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Author: Brian S McGowan, PhD

ABSTRACT: Modernization of an anatomy class: From conceptualization to implementation. A case for integrated multimodal-multidisciplinary teaching

Abstract
It has become increasingly apparent that no single method for teaching anatomy is able to provide supremacy over another. In an effort to consolidate and enhance learning, a modernized anatomy curriculum was devised by attempting to take advantage of and maximize the benefits from different teaching methods. Both the more traditional approaches to anatomy teaching, as well as modern, innovative educational programs were embraced in a multimodal system implemented over a decade. In this effort, traditional teaching with lectures and dissection was supplemented with models, imaging, computer-assisted learning, problem-based learning through clinical cases, surface anatomy, clinical correlation lectures, peer teaching and team-based learning. Here, we review current thinking in medical education and present our transition from a passive, didactic, highly detailed anatomy course of the past, to a more interactive, as well as functionally and clinically relevant anatomy curriculum over the course of a decade.

via Modernization of an anatomy class: Fro… [Anat Sci Educ. 2012 Nov-Dec] – PubMed – NCBI.

ABSTRACT: The use of reflection in emergency medicine education.

Abstract
Reflection is a cognitive process in which new information and experiences are integrated into existing knowledge structures and mental models, resulting in meaningful learning. Reflection often occurs after an experience is over, promoting professional development and lifelong learning. However, a reflective emergency physician (EP) is also able to apply reflection in real time: self-monitoring, coping with the unexpected, and quickly thinking on his or her feet to solve complicated, unique, and challenging clinical problems. Reflection is a skill that can be taught and developed in medical education. Evidence demonstrating the value of teaching reflection is emerging that substantiates longstanding educational theories. While a few educators have started to explore the use of reflection for emergency medicine (EM) learners, the potential for broader application exists. This review summarizes the literature regarding reflection in medical education and provides a basic primer for teaching reflection.

via The use of reflection in emergency medicine e… [Acad Emerg Med. 2012] – PubMed – NCBI.

MANUSCRIPT: Increased use of Twitter at a medical conference: a report and a review of the educational opportunities.

Abstract
BACKGROUND:
Most consider Twitter as a tool purely for social networking. However, it has been used extensively as a tool for online discussion at nonmedical and medical conferences, and the academic benefits of this tool have been reported. Most anesthetists still have yet to adopt this new educational tool. There is only one previously published report of the use of Twitter by anesthetists at an anesthetic conference. This paper extends that work.
OBJECTIVE:
We report the uptake and growth in the use of Twitter, a microblogging tool, at an anesthetic conference and review the potential use of Twitter as an educational tool for anesthetists.
METHODS:
A unique Twitter hashtag (#WSM12) was created and promoted by the organizers of the Winter Scientific Meeting held by The Association of Anaesthetists of Great Britain and Ireland (AAGBI) in London in January 2012. Twitter activity was compared with Twitter activity previously reported for the AAGBI Annual Conference (September 2011 in Edinburgh). All tweets posted were categorized according to the person making the tweet and the purpose for which they were being used. The categories were determined from a literature review.
RESULTS:
A total of 227 tweets were posted under the #WSM12 hashtag representing a 530% increase over the previously reported anesthetic conference. Sixteen people joined the Twitter stream by using this hashtag (300% increase). Excellent agreement (κ = 0.924) was seen in the classification of tweets across the 11 categories. Delegates primarily tweeted to create and disseminate notes and learning points (55%), describe which session was attended, undertake discussions, encourage speakers, and for social reasons. In addition, the conference organizers, trade exhibitors, speakers, and anesthetists who did not attend the conference all contributed to the Twitter stream. The combined total number of followers of those who actively tweeted represented a potential audience of 3603 people.
CONCLUSIONS:
This report demonstrates an increase in uptake and growth in the use of Twitter at an anesthetic conference and the review illustrates the opportunities and benefits for medical education in the future.

via Increased use of Twitter at a medical con… [J Med Internet Res. 2012] – PubMed – NCBI.

MANUSCRIPT: Impact of interactive web-based education with mobile and email-based support of general practitioners on treatment and referral patterns of patients with atopic dermatitis: randomized controlled trial.

Abstract
BACKGROUND:
The effects of various educational strategies have been examined in continuing medical education. Web-based learning has emerged as an alternative to ordinary classroom lessons.
OBJECTIVE:
To investigate whether an interactive Web-based course including personal guidance via email or cellular phone texting may be used to improve practice behavior of general practitioners in the management of atopic dermatitis.
METHODS:
General practitioners from all over Norway were eligible for this randomized controlled educational trial. During a period of 6 months, doctors in the intervention group were offered the opportunity to participate in a Web-based course on the management of atopic dermatitis. This was combined with guidance via email or multimedia messaging service (MMS) through mobile phones from a dermatologist. In the control group there was no education or guidance. Main outcome measures were the duration of topical steroid treatment prescribed to patients with atopic dermatitis (primary outcome), number of treatment modalities, and number of referred patients.
RESULTS:
We enrolled 46 physicians: 24 doctors were allocated to the intervention group and 22 doctors to the control group. They reported a total of 190 patient treatments. There were no statistically significant differences in the duration of topical steroid treatment or number of treatment modalities between the groups. The lack of effect on the primary outcome may be due to attrition as 54% (13/24) of the participants did not complete the course. 42% (10/24) of physicians sent at least one educational request via email or MMS. While 11% (8/73) of treatment reports in the intervention group were referred to a health care specialist (eg, dermatologist or pediatrician), 30% (21/71) of treatment reports in the control group did so. This difference in the number of referrals was significant (P = .03).
CONCLUSIONS:
A Web-based educational intervention aimed at general practitioners combined with personal support can reduce the number of atopic dermatitis patient referrals to specialists.

via Impact of interactive web-based education… [J Med Internet Res. 2012] – PubMed – NCBI.

ABSTRACT: A six step approach for developing computer based assessment in medical education.

Abstract
Assessment, which entails the systematic evaluation of student learning, is an integral part of any educational process. Computer-based assessment (CBA) techniques provide a valuable resource to students seeking to evaluate their academic progress through instantaneous, personalized feedback. CBA reduces examination, grading and reviewing workloads and facilitates training. This paper describes a six step approach for developing CBA in higher education and evaluates student perceptions of computer-based summative assessment at the College of Medicine, King Abdulaziz University. A set of questionnaires were distributed to 341 third year medical students (161 female and 180 male) immediately after examinations in order to assess the adequacy of the system for the exam program. The respondents expressed high satisfaction with the first Saudi experience of CBA for final examinations. However, about 50% of them preferred the use of a pilot CBA before its formal application; hence, many did not recommend its use for future examinations. Both male and female respondents reported that the range of advantages offered by CBA outweighed any disadvantages. Further studies are required to monitor the extended employment of CBA technology for larger classes and for a variety of subjects at universities.

via A six step approach for developing computer based … [Med Teach. 2013] – PubMed – NCBI.

ABSTRACT: A qualitative study on trainees’ and supervisors’ perceptions of assessment for learning in postgraduate medical education.

Abstract
Introduction: Recent changes in postgraduate medical training curricula usually encompass a shift towards more formative assessment, or assessment for learning. However, though theoretically well suited to postgraduate training, evidence is emerging that engaging in formative assessment in daily clinical practice is complex. Aim: We aimed to explore trainees’ and supervisors’ perceptions of what factors determine active engagement in formative assessment. Methods: Focus group study with postgraduate trainees and supervisors in obstetrics and gynaecology. Results: Three higher order themes emerged: individual perspectives on feedback, supportiveness of the learning environment and the credibility of feedback and/or feedback giver. Conclusion: Engaging in formative assessment with a genuine impact on learning is complex and quite a challenge to both trainees and supervisors. Individual perspectives on feedback, a supportive learning environment and credibility of feedback are all important in this process. Every one of these should be taken into account when the utility of formative assessment in postgraduate medical training is evaluated.

via A qualitative study on trainees’ and supervisors’ … [Med Teach. 2013] – PubMed – NCBI.

ABSTRACT: A retrospective and prospective look at medical education in the United States: trends shaping anatomical sciences education

Abstract
During the last decade of the 20th century and the first decade of the 21st century, curricular reform has been a popular theme. In fact, reform on the current scale has not occurred since the early 1900s, when Abraham Flexner released his landmark report ‘Medical Education in the United States and Canada’. His report, suggesting major changes in how physicians were educated, became the norm and few changes occurred until the last quarter of the 20th century. During this period increased demands on medical school curriculums due to the explosion of knowledge in biomedical sciences and the pressure to add additional clinical experiences increased the momentum for curriculum reform. In 1984 an Association of American Medical Colleges (AAMC) report, ‘Physicians for the Twenty-First Century: The Report of the Panel on the General Professional Education of the Physician (GPEP) and College Preparation for Medicine’, discussed many items related to reforming medical education including the value of integration, increased use of active learning formats, more self-directed learning, improved communication skills and increased problem-solving activities. This was followed by a report released in 1993 entitled ‘Educating Medical Students: Assessing Change in Medical Education – The Road to Implementation’ (ACME-TRI), which identified educational problems by surveying medical school deans, suggested ways to deal with these issues and presented a plan of action. Recently, the Carnegie Foundation for the Advancement of Teaching released ‘Education Physicians: A Call for Reform of Medical School and Residency’ with additional suggestions. At this point the question that might be asked is – Where is all this going and how is it going to affect anatomy education?

via A retrospective and prospective look at medical educa… [J Anat. 2013] – PubMed – NCBI.

ABSTRACT: Evaluation of GPs diagnostic knowledge and treatment practice in detection and treatment of early schizophrenia: a French postal survey in Brittany.

Abstract
AIMS:
Evaluating French general practitioners (GPs) diagnostic knowledge and practice in the detection and treatment of early schizophrenia as well as needs and preferences with specialist services.
METHODS:
A postal survey comprising 27 questions was conducted among 2,039 GPs from three counties of Western France. Composite scores were calculated to determine a level of diagnostic knowledge.
RESULTS:
A total of 515 GPs (25.3 %) responded to the survey. The mean score to determine a level of knowledge on the most important aspects in detecting early stages of schizophrenia was 5.3 ± 2.50 [median = 6 (range 0-10)]. The mean score to determine the overall knowledge of schizophrenia was 8.1 ± 2.98 [median = 8 (range 1-16)]. The majority of surveyed GPs (76.1 %) would treat early schizophrenia pharmacologically. A majority of GPs (53.9 %) advise an insufficient duration of anti-psychotic treatment for first episode psychosis. The vast majority (90.8 %) were in favour of a specialized outpatient service.
CONCLUSIONS:
French GPs tend to have a deficit in diagnostic knowledge and practice in detection and treatment of early schizophrenia. It seems important to provide GPs with continuing medical education (CME) on detection and management of early schizophrenia and to set up relevant specialized outpatient services.

via Evaluation of GPs diagnos… [Soc Psychiatry Psychiatr Epidemiol. 2013] – PubMed – NCBI.

ABSTRACT: 50 years of publication in the field of medical education.

Abstract
Background: The advent of new medical education (ME) journals makes evident the growth of the field of ME. However, the nature and context of growth is undefined. Aim: To analyze the evolution of publication in ME. Methods: MEDLINE retrieval using medical subject headings was used to analyze patterns of ME publications from 1960-2010: changes in number of ME publications; number of journals publishing ME articles; co-topics occurring frequently in ME articles; differences among journals’ publication of co-topics. Results: Annual publication of ME articles increased from 279 in 1960 to 3760 in 2010. 81 531 articles were published in 4208 different journals. 104 journals published ME articles in 1960, 855 in 2010. Despite an increase in journals in all fields, ME journals now account for a larger proportion of all journals indexed in MEDLINE than in 1960. One-quarter of all ME articles were indexed as internship/residency; 16% as graduate ME; 15% as undergraduate ME; and 14% as continuing ME. The five journals that published the most ME articles distinguished themselves by publishing some topics with greater or less frequency. Conclusions: The increase in the number of ME publications and in the number of journals publishing ME articles suggests a supportive environment for a growing field; but variation in journals’ foci has implications for readers, editors and authors.

via 50 years of publication in the field of medical ed… [Med Teach. 2013] – PubMed – NCBI.

ABSTRACT: Enhancing Quality Improvements in Cancer Care Through CME Activities at a Nationally Recognized Cancer Center.

Abstract
Changing healthcare policy will undoubtedly affect the healthcare environment in which providers function. The current Fee for Service reimbursement model will be replaced by Value-Based Purchasing, where higher quality and more efficient care will be emphasized. Because of this, large healthcare organizations and individual providers must adapt to incorporate performance outcomes into patient care. Here, we present a Continuing Medical Education (CME)-based initiative at the City of Hope National Cancer Center that we believe can serve as a model for using CME as a value added component to achieving such a goal.

via Enhancing Quality Improvements in Cancer Care … [J Cancer Educ. 2013] – PubMed – NCBI.