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Author: Brian S McGowan, PhD

ABSTRACT: Globalization and the modernization of medical education.

Abstract
BACKGROUND:
Worldwide, there are essential differences underpinning what educators and students perceive to be effective medical education. Yet, the world looks on for a recipe or easy formula for the globalization of medical education.
AIMS:
This article examines the assumptions, main beliefs, and impact of globalization on medical education as a carrier of modernity.
METHODS:
The article explores the cultural and social structures for the successful utilization of learning approaches within medical education. Empirical examples are problem-based learning (PBL) at two medical schools in Jamaica and the Netherlands, respectively.
RESULTS:
Our analysis shows that people do not just naturally work well together. Deliberate efforts to build group culture for effective and efficient collaborative practice are required. Successful PBL is predicated on effective communication skills, which are culturally defined in that they require common points of understanding of reality. Commonality in cultural practices and expectations do not exist beforehand but must be clearly and deliberately created.
CONCLUSIONS:
The globalization of medical education is more than the import of instructional designs. It includes Western models of social organization requiring deep reflection and adaptation to ensure its success in different environments and among different groups.

via Globalization and the modernization of medical edu… [Med Teach. 2012] – PubMed – NCBI.

ABSTRACT: Connecting to the Future: Telepsychiatry in Postgraduate Medical Education.

Abstract
Abstract Objective: This study characterized and examined factors influencing psychiatry residents’ and fellows’ interest, exposure, and future plans to use telepsychiatry. Subjects and Methods: A 17-item electronic survey was distributed to 485 psychiatry residency and fellowship programs in the United States. Each program director or administrator was asked to voluntarily distribute the survey to his or her trainees. Chi-squared tests were performed to test differences in proportions. Stepwise multivariate logistic regression was used to model outcomes of interest. Results: In total, 283 respondents completed the survey. A majority of respondents were interested in telepsychiatry and felt that it was an important part of training. Of the 50 respondents who had clinical exposure to telepsychiatry and completed the survey, most reported that their experience increased their interest level, and two-thirds reported having either a one-time encounter or less than 6 h of multiple patient experiences via telepsychiatry. Clinical exposure to telepsychiatry was significantly related to level of training (p=0.001) and program location (p=0.005). Residents in their postgraduate year (PGY) 4 or fellowship were 2.6 times more likely to be exposed to clinical telepsychiatry than PGY 1-3 residents (95% confidence interval [CI] 1.41-4.95). Residents and fellows in rural programs were 4.3 times more likely to be exposed than those in urban or suburban settings (95% CI 1.07-17.28). Factors affecting trainees’ plans to use telepsychiatry in their future practice include program location (p=0.013) and interest level (p<0.001). Residents and fellows in rural locations were 9.3 times more likely to report future plans to use telepsychiatry (95% CI 1.88-45.71). Conclusions: There is a practice gap between resident interest and resident exposure to telepsychiatry. Training programs should consider incorporating a brief telepsychiatry experience to fulfill both resident interest and the growing demand for psychiatrists.

via Connecting to the Future: Telepsychiatry … [Telemed J E Health. 2013] – PubMed – NCBI.

MANUSCRIPT: Reforming Premedical Education — Out with the Old, in with the New

The most consistent and strident calls for medical education reform over the past century have focused on premedical preparation. The first attempt at standardizing requirements for medical school admission came in 1904 from the American Medical Association’s Council on Medical Education. In 1910, Abraham Flexner recommended requiring biology, chemistry, botany, and physics, and by 1930, today’s premedical science preparation — biology, chemistry, organic chemistry, and physics — was firmly established. But criticism began as early as 1929, and in 1939 the Association of American Medical Colleges weighed in.1
Recent years have seen many calls for enhancing, overhauling, or abolishing the traditional premed requirements.1-3 Critics argue that the pace of scientific discovery and its clinical application have outstripped the requirements; that information technology has made memorizing vast amounts of content unnecessary; that the requirements lack clinical, scientific, and social relevance; that they’re used to cull the herd of talented aspiring physicians; that they disadvantage minority and female students; that they crowd out studies of bioethics, social justice, and health policy; and that rigidly structured premedical and medical school curricula hinder students from becoming self-directed lifelong learners.1-4 Furthermore, the current model has perpetuated “premed syndrome,” a culture of aggressive competition for grades that conflicts with the precepts of medical professionalism: academic and intellectual rigor, creative thinking, collaboration, and social conscience.2
Various solutions have been proposed, but little substantive change has occurred. Universities are neither equipped nor motivated to create new courses for medical school preparation. They have limited resources, siloed departments, educational inertia, and faculty with ingrained teaching habits.3

via Reforming Premedical Education — Out with the Old, in with the New — NEJM.

MANUSCRIPT: Clinician uptake of obesity-related drug information: A qualitative assessment using continuing medical education activities.

Abstract
BACKGROUND:
Medications necessary for disease management can simultaneously contribute to weight gain, especially in children. Patients with preexisting obesity are more susceptible to medication-related weight gain.How equipped are primary care practitioners at identifying and potentially reducing medication-related weight gain? To inform this question germane to public health we sought to identify potential gaps in clinician knowledge related to metabolic adverse drug effects of weight gain.
METHODS:
The study analyzed practitioner responses to the pre-activity questions of six continuing medical education (CME) activities from May 2009 through August 2010.
RESULTS:
The 20,705 consecutive, self-selected respondents indicated varied levels of familiarity with adverse metabolic effects and psychiatric indications of atypical antipsychotics. Correct responses were lower than predicted for drug indications pertaining to autism (-17% predicted); drug effects on insulin resistance (-62% predicted); chronic disease risk in mental illness (-34% predicted); and drug safety research (-40% predicted). Pediatrician knowledge scores were similar to other primary care practitioners.
CONCLUSIONS:
Clinicians’ knowledge of medication-related weight gain may lead them to overestimate the benefits of a drug in relation to its metabolic risks. The knowledge base of pediatricians appears comparable to their counterparts in adult medicine, even though metabolic drug effects in children have only become prevalent recently.

via Clinician uptake of obesity-related drug information:… [Nutr J. 2013] – PubMed – NCBI.

ABSTRACT: AOA Continuing Medical Education

Abstract
The author provides an update on the current continuing medical education (CME) cycle, which began on January 1, 2013, and will end on December 31, 2015. The author also details the changes to the CME guide for osteopathic physicians, the requirements for Category 1 CME sponsors accredited by the American Osteopathic Association (AOA), and new online CME opportunities. Topic areas include recent changes in CME policies and the continuing challenges associated with awarding and recording CME credits for osteopathic physicians who hold specialty board certification. In addition, the article provides an update for osteopathic specialists and subspecialists in requesting AOA Category 1-A credit for American Medical Association Physician’s Recognition Award Category 1 courses.

via AOA Continuing Medical Education. [J Am Osteopath Assoc. 2013] – PubMed – NCBI.

ABSTRACT: Local social knowledge management: A case study of social learning and knowledge sharing across organizational boundaries

Abstract

Knowledge management is normally approached in the context of a single organization’s activities. Recently the focus has been extended to activities which span beyond organizational boundaries, especially to the key role of social learning across organizations. The concept of ‘local social knowledge management’ has been used to stress the process of social learning in regional networking. This study describes the local social knowledge management in a regional development project. The knowledge sharing and creation practices in the theme groups of the project are described and particular attention is paid to the evolution of the social learning process. Three distinct but interdependent forms of knowledge sharing and creation were identified in networking. Operational networking helped people manage the current project responsibilities while strategic networking opened pathways to the future. The third form of networking boosted the personal development of project participants even when the cooperation was not continuing. The results show that there can be more accurate models in knowledge management research if the viewpoint is shifted to broader contexts where people normally interact.

via Local social knowledge management: A case study of social learning and knowledge sharing across organizational boundaries.

ABSTRACT: Web link-based relationships among top European universities

Abstract

In this paper, an analysis of interlinking between 100 major European universities is given. Since websites contain links to webpages for other organizations, they may reveal the strongest relationships established between two organizations. This analysis of web links allowed us to determine the different behaviours among the universities with regard to incoming or outgoing web links; some universities had significantly greater incoming than outgoing activity. In general, there was a low level of interaction between the universities studied. Also, we observed the existence of geographic–linguistic patterns in establishing links. Five primary nuclei or blocks of universities can be identified: the group composed almost exclusively of universities from the UK; the group composed in large part of German universities, along with some from Switzerland and Austria; the cluster of universities from Mediterranean countries, including various French universities; the group of Belgian and Dutch universities, along with some from French-speaking Switzerland; and finally, the group made up of universities from the Nordic countries. Although there are some universities that overlap with several groups or clusters, the overall design is rather clear. On the other hand, the whole picture seems to agree with the results of other studies based on bibliographic co-authorship production.

via Web link-based relationships among top European universities.

Team Innovation Processes

Abstract

This study investigates cycles of planning, enacting, and reviewing activities over time in teams engaged in creative projects. Drawing on longitudinal case studies of two interactive media development teams, two distinct cycles of planning, enacting, and reviewing activities are identified: experimentation cycles and validation cycles. Experimentation cycles are discovery-oriented processes where teams gather insights into project requirements, constraints, and design specifications through trial-and-error. Validation cycles are correction-oriented processes where teams align their output with project requirements through incremental modifications. These findings are then built on to develop testable propositions about the relationship between the duration of planning, enacting, and reviewing activities and the innovativeness and quality of team outcomes.

via Team Innovation Processes.

ABSTRACT: Online Medical Professionalism: Patient and Public Relationships: Policy Statement From the American College of Physicians and the Federation of State Medical Boards.

Abstract: User-created content and communications on Web-based applications, such as networking sites, media sharing sites, or blog platforms, have dramatically increased in popularity over the past several years, but there has been little policy or guidance on the best practices to inform standards for the professional conduct of physicians in the digital environment. Areas of specific concern include the use of such media for nonclinical purposes, implications for confidentiality, the use of social media in patient education, and how all of this affects the publics trust in physicians as patient-physician interactions extend into the digital environment. Opportunities afforded by online applications represent a new frontier in medicine as physicians and patients become more connected. This position paper from the American College of Physicians and the Federation of State Medical Boards examines and provides recommendations about the influence of social media on the patient-physician relationship, the role of these media in public perception of physician behaviors, and strategies for physician-physician communication that preserve confidentiality while best using these technologies.

via Online Medical Professionalism: Patient and P… [Ann Intern Med. 2013] – PubMed – NCBI.

ABSTRACT: A centralized research data repository enhances retrospective outcomes research capacity: a case report

Abstract
This paper describes our considerations and methods for implementing an open-source centralized research data repository (CRDR) and reports its impact on retrospective outcomes research capacity in the urology department at Columbia University. We performed retrospective pretest and post-test analyses of user acceptance, workflow efficiency, and publication quantity and quality (measured by journal impact factor) before and after the implementation. The CRDR transformed the research workflow and enabled a new research model. During the pre- and post-test periods, the department’s average annual retrospective study publication rate was 11.5 and 25.6, respectively; the average publication impact score was 1.7 and 3.1, respectively. The new model was adopted by 62.5% (5/8) of the clinical scientists within the department. Additionally, four basic science researchers outside the department took advantage of the implemented model. The average proximate time required to complete a retrospective study decreased from 12 months before the implementation to <6 months after the implementation. Implementing a CRDR appears to be effective in enhancing the outcomes research capacity for one academic department.

via A centralized research data repository enhances retrospective outcomes research capacity: a case report — Hruby et al. 20 (3): 563 — Journal of the American Medical Informatics Association.