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Author: Brian S McGowan, PhD

ABSTRACT: Using the health-care matrix to teach and improve patient safety culture in an OB/GYN residency training program

Abstract
OBJECTIVE:To assess the utility of health-care matrix in teaching patient safety in terms of the Institute of Medicine Aims for health-care improvement and Accreditation Council for Graduate Medical Education competencies.METHODS:As part of residency education, health-care matrix conference is held monthly. A multidisciplinary team is invited. Residents choose cases and develop a draft matrix under faculty supervision. The matrix is presented, and consensus action plan is generated after discussion. Approximately 2 years after initiation of the program, residents completed an anonymous 15-item survey.RESULTS:The study included 26 health-care matrix conferences from 2007 to 2009. Main reasons for residents selection of cases were management issues 42%, bleeding complications 35%, and medication errors 23%. Major contributors to patient safety concerns by Institute of Medicine Aims were timeliness 65%, and those by Accreditation Council for Graduate Medical Education competencies were system issues 77%, medical knowledge 69%, and communication issues 66%.Residents agreed that the program was useful. No resident thought that the program should be cancelled. Only 39% feel their communication skills were improved, 48% felt that preparation was time consuming, and 29% felt awkward presenting errors of superiors. Review of action plans developed after each matrix showed that implementation of recommendations was initiated in 92% of the cases.CONCLUSIONS:The health-care matrix curriculum can be used to teach patient safety culture, assess system processes, and improve patient care. This report highlights the importance of system issues, timeliness, medical knowledge, and communication for patient safety concerns.

via Using the health-care matrix to teach and impr… [J Patient Saf. 2012] – PubMed – NCBI.

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ABSTRACT: A reflective practice intervention for professional development, reduced stress and improved patient care-A qualitative developmental evaluation

AbstractOBJECTIVE:Professional capabilities, such as empathy and patient-centeredness, decline during medical education. Reflective practice is advocated for teaching these capabilities. The Clinical Reflection Training (CRT) is a reflective practice intervention using the professional dilemmas faced by medical students during clinical practice. The aim of this study was to evaluate students’ perceptions of the helpfulness of the CRT and its effects on their medical education.METHODS:Eighteen semi-structured interviews were conducted with medical students who had participated in the CRT. Content analysis was used to analyze the interview data.RESULTS:Medical students did not feel adequately prepared to manage the difficult personal and interpersonal problems frequently encountered in clinical practice. They reported that the CRT reduces stress, improves patient care and serves as a tool for professional development.CONCLUSION:The CRT may be a useful tool for developing professionalism during medical education, reducing stress and enhancing the quality of patient care.PRACTICE IMPLICATIONS:Providing students with reflective practice training that draws on their current personal clinical problems in order to improve their clinical work may be a productive investment in personal professional development, physician health, and quality improvement.

via A reflective practice intervention for pr… [Patient Educ Couns. 2013] – PubMed – NCBI.

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ABSTRACT: More than four decades of medical informatics education for medical students in Germany. New recommendations published.

Abstract
The publication of German competencybased learning objectives “Medical Informatics” for undergraduate medical education gives reason to report on more publications of the German journal GMS Medical Informatics, Biometry and Epidemiology ( MIBE ) in Methods. The publications in focus deal with support of medical education by health and biomedical informatics, hospital information systems and their relation to medical devices, transinstitutional health information systems and the need of national eHealth strategies, epidemiological research on predicting high consumption of resources, and with the interaction of epidemiologists and medical statisticians in examining mortality risks in diabetes, in genome wide association studies and in dealing with limits and thresholds. This report is the beginning of an annual series intending to support better international cooperation to achieve good information as a basis for good medicine and good healthcare.

via More than four decades of medical informatic… [Methods Inf Med. 2013] – PubMed – NCBI.

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ABSTRACT: Improving the Effect of FDA-Mandated Drug Safety Alerts with Internet-Based Continuing Medical Education

Abstract
The US Food and Drug Administration (FDA) requires risk communication as an element of Risk Evaluation and Mitigation Strategies (REMS) to alert and educate healthcare providers about severe toxicities associated with approved drugs. The educational effectiveness of this approach has not been evaluated. To support the communication plan element of the ipilimumab REMS, a Medscape Safe Use Alert (SUA) letter was distributed by Medscape via email and mobile device distribution to clinicians specified in the REMS. This alert contained the FDA-approved Dear Healthcare Provider (DHCP) letter mandated for distribution. A continuing medical education (CME) activity describing ipilimumab toxicities and the appropriate management was simultaneously posted on the website and distributed to Medscape members. Data were collected over a 6-month period regarding the handling of the letter and the responses to pre- and post-test questions for those who participated in the CME activity. Analysis of the answers to the pre- and posttest questions showed that participation in the CME activity resulted in an improvement in correct answer responses of 47%. Our experience shows that there are likely distinct information sources that are utilized by different HCP groups. The ready availability of a brief CME activity was utilized by 24,063 individuals, the majority of whom showed enhanced understanding of ipilimumab toxicity by improvement in post-test scores, educational data that are not available via implementation of standard safety alert communications. These results demonstrate that improvement in understanding of specific drug toxicities is enhanced by a CME intervention.

via Improving the Effect of FDA-Mandated Drug Safe… [Curr Drug Saf. 2013] – PubMed – NCBI.

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ABSTRACT: Promoting health behaviours in medical education.

Abstract
Background:  In light of the global trends of increasing obesity, the education of doctors and other health professionals warrants greater attention to promoting effective weight management through health behaviours related to eating and exercise. Context:  Gaps in training in these areas have been identified related to weight management and wellness. Diverse benefits of healthy lifestyle interventions have been noted. Innovation:  Recommendation for developing immersion programmes for medical students and other health professionals involving practical experience in weight management through lifestyle modification, addressing nutritional and caloric intake and energy expenditure through exercise. Implications:  Integrating healthy lifestyle programmes into medical and health professional education could yield several benefits. Enhancing curriculum and educational processes by promoting medical and health professional students’ awareness of, participation and immersion in, healthy lifestyle interventions may ultimately lead to better health outcomes for health professionals and their patients.

via Promoting health behaviours in medical education. [Clin Teach. 2013] – PubMed – NCBI.

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ABSTRACT: The military health system: a community of solutions for medical education, health care delivery, and public health.

Abstract
Multiple strategies have been proposed to improve health care in the United States. These include the development of communities of solution (COSs), implementation of patient-centered medical homes (PCMHs), and lengthening family medicine residency training. There is scant literature on how to build and integrate these ideal models of care, and no literature about how to build a model of care integrating all 3 strategies is available. The Military Health System has adopted the PCMH model and will offer some 4-year family medicine residency positions starting in 2013. Lengthening residency training to 4 years represents an unprecedented opportunity to weave experiential COS instruction throughout a family physician’s graduate medical education, providing future family physicians the skills needed to foster a COS in their future practice. This article describes our COS effort to synergize 3 aspects of modern military medicine: self-defined community populations, the transition to the PCMH model, and the initiation of the 4-year length of training pilot program in family medicine residency training. In this way we provide a starting point and general how-to guide that can be used to create a COS integrated with other current concepts in medicine.

via The military health system: a com… [J Am Board Fam Med. 2013 May-Jun] – PubMed – NCBI.

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ABSTRACT: Prioritizing health disparities in medical education to improve care.

Abstract
Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities.

via Prioritizing health disparities in medical … [Ann N Y Acad Sci. 2013] – PubMed – NCBI.

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ABSTRACT: Complementing anatomy education using 3D anatomy mobile software applications on tablet computers

Abstract
Anatomy has traditionally been a cornerstone of medical education, which has been taught via dissection and didactic lectures. The rising prevalence of mobile tablet technology means medical software applications (“apps”) play an increasingly important role in medical education. The applications highlighted in this article will aid anatomical educators to identify which are the most useful in clinical, academic, and educational environments. These have been systematically identified by downloading all applications with keywords related to anatomy and then carrying out qualitative assessment. Novel anatomy applications from developers such as Visible Body, 3D4Medical, and Pocket Anatomy allow students to visualize and manipulate complex anatomical structures using detailed 3D models. They often contain additional content including clinical correlations and a range of media from instructional videos to interactive quiz functions. The strength of tablet technology lies in its ability to consolidate and present anatomical information to the user in the most appropriate manner for their learning style. The only question mark remains over the level of detail and accuracy of these applications. Innovative medical educators who embrace tablet technology will find that anatomy applications serve as a useful learning tool when used in conjunction with existing teaching setups.

via Complementing anatomy education using three-dimens… [Clin Anat. 2013] – PubMed – NCBI.

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ABSTRACT: Getting it right: the impact of a continuing medical education program on hepatitis B knowledge of Australian primary care providers.

Abstract
INTRODUCTION:
In Australia, chronic hepatitis B (CHB) disproportionately affects migrants born in hepatitis B endemic countries, but its detection and management in high risk populations remains suboptimal. We piloted a primary care based program for CHB detection and management in an area of high disease prevalence in Sydney, Australia. Prior to its launch, all local general practitioners were invited to take part in a continuing medical education (CME) program on hepatitis B diagnosis and management.
MATERIAL AND METHODS:
Preceding each CME activity, participants completed an anonymous survey recording demographic data and hepatitis B knowledge, confidence in CHB management, and preferred CME modalities. We compared knowledge scores of first-time and repeat attendees.
RESULTS:
Most participants (75%) were males, spoke more than one language with their patients (91%), self-identified as Asian-Australians (91%), and had graduated over 20 years previously (69%). The majority (97%) knew what patient groups require CHB and hepatocellular cancer screening, but fewer (42%-75%) answered hepatitis B management and vaccination questions correctly. Knowledge scores were not significantly improved by seminar attendance and the provision of hepatitis B resources. At baseline, participants were fairly confident about their ability to screen for CHB, provide vaccinations, and manage CHB. This did not change with repeat attendances, and did not correlate with survey outcomes. Large group CMEs were the preferred learning modality.
DISCUSSION:
Knowledge gaps in hepatitis B diagnosis and management translate into missed opportunities to screen for CHB, to vaccinate those susceptible, and to prevent disease complications. The results suggest that a range of innovative CME programs are required to update general practitioners on the modern management of CHB infection.

via Getting it right: the impact of a continuing m… [Int J Gen Med. 2013] – PubMed – NCBI.

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RESOURCE: edX president on how MOOCs will change higher education

Agarwal kicks the panel off by explaining that the world has been changing at an unprecedented rate–but classrooms haven’t. Technology that was new ten years ago is already outdated today but, for some reason, the learning experience is the same as it was 50 years ago. Students still congregate in a lecture hall to listen to a professor deliver knowledge to them. Agarwal believes MOOCs can change that.

Agarwal show the audience a series of statistic from the first edX MOOC, which he co-taught (figures are rounded):

155,000 enrolled in first course
26,300 tried the first problem set
10,500 made it to the midterm
9,300 passed the midterm
8,200 took the final
7,200 received certification

via edX president on how MOOCs will change higher education | Education Dive.

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