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Author: Brian S McGowan, PhD

ABSTRACT: Medical Education in the Electronic Medical Record (EMR) Era: Benefits, Challenges, and Future Directions

Abstract
In the last decade, electronic medical record (EMR) use in academic medical centers has increased. Although many have lauded the clinical and operational benefits of EMRs, few have considered the effect these systems have on medical education. The authors review what has been documented about the effect of EMR use on medical learners through the lens of the Accreditation Council for Graduate Medical Education’s six core competencies for medical education. They examine acknowledged benefits and educational risks to use of EMRs, consider factors that promote their successful use when implemented in academic environments, and identify areas of future research and optimization of EMRs’ role in medical education.

via Medical Education in the Electronic Medical Record … [Acad Med. 2013] – PubMed – NCBI.

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ABSTRACT: Metric-based simulation training to proficiency in medical education:- What it is and how to do it.

Abstract
High profile error cases and reduced work hours have forced medicine to consider new approaches to training. Simulation-based learning for the acquisition and maintenance of skills has a growing role to play. Considerable advances have been made during the last 20 years on how simulation should be used optimally. Simulation is also more than a technology learning experience for supplanting the traditional approach of repeated practice. Research has shown that simulation works best when it is integrated into a curriculum. Learning is optimal when trainees receive metric-based feedback on their performance. Metrics should unambiguously characterize important aspects of procedure or skill performance. They are developed from a task analysis of the procedure or skills to be learned. The outcome of the task analysis should also shape how the simulation looks and behaves. Metric-based performance characterization can be used to establish a benchmark i.e., a level of proficiency which trainees must demonstrate before training progression. This approach ensures a more homogeneous skill-set in graduating trainees and can be applied to any level of training. Prospective, randomized and blinded clinical studies have shown that trainees who acquired their skills to a level of proficiency on a simulator in the skills laboratory perform significantly better in vivo in comparison to their traditionally trained colleagues. The Food and Drug Administration in the USA and the Department of Health in the UK have candidly indicated that they see an emergent and fundamental role for simulation-based training. Although a simulation-based approach to medical education and training may be conceptually and intellectually appealing it represents a paradigm shift in how doctors are educated and trained.

via Metric-based simulation training to proficiency… [Ulster Med J. 2012] – PubMed – NCBI.

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ABSTRACT: Leveraging Social Networks for Toxicovigilance

Abstract
The landscape of drug abuse is shifting. Traditional means of characterizing these changes, such as national surveys or voluntary reporting by frontline clinicians, can miss changes in usage the emergence of novel drugs. Delays in detecting novel drug usage patterns make it difficult to evaluate public policy aimed at altering drug abuse. Increasingly, newer methods to inform frontline providers to recognize symptoms associated with novel drugs or methods of administration are needed. The growth of social networks may address this need. The objective of this manuscript is to introduce tools for using data from social networks to characterize drug abuse. We outline a structured approach to analyze social media in order to capture emerging trends in drug abuse by applying powerful methods from artificial intelligence, computational linguistics, graph theory, and agent-based modeling. First, we describe how to obtain data from social networks such as Twitter using publicly available automated programmatic interfaces. Then, we discuss how to use artificial intelligence techniques to extract content useful for purposes of toxicovigilance. This filtered content can be employed to generate real-time maps of drug usage across geographical regions. Beyond describing the real-time epidemiology of drug abuse, techniques from computational linguistics can uncover ways that drug discussions differ from other online conversations. Next, graph theory can elucidate the structure of networks discussing drug abuse, helping us learn what online interactions promote drug abuse and whether these interactions differ among drugs. Finally, agent-based modeling relates online interactions to psychological archetypes, providing a link between epidemiology and behavior. An analysis of social media discussions about drug abuse patterns with computational linguistics, graph theory, and agent-based modeling permits the real-time monitoring and characterization of trends of drugs of abuse. These tools provide a powerful complement to existing methods of toxicovigilance.

via Leveraging Social Networks for Toxicovigilance. [J Med Toxicol. 2013] – PubMed – NCBI.

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MANUSCRIPT: Social Media Use in Medical Education: A Systematic Review

Purpose: The authors conducted a systematic review of the published literature on social media use in medical education to answer two questions: (1) How have interventions using social media tools affected outcomes of satisfaction, knowledge, attitudes, and skills for physicians and physicians-in-training? and (2) What challenges and opportunities specific to social media have educators encountered in implementing these interventions?

Method: The authors searched the MEDLINE, CINAHL, ERIC, Embase, PsycINFO, ProQuest, Cochrane Library, Web of Science, and Scopus databases (from the start of each through September 12, 2011) using keywords related to social media and medical education. Two authors independently reviewed the search results to select peer-reviewed, English-language articles discussing social media use in educational interventions at any level of physician training. They assessed study quality using the Medical Education Research Study Quality Instrument.

Results: Fourteen studies met inclusion criteria. Interventions using social media tools were associated with improved knowledge (e.g., exam scores), attitudes (e.g., empathy), and skills (e.g., reflective writing). The most commonly reported opportunities related to incorporating social media tools were promoting learner engagement (71% of studies), feedback (57%), and collaboration and professional development (both 36%). The most commonly cited challenges were technical issues (43%), variable learner participation (43%), and privacy/security concerns (29%). Studies were generally of low to moderate quality; there was only one randomized controlled trial.

Conclusions: Social media use in medical education is an emerging field of scholarship that merits further investigation. Educators face challenges in adapting new technologies, but they also have opportunities for innovation.

Social Media Use in Medical Education - A Systematic Review

via Social Media Use in Medical Education: A Systematic Review : Academic Medicine.

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RESOURCE: Proving dissemination is only one half of your impact story: Twitter provides proof of real-time engagement with the public

Especially in arts and humanities disciplines which may not have readily quantifiable economic benefits, the movement of research from academic to public discourse may be a key component of an impact statement. For REF 2014, impact is defined as “an effect on, change or benefit to the economy, society, culture, public policy or services, health, the environment or quality of life, beyond academia.” Researchers are increasingly encouraged to share their research “beyond academia” as a way of demonstrating their contribution to society at large. Research insights may, in the first instance at least, be interesting to people in their own right even if not more instrumentally significant.

via Proving dissemination is only one half of your impact story: Twitter provides proof of real-time engagement with the public | Impact of Social Sciences.

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ABSTRACT: Physicians who use social media and other internet-based communication technologies.

AbstractThe demographic and practice-related characteristics of physicians who use social networking websites, portable devices to access the internet, email to communicate with patients, podcasts, widgets, RSS feeds, and blogging were investigated. Logistic regression was used to analyze a survey of US primary care physicians, pediatricians, obstetrician/gynecologists, and dermatologists N=1750. Reported technology use during the last 6 months ranged from 80.6% using a portable device to access the internet to 12.9% writing a blog. The most consistent predictors of use were being male, being younger, and having teaching hospital privileges. Physician specialty, practice setting, years in practice, average number of patients treated per week, and number of physicians in practice were found to be inconsistently associated or unassociated with use of the technologies examined. Demographic characteristics, rather than practice-related characteristics, were more consistent predictors of physician use of seven internet-based communication technologies with varying levels of uptake.

via Physicians who use social medi… [J Am Med Inform Assoc. 2012 Nov-Dec] – PubMed – NCBI.

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MANUSCRIPT: Using databases in medical education research: AMEE Guide No. 77

Abstract
This AMEE Guide offers an introduction to the use of databases in medical education research. It is intended for those who are contemplating conducting research in medical education but are new to the field. The Guide is structured around the process of planning your research so that data collection, management and analysis are appropriate for the research question. Throughout we consider contextual possibilities and constraints to educational research using databases, such as the resources available, and provide concrete examples of medical education research to illustrate many points. The first section of the Guide explains the difference between different types of data and classifying data, and addresses the rationale for research using databases in medical education. We explain the difference between qualitative research and qualitative data, the difference between categorical and quantitative data, and the difference types of data which fall into these categories. The Guide reviews the strengths and weaknesses of qualitative and quantitative research. The next section is structured around how to work with quantitative and qualitative databases and provides guidance on the many practicalities of setting up a database. This includes how to organise your database, including anonymising data and coding, as well as preparing and describing your data so it is ready for analysis. The critical matter of the ethics of using databases in medical educational research, including using routinely collected data versus data collected for research purposes, and issues of confidentiality, is discussed. Core to the Guide is drawing out the similarities and differences in working with different types of data and different types of databases. Future AMEE Guides in the research series will address statistical analysis of data in more detail.

http://informahealthcare.com/doi/pdf/10.3109/0142159X.2013.785632

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RESOURCE: The MOOC School of Medicine

The pedagogical advances occurring in the world of education are certainly fast paced. Didactic lecture hall teaching is now outdated courtesy of problem and team based learning in addition to the novel approach of the ‘flipped classroom’.

With the advent of technology and emphasis on E and M learning, we are now experiencing an era of continuous educational revolution with MOOC’s being evident of this phenomenon. Such massive open online courses have sparked from the fact that in the vast majority of cases people are often unable to gain education from world renowned institutions if not physically resident in such areas or unable to gain education due to issues allied to affordability.

via MedEdWorld – The MOOC School of Medicine.

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ReachMD Interview: “Understanding Personal Learning Strategies in Medical Education”

A few weeks back I had the pleasure of being interviewed by Lawrence Sherman as part of the ReachMD lifelong learning series produced in conjunction with the Alliance for CEhp.  The interview is airing all this week on ReachMD (channel 167 on SiriusXM) and the podcast is available for download on ReachMD.com (after registering). The interview touches on a number of topics related to how clinicians form questions in practice, how they structure their learning opportunities, and (of course) the natural learning actions model.

Here is the summary of the interview as described on the reachMD site:

Physicians and other medical professionals face an endless array of options for how to approach their own continuing education throughout their clinical careers. But there is a science behind learning behaviors that can help improve the quality of clinical education at the individual level. How is this science being investigated, and what are the practical applications for lifelong learning? Join host Lawrence Sherman in welcoming Dr. Brian McGowan, Chief Learning Officer of ArcheMedX, Inc, to consider this personalized CME movement and its potential impacts on medical careers.

Enjoy!

[soundcloud url=”http://api.soundcloud.com/tracks/89035260%3Fsecret_token%3Ds-fpL0o” params=”” width=” 100%” height=”166″ iframe=”true” /]

 

The interview will air 20 times this week (All times Eastern)

Monday 2:40 AM, 2:40 PM and 7:00 AM, 7:00 PMREACHMD logo
Tuesday 12:40 AM, 12:40 PM and 5:00 AM, 5:00 PM
Wednesday 10:40 AM, 10:40 PM and 3:00 AM, 3:00 PM
Thursday 8:40 AM, 8:40 PM and 1:00 AM, 1:00 PM
Friday 6:40 AM, 6:40 PM and 11:00 AM, 11:00 PM

For what it is worth, I recommend the entire series and would love to see more of this broad sharing and dissemination being leveraged across the medical education community.  Kudos to the Alliance and ReachMD for continuing this series, and here’s hoping that we can build this out over time.

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ABSTRACT: Barriers to Improving Primary Care of Depression

Using clinical trials, researchers have demonstrated effective methods for treating depression in primary care, but improvements based on these trials are not being implemented. This might be because these improvements require more systematic organizational changes than can be made by individual physicians. We interviewed 82 physicians and administrative leaders of 41 medical groups to learn what is preventing those organizational changes. The identified barriers to improving care included external contextual problems reimbursement, scarce resources, and access to/communication with specialty mental health, individual attitudes physician and patient resistance, and internal care process barriers organizational and condition complexity, difficulty standardizing and measuring care. Although many of these barriers are challenging, we can overcome them by setting clear priorities for change and allocating adequate resources. We must improve primary care of depression if we are to reduce its enormous adverse social and economic impacts.

via Barriers to Improving Primary Care of Depression.

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