MENUCLOSE

 

Connect with us

Author: Brian S McGowan, PhD

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.

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.

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.

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.

ABSTRACT: The ERCP Quality Network A Pilot Study of Benchmarking Practice and Performance

There is increasing interest in the quality of endoscopic practice and in documenting it. Endoscopic retrograde cholangiopancreatography (ERCP) is the most complex and risky procedure performed regularly by gastroenterologists. The goal was to test the acceptability and functioning of a voluntary system for individual endoscopists to report details of their ERCP cases and to compare them with unidentified peers. Participants were compared by site of practice, procedure complexity, volumes, durations, and selected technical success rates. There was no independent audit. A total of 63 endoscopists in the United States entered data on 18 182 procedures over 3 years. Results in academic and community practices were similar, but there were significant and expected differences in the complexity of practice and key quality metrics between endoscopists performing more than and fewer than 100 cases per year. The study provided useful data on variations in ERCP practice in the United States and will assist in planning the development of national projects in this field.

via The ERCP Quality Network.

ABSTRACT: Improving Resident Engagement in Quality Improvement and Patient Safety Initiatives at the Bedside The Advocate for Clinical Education (ACE)

Quality improvement (QI) and patient safety (PS) are essential competencies in residency training; however, the most effective means to engage physicians remains unclear. The authors surveyed all medicine and surgery physicians at their institution to describe QI/PS practices and concurrently implemented the Advocate for Clinical Education (ACE) program to determine if a physician-centered program in the context of educational structures and at the point of care improved performance. The ACE rounded with medicine and surgery teams and provided individual and team-level education and feedback targeting 4 domains: professionalism, infection control, interpreter use, and pain assessment. In a pilot, the ACE observed 2862 physician-patient interactions and 178 physicians. Self-reported compliance often was greater than the behaviors observed. Following ACE implementation, observed professionalism behaviors trended toward improvement; infection control also improved. Physicians were highly satisfied with the program. The ACE initiative is one coaching/feedback model for engaging residents in QI/PS that may warrant further study.

via Improving Resident Engagement in Quality Improvement and Patient Safety Initiatives at the Bedside.

ABSTRACT: Integrating Quality Improvement Into Continuing Medical Education Activities Within a Community Hospital System

The integration of the Mercy Health System’s quality improvement (QI) and continuing medical educational (CME) activities is described. With the implementation of computerized medical data, the opportunities for QI-focused CME are growing. The authors reviewed their regularly scheduled series and special CME programs to assess their impact on quality care processes. Clinical improvements were affected by combining national guidelines and advancements with local clinical data and interactions with physicians within interdisciplinary as well as specialty conferences. Case-based, multidisciplinary conferences lent themselves to this process to a greater extent than didactic conferences. The latter also could lead to QI when the topics were focused on specific quality initiatives that often are part of a national QI initiative. Although the authors consider these efforts to be at an intermediate stage of development, they have observed several QI/patient safety process improvements.

via Integrating Quality Improvement Into Continuing Medical Education Activities Within a Community Hospital System.

ABSTRACT: Delivering Influenza Vaccine to High-Risk Adults Subspecialty Physician Practices

Influenza is responsible for significant morbidity and mortality in the United States. Despite long-standing national recommendations, only 47% of adults with a high-risk condition received the influenza vaccine in 2009-2010. Subspecialty practices provide a significant portion of ambulatory care visits for high-risk adults and understanding their role in the immunization infrastructure may increase immunization rates, decrease public health burden, and reduce influenza-associated disease. A cross-sectional survey of cardiology, pulmonology, and obstetrics/gynecology practices was conducted to assess influenza vaccination practices, plans, patient acceptance, frustrations, and reasons for not vaccinating. It was found that 51% of respondents planned to vaccinate patients. Plans differed significantly by practice type. Practices that do not vaccinate generally recommend vaccination and refer patients to public health clinics, primary care, and pharmacies.   Administrative and patient-related barriers affected most practices, but practices that vaccinate were able to overcome these barriers. Improvements in vaccination may be addressed by adapting practice support services for subspecialty practices.

via Delivering Influenza Vaccine to High-Risk Adults.

ABSTRACT: Teaching Quality Essentials The Effectiveness of a Team-Based Quality Improvement Curriculum in a Tertiary Health Care Institution

A unique quality improvement (QI) curriculum was implemented within the Division of General Internal Medicine to improve QI knowledge through multidisciplinary, team-based education, which also met the QI requirement for the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) and the Mayo Quality Fellows program. Participants completed up to 4 QI learning modules, including pretest and posttest assessments. A participant who successfully completed all 4 modules received certification as a Silver Quality Fellow and credit toward the quality requirement for ABIM MOC. Of 62 individuals invited to participate, 33 (53%) completed all 4 modules and corresponding pretests and posttests. Participants substantially improved knowledge in all 4 quality modules. Study group participants’ pretest scores averaged 71.0%, and their posttest scores averaged 92.7%. Posttest scores of reference group participants compared favorably, averaging 89.2%. Initial assessments showed substantial knowledge improvements and successful implementation of staff-developed QI projects.

via Teaching Quality Essentials.

ABSTRACT: Impacts of Organizational Context on Quality Improvement

Abstract

Variation in how hospitals perform on similar quality improvement (QI) efforts argues for a need to understand how different organizational characteristics affect QI performance. The objective of this study was to use data-mining methods to evaluate relationships between measures of organizational characteristics and hospital QI performance. Organizational characteristics were extracted from 2 surveys and analyzed in 3 separate decision-tree models. The decision trees did not find any predictive associations in this sample of 100 hospitals participating in a national QI collaborative. Further model review identified that measures of QI Experience were associated with an ability to make improvements, whereas measures of Staffing and Culture were associated with an ability to sustain improvements. A key area for future research is to understand the challenges faced as QI teams transition from improving care to sustaining quality and to ascertain what organizational characteristics can best overcome those challenges.

via Impacts of Organizational Context on Quality Improvement.