Vera P Luther
- Division of Infectious Diseases, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Wendy S Armstrong
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Brian S Schwartz
- Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, California, USA
| | | | - Ashleigh Logan
- Infectious Diseases Society of America, Arlington, Virginia, USA
| | - Kenza Bennani
- Infectious Diseases Society of America, Arlington, Virginia, USA
| | - Jennifer O Spicer
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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Leach A, Shim J, Murphy K, Godard M, Ortiz F, Swartz M, Sokoll LJ. A novel internal training program using Kern's 6-step approach to curriculum development for medical laboratory scientists training to be international quality assurance/quality control coordinators. Lab Med 2023; 54:e186-e196. [PMID: 37471140 PMCID: PMC10629921 DOI: 10.1093/labmed/lmad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
OBJECTIVE Patient Safety Monitoring in International Laboratories (pSMILE) is a resource ensuring quality testing in clinical laboratories performing National Institutes of Health-funded HIV research requiring specific staff training. We demonstrate the development of an online asynchronous training model using Kern's 6-step approach to support pSMILE functions. METHODS An existing curriculum was revamped to incorporate Kern's approach. Metrics for success were described in rubrics with feedback guiding improvements and updates. RESULTS Curriculum updates took more than a year. Direct observations of skills informed curriculum changes. Module self-evaluations were reviewed to assess performance and the overall curriculum. The content, curriculum, and training documentation were deemed compliant with International Organization for Standardization (ISO) 9001:2015. CONCLUSION Asynchronous training for highly skilled and self-directed staff is a novel way to deploy training while maintaining productivity of existing staff. Feedback and evaluation allowed for curriculum updates including previously underdeveloped topics. Kern's approach ensured that the needs of the sponsor, management, laboratories, and learners were met.
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Affiliation(s)
- Anne Leach
- Clinical Chemistry Division, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Josephine Shim
- Clinical Chemistry Division, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Kristin Murphy
- Clinical Chemistry Division, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Mandana Godard
- Clinical Chemistry Division, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Felix Ortiz
- Clinical Chemistry Division, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Mark Swartz
- Clinical Chemistry Division, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Lori J Sokoll
- Clinical Chemistry Division, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, US
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Manohar S, Moniz T, Haidet P, Chisolm MS, Balhara KS. Applying the Prism Model to design arts and humanities medical curricula. Int Rev Psychiatry 2023; 35:576-582. [PMID: 38461395 DOI: 10.1080/09540261.2023.2254384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/29/2023] [Indexed: 03/11/2024]
Abstract
The arts and humanities (A&H) play a fundamental role in medical education by supporting medical learners' development of core competencies. Like all medical curricula, those integrating the A&H are more likely to achieve the desired outcomes when the learning domains, goals, objectives, activities, and evaluation strategies are well-aligned. Few faculty development programs focus on helping medical educators design A&H curricula in a scholarly manner. The Prism Model, an evidence-based tool, supports educators developing A&H medical curricula in a rigorous way for maximum impact. The model posits that the A&H can serve four pedagogical functions for medical learners: 1) skill mastery, 2) perspective taking, 3) personal insight, and 4) social advocacy. Although this model has been described in the literature, no practical guidance exists for medical educators seeking to apply it to the development of a specific curriculum. This paper provides a step-by-step demonstration of how to use the Prism Model to design an A&H curriculum. Beginning with the first step of selecting a learning domain through the final step of curriculum evaluation, this paper helps medical educators apply the Prism Model to develop A&H curricula with intentionality and rigour to achieve the desired learning outcomes.
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Affiliation(s)
| | - Tracy Moniz
- Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Paul Haidet
- Woodward Center for Excellence in Health Sciences Education, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | | | - Kamna S Balhara
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Lin J, Cook M, Siegel T, Marterre B, Chapman AC. Time is Short: Tools to Integrate Palliative Care and Communication Skills Education into Your Surgical Residency. J Surg Educ 2023; 80:1669-1674. [PMID: 37385930 DOI: 10.1016/j.jsurg.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 07/01/2023]
Abstract
The need to integrate palliative care (PC) training into surgical education has been increasingly recognized. Our aim is to describe a set of PC educational strategies, with a range of requisite resources, time, and prior expertise, to provide options that surgical educators can tailor for different programs. Each of these strategies has been successfully employed individually or in some combination at our institutions, and components can be generalized to other training programs. Asynchronous and individually paced PC training can be provided using existing resources published by the American College of Surgeons and upcoming SCORE curriculum modules. A multiyear PC curriculum, with didactic components of increasing complexity for more advanced residents, can be applied based on available time in the didactic schedule and local expertise. Simulation-based training in PC skills can be developed to provide objective competency-based training. Finally, a dedicated rotation on a surgical palliative care service can provide the most immersive experience with steps toward clinical entrustment of PC skills for trainees.
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Affiliation(s)
- Joseph Lin
- Department of Surgery, University of California San Francisco, San Francisco, California; Division of Palliative Medicine, Department of Medicine, University of California San Francisco, San Francisco, California
| | - Mackenzie Cook
- Department of Surgery, Oregon Health & Science University, Portland, Oregon
| | - Timothy Siegel
- Department of Surgery, Oregon Health & Science University, Portland, Oregon; Division of Hematology/Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Buddy Marterre
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina; Section of Gerontology and Geriatric Medicine, Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Allyson Cook Chapman
- Department of Surgery, University of California San Francisco, San Francisco, California; Division of Palliative Medicine, Department of Medicine, University of California San Francisco, San Francisco, California.
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Landeen KC, Esianor B, Stevens MN, Fernando S, Merriam J, Kreth K, Whigham AS, Haynes D, Eavey R. Online Otolaryngology: A Comprehensive Model for Medical Student Engagement in the Virtual Era and Beyond. Ear Nose Throat J 2023; 102:739-741. [PMID: 34218707 DOI: 10.1177/01455613211029748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
When in-person experiences were taken away from medical students and residency applicants during the COVID-19 pandemic, institutions had to pivot to virtual experiences. We present here a comprehensive overview of virtual engagement for medical students. As we increasingly embrace virtual opportunities, it may be possible to continue utilizing these programs for many years to come.
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Affiliation(s)
- Kelly C Landeen
- Department of Otolaryngology, Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brandon Esianor
- Department of Otolaryngology, Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Madelyn N Stevens
- Department of Otolaryngology, Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shanik Fernando
- Department of Otolaryngology, Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Joanne Merriam
- Division of Pediatrics, Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kimberly Kreth
- Division of Pediatrics, Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amy S Whigham
- Division of Pediatrics, Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David Haynes
- Division of Otology, Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Roland Eavey
- Guy M. Maness Professor and Chair of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
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Yu W, Zhu Z, Su T, Weng W, Xu C. A pilot study on the use of a novel digital real-time evaluation system in undergraduate preclinical training of tooth preparation in fixed prosthodontics. Eur J Dent Educ 2023; 27:949-955. [PMID: 36527298 DOI: 10.1111/eje.12886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/26/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION In the light of the digital teaching, it is necessary that the effectiveness of a new digital real-time evaluation system in the preclinical training of tooth preparation be evaluated. MATERIALS AND METHODS Forty undergraduate dental students of the fourth year were randomly divided into the control group and the experimental group to complete the training task of tooth preparation for porcelain fused to metal (PFM) crown restoring the upper right central incisor. The control students received conventional training with instructor's guidance. The experimental students received training with the digital system without instructor's guidance. Every student exercised preparation in two resin incisors in 3 h training by respective training methods. A third incisor was prepared on a dental model in the simulated head phantom by each student as the test on the next day. All students' tooth preparations were scored by the same two experienced experts. The experimental students were asked to answer a questionnaire regarding their attitudes and opinions on the digital evaluation system in preclinical training. RESULTS There was no significant difference between the scores of the experimental group and the control group (p > .05). The students of two groups obtained the similar scores in the test (p > .05). Most of the students were supportive of the application of digital training system in the preclinical tooth preparation training course. CONCLUSIONS The digital real-time evaluation system could provide effective training effects for the dental undergraduate students in the preclinical training of tooth preparation in fixed prosthodontics.
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Affiliation(s)
- Weiqiang Yu
- Department of Prosthodontics, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Huangpu District, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Pudong District, Shanghai, China
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Ziyuan Zhu
- Department of Prosthodontics, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Huangpu District, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Pudong District, Shanghai, China
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Tingshu Su
- Department of Prosthodontics, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Huangpu District, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Pudong District, Shanghai, China
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Weimin Weng
- Department of Prosthodontics, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Huangpu District, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Pudong District, Shanghai, China
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Chun Xu
- Department of Prosthodontics, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Huangpu District, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Pudong District, Shanghai, China
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
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Stewart CL, Green C, Meara MP, Awad MM, Nelson M, Coker AM, Porterfield J. Common Components of General Surgery Robotic Educational Programs. J Surg Educ 2023; 80:1717-1722. [PMID: 37596106 DOI: 10.1016/j.jsurg.2023.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE Robotically assisted surgery has become more common in general surgery, but there is limited guidance from the Accreditation Council for Graduate Medical Education (ACGME) regarding this type of training. We sought to determine common elements and differences in the robotic educational curricula developed by general surgery residency programs. DESIGN Robotic educational curricula were obtained from the 7 individuals who presented at the workshop, "Robotic Education in General Surgery" at the 2023 Association of Program Directors in Surgery annual meeting. RESULTS All 7 general surgery programs had training beginning intern year, required online robotic modules, had at least 1 dedicated simulation training console not used for clinical purposes, and ran dry and wet (tissue) robotic labs at least annually. All programs had bedside and console surgeon case minimums and had administrative support to run the educational programs. Differences existed regarding how training intern year was executed, the simulations required, clinical practice minimum requirements, how progress was monitored over time, and how case numbers were tracked. Some programs had salary support for a director of robotic education. CONCLUSIONS There are several common elements to robotic educational curricula in general surgery, however significant variation does exist between programs. Given the frequency of robotic use in general surgery and current lack of standardization, formal guidance from the ACGME specifically regarding robotic education in general surgery residency is warranted.
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Affiliation(s)
- Camille L Stewart
- Department of Surgery, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, Colorado.
| | - Courtney Green
- Department of Surgery, University of California San Francisco School of Medicine, San Francisco, California
| | - Michael P Meara
- Department of Surgery, The Ohio State University, Columbus, Ohio
| | - Michael M Awad
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Megan Nelson
- Department of Surgery, Mayo Clinic Arizona, Phoenix, Arizona
| | - Alisa M Coker
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - John Porterfield
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
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Bajra R, Srinivasan M, Torres EC, Rydel T, Schillinger E. Training future clinicians in telehealth competencies: outcomes of a telehealth curriculum and teleOSCEs at an academic medical center. Front Med (Lausanne) 2023; 10:1222181. [PMID: 37849494 PMCID: PMC10577422 DOI: 10.3389/fmed.2023.1222181] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/29/2023] [Indexed: 10/19/2023] Open
Abstract
Background This study describes the program and learning outcomes of a telehealth skills curriculum based on the Association of American Medical Colleges (AAMC) telehealth competencies for clerkship-level medical students. Methods A total of 133 third- and fourth-year medical students in a required family medicine clerkship at Stanford University School of Medicine participated in a telehealth curriculum, including a telehealth workshop, site-specific telehealth clinical encounters, and telemedicine objective structured clinical examinations (teleOSCEs) between July 2020 and August 2021. Their workshop communication and physical examination competencies were assessed in two teleOSCEs utilizing a novel telehealth assessment tool. Students' attitudes, skills, and self-efficacy were assessed through voluntary pre-clerkship, post-workshop, and post-OSCE surveys. Discussion Most learners reported low confidence in their telehealth physical examinations [n = 79, mean = 1.6 (scale 0-5, 5 = very confident, SD = 1.0)], which improved post-workshop [n = 69, 3.3 (0.9), p < 0.001]; almost all (97%, 70/72) felt the workshop prepared them to see patients in the clinic. In formative OSCEs, learners demonstrated appropriate "webside manner" (communication scores 94-99%, four items) but did not confirm confidentiality (21%) or review limitations of the visit (35%). In a low back pain OSCE, most learners assessed pain location (90%) and range of motion (87%); nearly half (48%) omitted strength testing. Conclusion Our telehealth curriculum demonstrated that telehealth competencies can be taught and assessed in medical student education. Improvement in self-efficacy scores suggests that an 80-min workshop can prepare students to see patients in the clinical setting. Assessment of OSCE data informs opportunities for growth for further development in the curriculum, including addressing visit limitations and confidentiality in telehealth visits.
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Affiliation(s)
- Rika Bajra
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Malathi Srinivasan
- One Health Teaching Scholars Program, Stanford CARE Internships Programs, Stanford Center for Asian Healthcare Research and Education, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Elise Cheng Torres
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Tracy Rydel
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Erika Schillinger
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
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Noguchi J, Knopov A, Bencie N, Mather TS, Chofay DR, Warrier S, Rougas S. A Community-engaged Curriculum at Alpert Medical School: Centering Patient Communities in Medical Education. R I Med J (2013) 2023; 106:14-19. [PMID: 37768156] [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] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
BACKGROUND Incorporating opportunities for community engagement into undergraduate medical education (UME) can help learners to identify and address social determinants of health (SDoH). Multiple challenges exist in operationalizing these experiences. METHODS Using the Assessing Community Engagement (ACE) model, course directors at the Warren Alpert Medical School of Brown University (AMS) mapped community engagement initiatives to the four-year curriculum. FINDINGS Service-learning, community engagement projects, and clinical rotations at health centers and free clinics aim to equip learners at AMS with the necessary skills to address SDoH. Careful consideration should be given to the time and resources required to facilitate relationships with community-based agencies, learner reflection, program evaluation, and community-level outcomes. CONCLUSIONS Community engagement activities should be aligned with learning objectives during the pre-clerkship and clerkship stages of the existing UME curricula. Embarking on a curriculum redesign can create opportunities to expand partnerships with local agencies and deepen student engagement.
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Affiliation(s)
- Julia Noguchi
- Director of Community Engagement & Scholarship, Assistant Professor of Medical Science, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Anita Knopov
- Medical Education Research Fellow, Brown Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Nicole Bencie
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Thais Salazar Mather
- Assistant Dean for Medical Education, Assistant Professor of Medical Science & Assistant Professor of Molecular Microbiology and Immunology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Dana Ricci Chofay
- Course Leader, Doctoring I and II, Assistant Professor of Medicine and Medical Science, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Sarita Warrier
- Associate Dean for Medical Education, Associate Professor of Medicine and Medical Science, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Steven Rougas
- Director, Doctoring Program, Associate Professor of Emergency Medicine and Medical Science, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Lingham V, Chandwarkar A, Miller M, Baker C, Genes N, Hellems M, Khanna R, Mize D, Silverman H. A Systematic Approach to the Design and Implementation of Clinical Informatics Fellowship Programs. Appl Clin Inform 2023; 14:951-960. [PMID: 38057262 PMCID: PMC10700146 DOI: 10.1055/s-0043-1776404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/20/2023] [Indexed: 12/08/2023] Open
Abstract
Clinical Informatics (CI), a medical subspecialty since 2011, has grown from the initial four fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) in 2014 to more than 50 and counting in the present day. In parallel, the literature guiding Clinical Informatics Fellowship training and the curriculum evolved from the original core content published in 2009 to the more recent CI Subspecialty Delineation of Practice and the updated ACGME Milestones 2.0 for CI. In this paper, we outline this evolution and its impact on CIF Curricula. We then propose a framework, specific processes, and tools to standardize the design and optimize the implementation of CIF programs.
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Affiliation(s)
- Veena Lingham
- Department of Biomedical Informatics, Stony Brook Medicine, Stony Brook, New York, United States
| | - Aarti Chandwarkar
- Divisions of Clinical Informatics and Primary Care Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, United States
| | - Michael Miller
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Carrie Baker
- Department of Family Medicine, Kettering Health, Indu and Raj Soin Medical Center, Dayton, Ohio, United States
| | - Nicholas Genes
- Ronald O Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, New York, United States
| | - Martha Hellems
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Raman Khanna
- Division of Hospital Medicine, UCSF, San Francisco, California, United States
| | - Dara Mize
- Department of Biomedical Informatics and Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Howard Silverman
- Department of Biomedical Informatics, The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, United States
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Kreider EF, Ortega-Burgos Y, Dumeng-Rodriguez J, Gesualdi J, O’Brien C, Bracy D, Johnson J, Bowman J, Metzger D, Dine CJ, Favor K, Jordan-Sciutto KL, Momplaisir F. Early Engagement in HIV Research: Evaluation of the Penn CFAR Scholars Program Aimed at Increasing Diversity of the HIV/AIDS Workforce. J Acquir Immune Defic Syndr 2023; 94:S28-S35. [PMID: 37707845 PMCID: PMC10754256 DOI: 10.1097/qai.0000000000003260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND Demographic diversity is not represented in the HIV/AIDS workforce. Engagement of underrepresented trainees as early as high school may address this disparity. METHODS We established the Penn Center for AIDS Research (CFAR) Scholars Program, a mentored research experience for underrepresented minority (URM) trainees spanning educational stages from high school to medical school. The program provides participants with tailored educational programming, professional skill building, and mentored research experiences. We conducted qualitative interviews with scholar, mentor, and leadership groups to evaluate the program's impact. RESULTS Eleven participants were selected to partake in 1 of 5 existing mentored research programs as CFAR scholars. Scholars attended an 8-week HIV Seminar Series that covered concepts in the basic, clinical, behavioral, and community-based HIV/AIDS research. Program evaluation revealed that scholars' knowledge of HIV pathophysiology and community impact increased because of these seminars. In addition, they developed tangible skills in literature review, bench techniques, qualitative assessment, data analysis, and professional network building. Scholars reported improved academic self-efficacy and achieved greater career goal clarity. Areas for improvement included clarification of mentor-mentee roles, expectations for longitudinal mentorship, and long-term engagement between scholars. Financial stressors, lack of social capital, and structural racism were identified as barriers to success for URM trainees. CONCLUSION The Penn CFAR Scholars Program is a novel mentored research program that successfully engaged URM trainees from early educational stages. Barriers and facilitators to sustained efforts of diversifying the HIV/AIDS workforce were identified and will inform future program planning.
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Affiliation(s)
- Edward F. Kreider
- Department of Medicine, Hospital of the University of Pennsylvania
- Perelman School of Medicine, University of Pennsylvania
| | - Yohaniz Ortega-Burgos
- Perelman School of Medicine, University of Pennsylvania
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Philadelphia
| | | | | | | | - Danny Bracy
- Mixed Methods Research Lab, University of Pennsylvania
| | | | - Jacqui Bowman
- Center For Education, College of Physicians of Philadelphia
| | - David Metzger
- Department of Psychiatry, Perelman School of Medicine
| | - C. Jessica Dine
- Department of Medicine, Hospital of the University of Pennsylvania
- Leonard Davis Institute of Economics, University of Pennsylvania
| | - Kevin Favor
- Psychology and Human Services Department, Lincoln University
| | - Kelly L. Jordan-Sciutto
- Department of Medicine, Hospital of the University of Pennsylvania
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania
| | - Florence Momplaisir
- Department of Medicine, Hospital of the University of Pennsylvania
- Leonard Davis Institute of Economics, University of Pennsylvania
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Johnson E, Ghosh M, Daniels VJ, Wild TC, Campbell-Scherer D, Mellinger J, Winder GS, Fernandez AC, Kirkwood J, Tandon P. The development and evaluation of a provider-focused educational intervention about alcohol use disorder in patients with cirrhosis. Can Liver J 2023; 6:295-304. [PMID: 38020191 PMCID: PMC10652990 DOI: 10.3138/canlivj-2022-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 12/01/2023]
Abstract
Background Alcohol use disorder (AUD) is a leading cause of cirrhosis. Insufficient clinician knowledge and comfort managing AUD impacts access to treatment. Using Kern's Framework for Curriculum Development, we aimed to (i) develop and evaluate the effect of an "AUD in cirrhosis" educational intervention on clinicians' knowledge, attitudes, comfort, preparedness, and intention (practice habits) to integrate AUD management into their practice, and (ii) assess clinicians' motivation using Self Determination Theory. Methods Kern's approach was used for curriculum development. Pilot session feedback informed a three-part flipped-classroom series conducted by interdisciplinary clinicians in hepatology, psychiatry, primary care, and addiction psychology. Participants watched a video followed by a live session focused on (a) withdrawal, (b) screening and brief intervention, and (c) prescribing pharmacotherapy. Questionnaires assessing knowledge and practice habits were adapted from the literature. Attitudes were evaluated using the Short Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ). Self Determination Theory informed motivation questions. Results Paired sample t-tests on pre-post questionnaires (n = 229 clinicians; 95 completed questionnaires) revealed significant improvements in preparedness and comfort screening, providing a brief intervention, prescribing pharmacotherapy, and SAAPPQ domains. No significant changes were observed in the intention to prescribe pharmacotherapy. Effect size analysis showed medium to large effects across most topic areas. Conclusions The developed sessions improved knowledge, attitudes, and practice habits of clinicians caring for this patient population. Given the rise in AUD and significant consequences in cirrhosis, this data offers promise that interactive education may improve practice habits of clinicians interfacing with this patient population.
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Affiliation(s)
- Emily Johnson
- Division of Gastroenterology (Liver Unit), Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Monty Ghosh
- Division of General Internal Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Vijay John Daniels
- Division of General Internal Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - T Cameron Wild
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Denise Campbell-Scherer
- Physician Learning Program, University of Alberta, Edmonton, Alberta, Canada
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Jessica Mellinger
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbour, Michigan, United States
| | - Gerald S Winder
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, United States
| | - Anne C Fernandez
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, United States
| | - Jessica Kirkwood
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Puneeta Tandon
- Division of Gastroenterology (Liver Unit), Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Physician Learning Program, University of Alberta, Edmonton, Alberta, Canada
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Jain N, Jersovs K, Safina T, Pilmane M, Jansone-Ratinika N, Grike I, Petersons A. Medical education in Latvia: an overview of current practices and systems. Front Med (Lausanne) 2023; 10:1250138. [PMID: 37809335 PMCID: PMC10551541 DOI: 10.3389/fmed.2023.1250138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Located in northern Europe, Latvia is one of the three Baltic States with a population of 1.9 million. The country has a rich history of medical education spanning a century and is becoming an emerging global hub for medical education. Although the surge in international students has been beneficial for the development of educational and research infrastructure, increasing demands from local students, along with institutional capacity constraints, have overburdened the available resources. Substantial investments are being made to adapt to the rapidly changing geopolitical and techno-biomedical landscape. This perspective paper presents an overview of the country's medical education system, its challenges, and prospects from pre-university to doctoral level.
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Affiliation(s)
- Nityanand Jain
- Faculty of Medicine, Riga Stradinš University, Riga, Latvia
- Institute of Anatomy and Anthropology, Riga Stradinš University, Riga, Latvia
| | - Kirils Jersovs
- Faculty of Medicine, Riga Stradinš University, Riga, Latvia
| | - Taira Safina
- Faculty of Medicine, Riga Stradinš University, Riga, Latvia
| | - Mara Pilmane
- Institute of Anatomy and Anthropology, Riga Stradinš University, Riga, Latvia
| | | | - Ieva Grike
- Faculty of Residency, Riga Stradinš University, Riga, Latvia
| | - Aigars Petersons
- Faculty of Medicine, Riga Stradinš University, Riga, Latvia
- Children's Clinical University Hospital, Riga, Latvia
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Keim SA, Harmon DJ, Martindale JR, Lopez EN, Sanky C, Brooks WS, Cotter MM, Davies DL, Doroudi M, Fahl JC, Farias A, Granite G, Harrell KM, Kar R, Kramer KL, Jackson J, Jones S, Lackey-Cornelison W, Laitman JT, Latacha K, Lewis SR, Lovejoy Mork A, Marzban H, McNary TG, McWhorter DL, Merchant A, Mussell JC, Quinn MM, Reidenberg JS, Royer D, Sakaguchi A, Sawyer FK, Topping DB, Wainman B, Wineski LE, Zumwalt AC, Hankin MH. Essential anatomy for core clerkships: A clinical perspective. Anat Sci Educ 2023; 16:943-957. [PMID: 36929575 DOI: 10.1002/ase.2272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Clerkships are defining experiences for medical students in which students integrate basic science knowledge with clinical information as they gain experience in diagnosing and treating patients in a variety of clinical settings. Among the basic sciences, there is broad agreement that anatomy is foundational for medical practice. Unfortunately, there are longstanding concerns that student knowledge of anatomy is below the expectations of clerkship directors and clinical faculty. Most allopathic medical schools require eight "core" clerkships: internal medicine (IM), pediatrics (PD), general surgery (GS), obstetrics and gynecology (OB), psychiatry (PS), family medicine (FM), neurology (NU), and emergency medicine (EM). A targeted needs assessment was conducted to determine the anatomy considered important for each core clerkship based on the perspective of clinicians teaching in those clerkships. A total of 525 clinical faculty were surveyed at 24 United States allopathic medical schools. Participants rated 97 anatomical structure groups across all body regions on a 1-4 Likert-type scale (1 = not important, 4 = essential). Non-parametric ANOVAs determined if differences existed between clerkships. Combining all responses, 91% of anatomical structure groups were classified as essential or more important. Clinicians in FM, EM, and GS rated anatomical structures in most body regions significantly higher than at least one other clerkship (p = 0.006). This study provides an evidence-base of anatomy content that should be considered important for each core clerkship and may assist in the development and/or revision of preclinical curricula to support the clinical training of medical students.
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Affiliation(s)
- Sarah A Keim
- Department of Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Derek J Harmon
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - James R Martindale
- Office of Medical Education, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Elisabeth N Lopez
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Charles Sanky
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - William S Brooks
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Meghan M Cotter
- Department of Academic Affairs, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - David L Davies
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Majid Doroudi
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey C Fahl
- Department of Anatomy, Albany Medical College, Albany, New York, USA
| | - Anna Farias
- Schulich School of Medicine and Dentistry, Windsor, Ontario, Canada
| | - Guinevere Granite
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Kelly M Harrell
- Department of Anatomy and Neurobiology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Rekha Kar
- Department of Cell Systems and Anatomy, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Kenneth L Kramer
- Department of Medical Education, Creighton University, Omaha, Nebraska, USA
| | - Jon Jackson
- Anatomy & Cell Biology, Burrell College of Osteopathic Medicine, Las Cruces, New Mexico, USA
| | - Shiloh Jones
- Anatomical Sciences Education Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Wendy Lackey-Cornelison
- Department of Medical Education, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Jeffrey T Laitman
- Medical Education (Anatomy), Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kimberly Latacha
- Department of Genetics, Cell Biology, and Anatomy, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Steven R Lewis
- New York Institute of Technology College of Osteopathic Medicine, Jonesboro, Arkansas, USA
| | - Amy Lovejoy Mork
- Department of Pathology and Anatomy, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Hassan Marzban
- Department of Human Anatomy and Cell Science, University of Manitoba, Winnipeg, Canada
| | - Thomas G McNary
- Division of Anatomy and Molecular Medicine, Alabama College of Osteopathic Medicine, Dothan, Alabama, USA
| | | | - Aftab Merchant
- Department of Health Sciences Education, University of Illinois College of Medicine, Rockford, Illinois, USA
| | - Jason C Mussell
- Department of Cell Biology and Anatomy, LSUHSC-NO, New Orleans, Louisiana, USA
| | - Melissa M Quinn
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Joy S Reidenberg
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Danielle Royer
- Department of Cell and Developmental Biology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Alan Sakaguchi
- Department of Cell Systems and Anatomy, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - F Kip Sawyer
- Department of Anesthesiology, Huntington Hospital, Pasadena, California, USA
| | - Daniel B Topping
- Department of Anatomy and Cell Biology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Bruce Wainman
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence E Wineski
- Department of Pathology and Anatomy, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Ann C Zumwalt
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Mark H Hankin
- Anatomical Sciences Education Center, Oregon Health & Science University, Portland, Oregon, USA
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Dulay M, Bowen JL, Weppner WG, Eastburn A, Poppe AP, Spanos P, Wojtaszek D, Printz D, Kaminetzky CP. Interprofessional population health advocacy: Developing and implementing a panel management curriculum in five Veterans Administration primary care practices. J Interprof Care 2023; 37:S75-S85. [PMID: 29746221 DOI: 10.1080/13561820.2018.1469476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 12/04/2017] [Accepted: 04/23/2018] [Indexed: 10/16/2022]
Abstract
Health care systems expect primary care clinicians to manage panels of patients and improve population health, yet few have been trained to do so. An interprofessional panel management (PM) curriculum is one possible strategy to address this training gap and supply future primary care practices with clinicians and teams prepared to work together to improve the health of individual patients and populations. This paper describes a Veterans Administration (VA) sponsored multi-site interprofessional PM curriculum development effort. Five VA Centers of Excellence in Primary Care Education collaborated to identify a common set of interprofessionally relevant desired learning outcomes (DLOs) for the PM and to develop assessment instruments for monitoring trainees' PM learning. Authors cataloged teaching and learning activities across sites. Results from pilot testing were systematically discussed leading to iterative revisions of curricular elements. Authors completed a retrospective self-assessment of curriculum implementation for the academic year 2015-16 using a 5-point scale: contemplation (score = 0), pilot (1), action (2), maintenance (3), and embedded (4). Implementation scores were analyzed using descriptive statistics. DLOs were organized into five categories (individual patients, populations, guidelines/measures, teamwork, and improvement) along with a developmental continuum and mapped to program competencies. Instruction and implementation varied across sites based on resources and priorities. Between 2015 and 2016, 159 trainees (internal medicine residents, nurse practitioner students and residents, pharmacy residents, and psychology post-doctoral fellows) participated in the PM curriculum. Curriculum implementation scores for guidelines/measures and improvement DLOs were similar for all trainees; scores for individual patients, populations, and teamwork DLOs were more advanced for nurse practitioner and physician trainees. In conclusion, collaboratively identified DLOs for PM guided development of assessment instruments and instructional approaches for panel management activities in interprofessional teams. This PM curriculum and associated tools provide resources for educators in other settings.
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Affiliation(s)
- Maya Dulay
- Center of Excellence in Primary Care Education, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Judith L Bowen
- Schools of Medicine and Nursing, Oregon Health & Science University, Portland, WA, USA
- Office of Academic Affiliations, Department of Veterans Affairs (VA), Washington DC, USA
| | - William G Weppner
- Center of Excellence in Primary Care Education, Boise VA Medical Center, Boise, ID, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Abigail Eastburn
- Center of Excellence in Primary Care Education, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Anne P Poppe
- Center of Excellence in Primary Care Education, Seattle, WA, USA
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Pete Spanos
- Center of Excellence in Primary Care Education, Louis Stokes Cleveland VAMC, Cleveland, OH, USA
| | - Danielle Wojtaszek
- West Haven Center of Excellence in Primary Care Education, VA Connecticut Health Care System, West Haven, CT, USA
| | - Destiny Printz
- Center of Excellence in Primary Care Education, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, USA
| | - Catherine P Kaminetzky
- VA Puget Sound Health Care System, Seattle, WA, USA
- School of Medicine, University of Washington, Seattle, WA
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Hege I, Adler M, Donath D, Durning SJ, Edelbring S, Elvén M, Bogusz A, Georg C, Huwendiek S, Körner M, Kononowicz AA, Parodis I, Södergren U, Wagner FL, Wiegleb Edström D. Developing a European longitudinal and interprofessional curriculum for clinical reasoning. Diagnosis (Berl) 2023; 10:218-224. [PMID: 36800998 DOI: 10.1515/dx-2022-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/24/2023] [Indexed: 02/19/2023]
Abstract
Clinical reasoning is a complex and crucial ability health professions students need to acquire during their education. Despite its importance, explicit clinical reasoning teaching is not yet implemented in most health professions educational programs. Therefore, we carried out an international and interprofessional project to plan and develop a clinical reasoning curriculum with a train-the-trainer course to support educators in teaching this curriculum to students. We developed a framework and curricular blueprint. Then we created 25 student and 7 train-the-trainer learning units and we piloted 11 of these learning units at our institutions. Learners and faculty reported high satisfaction and they also provided helpful suggestions for improvements. One of the main challenges we faced was the heterogeneous understanding of clinical reasoning within and across professions. However, we learned from each other while discussing these different views and perspectives on clinical reasoning and were able to come to a shared understanding as the basis for developing the curriculum. Our curriculum fills an important gap in the availability of explicit clinical reasoning educational materials both for students and faculty and is unique with having specialists from different countries, schools, and professions. Faculty time and time for teaching clinical reasoning in existing curricula remain important barriers for implementation of clinical reasoning teaching.
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Affiliation(s)
- Inga Hege
- Medical Education Sciences, University of Augsburg, Augsburg, Germany
| | | | - Daniel Donath
- Faculty of Medicine and Health, EDU Higher Education Institute, Kalkara, Malta
| | - Steven J Durning
- Uniformed Services University of the Health Sciences, Bethesda, USA
| | | | - Maria Elvén
- School of Health Sciences, Örebro University, Örebro, Sweden
- School of Health, Care and Social Welfare, Mälardalen University, Örebro, Sweden
| | - Ada Bogusz
- Jagiellonian University Medical College, Kraków, Poland
| | - Carina Georg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Sören Huwendiek
- Department for Assessment and Evaluation, Institute for Medical Education, Bern, Switzerland
| | - Melina Körner
- Medical Education Sciences, University of Augsburg, Augsburg, Germany
| | | | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Felicitas L Wagner
- Department for Assessment and Evaluation, Institute for Medical Education, Bern, Switzerland
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Brown A, Wall TN, Pratt G, Talen MR, O'Grady C, Reitz R. Even one voice: Teaching legislative advocacy as a core competency in family medicine. Int J Psychiatry Med 2023:912174231190136. [PMID: 37469126 DOI: 10.1177/00912174231190136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Credentialing bodies increasingly focus on advocacy as a competency to be developed by physicians during residency. The skills of advocacy are especially important with the increased attention on social determinants of health and as restrictive state and federal health policy decisions gain widespread attention in the national news media. This movement is reflected in the ACGME's recently revised statement on the training mission of family medicine residencies and with their most recent update of the Milestones which identifies advocacy as a core competency. Additionally, the major family medicine organizations and governing bodies all similarly identify advocacy as an important professional responsibility for family physicians. Advocacy is a broad term that can be applied across a range of settings and scenarios. For the purposes of this paper we focus primarily on legislative advocacy as a specific area for growing curricular experiences in family medicine residency programs.
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Affiliation(s)
- Alexander Brown
- NH Dartmouth Family Medicine Residency, Concord Hospital Family Health Center, Concord, NH, USA
| | - Terri N Wall
- Family Medicine, St Vincent's HealthCare, Jacksonville, FL, USA
| | - Grace Pratt
- Great Plains Family Medicine, INTEGRIS Health Inc, Oklahoma, OK, USA
| | - Mary R Talen
- Family Medicine, Ascension Health Resurrection Medical Center, Chicago, IL, USA
- Family Medicine¸ AMITA Health Resurrection Medical Center Chicago Family Medicine Residency, Chicago, IL, USA
| | - Clare O'Grady
- NH Dartmouth Family Medicine Residency, Concord Hospital Family Health Center, Concord, NH, USA
| | - Randall Reitz
- St. Mary's Family Medicine Residency, Grand Junction, CO, USA
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Sanders CE, Byrd AR, Gibson KE, Golson A, Lamm KW, Lamm AJ. Teaching Systems-Thinking Concepts with Hypothetical Case Scenarios: An Exploration in Food-Systems Science Education. Foods 2023; 12:2663. [PMID: 37509755 PMCID: PMC10379014 DOI: 10.3390/foods12142663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/19/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The ability to solve complex challenges facing the food system is an increasingly important skill for undergraduate students entering into the global workforce. However, the curriculum tools to enhance systems thinking in the undergraduate agricultural and natural resource classroom are limited, specifically related to food systems education. METHODS The current study explored the use of hypothetical case scenarios in a teaching curriculum related to the seafood industry, in order to determine the use of these tools as a mechanism for increasing undergraduate students' systems-thinking capacity. The mixed-method study used a survey and focus groups. Results indicated that participants' understanding of, and capacity for, using systems thinking to reason through complex scenarios increased during the mixed-method educational intervention. Participants stated the experience helped them learn more about their own patterns of thinking, created transformational learning moments through dissonance, helped them learn about the unintended consequences of decision-making, and increased their understanding of system complexity. CONCLUSIONS The implications of using hypothetical case scenarios in the food system education classroom are explored.
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Affiliation(s)
- Catherine E Sanders
- Department of Agricultural and Human Sciences, College of Agriculture and Life Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - Allison R Byrd
- Department of Agricultural Leadership, Education, and Communication, College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA 30602, USA
| | - Kristin E Gibson
- Department of Agricultural Leadership, Education, and Communication, College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA 30602, USA
| | - Aaron Golson
- Department of Agricultural Leadership, Education, and Communication, College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA 30602, USA
| | - Kevan W Lamm
- Department of Agricultural Leadership, Education, and Communication, College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA 30602, USA
| | - Alexa J Lamm
- Department of Agricultural Leadership, Education, and Communication, College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA 30602, USA
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Weimer JM, Widmer N, Strelow KU, Hopf P, Buggenhagen H, Dirks K, Künzel J, Börner N, Weimer AM, Lorenz LA, Rink M, Bellhäuser H, Schiestl LJ, Kloeckner R, Müller L, Weinmann-Menke J. Long-Term Effectiveness and Sustainability of Integrating Peer-Assisted Ultrasound Courses into Medical School-A Prospective Study. Tomography 2023; 9:1315-1328. [PMID: 37489472 PMCID: PMC10366829 DOI: 10.3390/tomography9040104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION Ultrasound diagnostics is an important examination method in everyday clinical practice, but student education is often inadequate for acquiring sufficient basic skills. Individual universities have therefore started integrating (extra)curricular training concepts into medical education. This study aimed to evaluate sustainable skills development through participation in peer-assisted ultrasound courses. METHODS From 2017, students in the clinical part of medical school could opt for extracurricular peer-assisted ultrasound courses. Depending on the format (10-week course/2-day compact course) these comprised 20 teaching units focusing on abdominal and emergency ultrasonography. Students attending compulsory workshops at the start of their practical year were enrolled in this study, allowing for a comparison between the study group (attended ultrasound course) and the control group (did not attend ultrasound course). Competency from two out of four practical exams (subjects: "aorta", "gallbladder", "kidney" and "lung") was measured, and a theory test on the same subject areas ("pathology recognition") was administered. Additional questions concerned biographical data, subjective competency assessment (7-point Likert scale), and "attitude to ultrasound training in the curriculum". RESULTS Analysis included 302 participants in total. Ultrasound courses had been attended on average 2.5 years earlier (10-week course) and 12 months earlier (2-day compact course), respectively. The study group (n = 141) achieved significantly better results than the control group (n = 161) in the long-term follow-up. This applies both to practical exams (p < 0.01) and theory tests (p < 0.01). After course attendance, participants reported a significantly higher subjective assessment of theoretical (p < 0.01) and practical (p < 0.01) ultrasound skills. CONCLUSIONS Peer-assisted ultrasound courses can sustainably increase both theoretical and practical competency of medical students. This highlights the potential and need for standardised implementation of ultrasound courses in the medical education curriculum.
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Affiliation(s)
- Johannes Matthias Weimer
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Nina Widmer
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Kai-Uwe Strelow
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Paula Hopf
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Holger Buggenhagen
- Rudolf Frey Learning Clinic, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Klaus Dirks
- Department of General Internal Medicine and Geriatrics, Rems-Murr-Klinikum, 71364 Winnenden, Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, 95053 Regensburg, Germany
| | - Norbert Börner
- Gastroenterological Medical Group Offices at the MED Specialist Centre Mainz, 55131 Mainz, Germany
| | - Andreas Michael Weimer
- Centre of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital Heidelberg, 69118 Heidelberg, Germany
| | - Liv Annebritt Lorenz
- Department of Radiation Oncology and Radiotherapy, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Maximilian Rink
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, 95053 Regensburg, Germany
| | - Henrik Bellhäuser
- Institute of Psychology, Johannes Gutenberg University of Mainz, 55112 Mainz, Germany
| | - Lina Judit Schiestl
- Department of Gynaecology and Obstetrics, University Medical Centre of the Johannes-Gutenberg University Mainz, 55131 Mainz, Germany
| | - Roman Kloeckner
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein-Campus Lübeck, 23583 Lübeck, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Centre of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Julia Weinmann-Menke
- I. Department of Medicine, University Medical Centre of the Johannes Gutenberg University-Mainz, 55131 Mainz, Germany
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Abstract
Entrustable professional activities (EPAs), units of professional practice that require proficient integration of multiple competencies and can be entrusted to a sufficiently competent learner, are increasingly being used to define and inform curricula of health care professionals. The process of developing EPAs can be challenging and requires a deep yet pragmatic understanding of the concepts underlying EPA construction. Based on recent literature and the authors' lessons learned, this article provides the following practical and more or less sequential recommendations for developing EPAs: [1] Assemble a core team; [2] Build up expertise; [3] Establish a shared understanding of the purpose of EPAs; [4] Draft preliminary EPAs; [5] Elaborate EPAs; [6] Adopt a framework of supervision; [7] Perform a structured quality check; [8] Use a Delphi approach for refinement and/or consensus; [9] Pilot test EPAs; [10] Attune EPAs to their feasibility in assessment; [11] Map EPAs to existing curriculum; [12] Build a revision plan.
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Affiliation(s)
| | - Jennie B Jarrett
- Department of Pharmacy Practice, University of Illinois Chicago College of Pharmacy, Chicago, IL, USA
| | - David R Taylor
- Department of Medicine, Queen's University School of Medicine, Kingston, Ontario, Canada
| | - Olle Ten Cate
- Center for Research and Development of Education, University Medial Center Utrecht, Utrecht, the Netherlands
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Martin S, Kalra A, Jenny A, Maher AD, Foreman A, Chavez A, Gagliano J, Reid MJA, Brickley DB. Rapid and sustained contact tracing training for COVID-19 in San Francisco: a training model for developing an emergency public health workforce. Front Public Health 2023; 11:1125927. [PMID: 37457246 PMCID: PMC10347383 DOI: 10.3389/fpubh.2023.1125927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
The City and County of San Francisco was the first municipality in the United States to institute a COVID-19 contact tracing program. The San Francisco Department of Public Health (SFDPH) and the University of California, San Francisco (UCSF) created an outcome-based fully remote contact tracing curriculum using participatory learning methods to train non-public health emergency workers as contact tracers. Between April and December 2020, we trained over 300 individuals in contact tracing skills and procedures over three training phases. Using iterative curriculum design and Kirkpatrick's evaluation methodology, we aimed to ensure high quality and successful person-centered contact tracing. The resulting curriculum consisted of 24 learning outcomes taught with six participatory skills development activities, asynchronous materials, and one-on-one contact tracer support. We collected more than 700 responses from trainees using various evaluation tools across the training phases, and contact tracers interviewed more than 24,000 contacts after training in our program. Our evaluations showed that knowledge and skills improved for most trainees and demonstrated the utility of the training program in preparing trainees to perform person-centered contact tracing in San Francisco. Local health jurisdictions and state health agencies can use this model of curriculum development and evaluation to rapidly train a non-public health workforce to respond to future public health emergencies.
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Affiliation(s)
- Shayanne Martin
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Anika Kalra
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Alisa Jenny
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Andrew D. Maher
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Allison Foreman
- School of Medicine, University of California San Diego, San Diego, CA, United States
| | - Alejandro Chavez
- School of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Jayne Gagliano
- Department of Public Health, COVID-19 Command Center, San Francisco, CA, United States
| | - Michael J. A. Reid
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
- School of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | - Debbie Bain Brickley
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
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50
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Monkman H, Kuziemsky C, Homco J, Liew A, Rodriguez K, Skaggs J, Wen F, Lesselroth B. Identifying Failure Modes in Telemedicine: An Instructional Needs Assessment. Stud Health Technol Inform 2023; 304:39-43. [PMID: 37347566 DOI: 10.3233/shti230365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Technology failures in telehealth are common, and clinicians need the skills to diagnose and manage them at the point of care. However, there are issues beyond technology failures mediating the effective use of telehealth. We must teach best-practice procedures for conducting telemedicine visits and include in instructional simulations commonly encountered failure modes so students can build their skills. To this end, we recruited medical students to conduct a Healthcare Failure Modes and Effects Analysis (HFMEA) to predict failures in telemedicine, their potential causes, and the consequences to develop and teach prevention strategies. Sixteen students observed telehealth appointments independently. Based on their observations, we identified four categories of failures in telemedicine: technical issues, patient safety, communication, and social and structural determinants. We proposed a normalized workflow that included management and prevention strategies. Our findings can inform the creation of new curricula.
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Affiliation(s)
- Helen Monkman
- School of Health Information Science, University of Victoria, Canada
| | | | - Juell Homco
- University of Oklahoma-Tulsa School of Community Medicine, USA
| | - Andrew Liew
- University of Oklahoma-Tulsa School of Community Medicine, USA
| | | | | | - Frances Wen
- University of Oklahoma-Tulsa School of Community Medicine, USA
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