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Author: Brian S McGowan, PhD

ABSTRACT: National Lipid Association Annual Summary of Clinical Lipidology 2016

The National Lipid Association (NLA) Annual Summary of Clinical Lipidology is a yearly updated summary of principles important to the patient-centered evaluation, management, and care of patients with dyslipidemia. This summary is intended to be a “living document,” with future annual updates based on emerging science, clinical considerations, and new NLA Position, Consensus, and Scientific Statements, thus providing an ongoing resource that applies the latest in medical science towards the clinical management of patients with dyslipidemia. Topics include the NLA Recommendations for Patient-Centered Management of Dyslipidemia, genetics, Familial Hypercholesterolemia, secondary causes of dyslipidemia, biomarkers and advanced lipid testing, nutrition, physical activity, obesity, adiposopathy, metabolic syndrome, diabetes mellitus, lipid pharmacotherapy, lipid-altering drug interactions, lipoprotein apheresis, dyslipidemia management and treatment based upon age (children, adolescents, and older individuals), dyslipidemia considerations based upon race, ethnicity and gender, dyslipidemia and human immune virus infection, dyslipidemia and immune disorders, adherence strategies and collaborative care, and lipid-altering drugs in development. Hyperlinks direct the reader to sentinel online tables, charts, and figures relevant to lipidology, access to online atherosclerotic cardiovascular disease risk calculators, worldwide lipid guidelines, recommendations, and position/scientific statements, as well as links to online audio files, websites, slide shows, applications, continuing medical education opportunities, and patient information.

via National Lipid Association Annual Summary of Clinical Lipidology 2016. – PubMed – NCBI.

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ABSTRACT: Introducing Twitter as an assessed component of the undergraduate nursing curriculum: case study

AIMS:
To ask: (i) is it feasible to include Twitter as an assessed element of the first-year nursing curriculum; (ii) how should it be introduced and assessed; and (iii) do students think it worthwhile and learn anything from its use?
BACKGROUND:
Nursing students need to use social media professionally, avoiding pitfalls but using learning opportunities.
DESIGN:
This case study (2014-2015) comprised: (i) pilot introduction of Digital Professionalism (including Twitter) with second- and third-year students; (ii) introduction and assessment with a first cohort of 450 first-year students. Based on feedback, methods were revised for; (iii) a second cohort of 97.
METHODS:
Students received a face-to-face lecture, two webinars, used chat rooms and were asked to create course Twitter accounts and were assessed on their use.
RESULTS:
Few second and third year students started optional Twitter use whereas nearly all first years used it. Most students (70·1% first, 88·0% second cohort) thought inclusion of Twitter was worthwhile. Changes from first to second cohort included better peer-peer support, more contextualization and more emphasis on nursing communities. More second cohort students learned from Twitter (44·4% vs. 70·8%) and used Twitter recently (43·3% vs. 81·6%). Students gained wider perspectives on nursing, better understanding of social media, ‘being student nurses’ and topics like health promotion. Students mostly followed not only online nursing communities but also patient organizations.
CONCLUSION:
Including Twitter as an assessed element for first-year nursing students was feasible, students think it worthwhile and other nursing schools should consider introducing it in the broader context of Digital Professionalism.

via Introducing Twitter as an assessed component of the undergraduate nursing curriculum: case study. – PubMed – NCBI.

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ABSTRACT: Project ECHO: A new model for educating primary care providers about treatment of substance use disorders.

BACKGROUND:Project ECHO trains and mentors primary care providers (PCPs) in the care of patients with complex conditions. ECHO is a distance education model that connects specialists with numerous PCPs via simultaneous video link for the purpose of facilitating case-based learning. We describe a teleECHO clinic based at the University of New Mexico Health Sciences Center that is focused on treatment of substance use disorders (SUDs) and behavioral health disorders.METHODS:Since 2005, specialists in treatment of SUDs and behavioral health disorders at Project ECHO have offered a weekly 2-hour Integrated Addictions and Psychiatry (IAP) TeleECHO Clinic focused on supporting PCP evaluation and treatment of SUDs and behavioral health disorders. We tabulate the number of teleECHO clinic sessions, participants, and CME/CEU credits provided annually. This teleECHO clinic has also been used to recruit physicians to participate in DATA-2000 buprenorphine waiver trainings. Using a database of the practice location of physicians who received the buprenorphine waiver since 2002, we calculate the number of waivered physicians per capita in US states. We evaluate the increase in waivered physicians practicing in underserved areas in NM compared to the rest of the US.RESULTS:Since 2008, approximately 950 patient cases have been presented during the teleECHO clinic, and more than 9000 hours of CME/CEU have been awarded. Opioids are the substances discussed most commonly (31%), followed by Alcohol (21%) and Cannabis (12%). New Mexico is near the top among US states in DATA-2000 buprenorphine waivered physicians per capita, and has had much more rapid growth in waivered physicians practicing in traditionally-underserved areas compared with the rest of the US since the initiation of the teleECHO clinic focused on SUDs in 2005.CONCLUSION:The ECHO model provides an opportunity to promote expansion of access to treatment for opioid use disorder and other SUDs, particularly in underserved areas.

via Project ECHO: A new model for educating primary care providers about treatment of substance use disorders. – PubMed – NCBI.

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ABSTRACT: The Use of an Informational Video to Improve Patient Satisfaction, Preparedness, Mood, and Empowerment

BACKGROUND:
Massage therapy is commonly used in Canada for the treatment of a wide range of health concerns. Massage therapy is changing to meet the health care needs of Canadians. Rapid changes to the profession may create a gap between patient expectations of massage therapy treatment based on historic views of the profession and their experience in today’s practice. This gap could lead to patient confusion, dissatisfaction, or other negative outcomes.
PURPOSE:
This study sought to understand whether patient satisfaction, preparedness, mood, and patient empowerment are improved when new patients who attend a student massage therapy clinic watch an informational video, compared to those who receive the standard paper information sheet.
PARTICIPANTS:
The study used a convenience sample of new patients who presented for their first massage therapy appointment to the Humber College Student Massage Therapy Clinic. Participants were randomized either to the intervention group (video and paper information) or the comparison group (paper information only). The outcomes of interest in this study were patient preparedness, satisfaction, mood, and empowerment. Data were collected using two questionnaires, one before treatment and one after.
RESULTS:
A total of 108 patients participated in the study (55 comparison group; 53 intervention group). Demographic and clinical characteristics were comparable between the two groups. A statistically significant difference was seen between the two groups when comparing their responses to the pre-appointment statement: “I know what will happen in my initial massage therapy appointment” (p < .001). There was no statistically significant difference seen when comparing the responses of the related post-appointment statement (p = .63).
CONCLUSION:
This study found that an informational video improved perceived knowledge as patients entered the massage therapy treatment, but did not have a significant effect on satisfaction, mood, or patient empowerment. Other student clinics should consider the addition of an informational video to their procedures to increase patient knowledge of what to expect.

via The Use of an Informational Video to Improve Patient Satisfaction, Preparedness, Mood, and Empowerment. – PubMed – NCBI.

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MANUSCRIPT: Emotional intelligence as a crucial component to medical education.

OBJECTIVE:
The primary focus of this review was to discover what is already known about Emotional Intelligence (EI) and the role it plays within social relationships, as well as its importance in the fields of health care and health care education. This article analyzes the importance of EI in the field of health care and recommends various ways that this important skill can be built into medical programs.
METHODS:
Information was gathered using various database searches including EBSCOHOST, Academic Search Premier and ERIC. The search was conducted in English language journals from the last ten years. Descriptors include: Emotional Intelligence, medical students and communication skills, graduate medical education, Emotional Intelligence and graduate medical education, Emotional Intelligence training programs, program evaluation and development.
RESULTS:
Results of the study show a direct correlation between medical education and emotional intelligence competencies, which makes the field of medical education an ideal one in which to integrate further EI training.
CONCLUSIONS:
The definition of EI as an ability-based skill allows for training in specific competencies that can be directly applied to a specialized field. When EI is conceptualized as an ability that can be taught, learned, and changed, it may be used to address the specific aspects of the clinician-patient relationship that are not working well. For this reason, teaching EI should be a priority in the field of medical education in order to better facilitate this relationship in the future.

via Emotional intelligence as a crucial component to medical education. – PubMed – NCBI.

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ABSTRACT: Effect of Teachers Training Workshop Outcomes on Real Classroom Situations of Undergraduate Medical Students.

Faculty development by conducting regular training, workshops and research related to medical education has been a key feature to upgrade quality of medical education. Objective The aim of this study was to explore responses of the health science teachers, students and peers after the workshop after providing training on student assessment tools and teaching-learning methods. Method Two teacher-training workshops were conducted to the faculty members of B.P. Koirala Institute of Health Sciences from the departments of basic, clinical and allied sciences in Oct. 2010 and Jan. 2011. Qualitative questionnaire based study was conducted, and the questions were validated before the study by expert peer review process. The effect of the training workshop in real classroom outcomes was assessed incorporating student’s feedback, evaluation by peers and the self-evaluation by the teacher trainees. Result Pre-test and post-test scores of the participating teachers, before and after the workshop were 62.53 and 71.17 respectively. Among the participants 90.3% teachers expressed enhanced in their role as a teacher for medical undergraduates after the workshop. Conclusion In present study, the faculty members showed accrued interest to participate in teacher’s training workshops. The peer evaluation of teacher’s performance in their real classroom situations were rated higher than evaluation by the students. Therefore, such training workshops will have a greater impact on the ability of teachers in effective teaching in real classroom situations.

via Effect of Teachers Training Workshop Outcomes on Real Classroom Situations of Undergraduate Medical Students. – PubMed – NCBI.

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ABSTRACT: The effect of stress on learning in surgical skill acquisition.

BACKGROUND:
An excessive level of stress and anxiety in medical education can have a negative impact on learning. In particular, the interaction between attending surgeons and trainees in the operating room could induce stress on trainees that is counterproductive, especially if the teaching style or feedback is unduly harsh or critical.
AIM:
To characterize the effects of stress resulting from attending-trainee interaction during surgical skill acquisition.
METHODS:
Forty medical students learned to perform the FLS pattern-cutting task for the first time in one of four scenarios. In the control condition, no mentor was present. In the three experimental conditions, participants were observed, encouraged, or criticized by an expert surgeon.
RESULTS:
Task performance, as well as physiological and subjective indicators of stress, were measured. Taking both speed and accuracy into account, participants who were criticized performed the worst on the task, and those who were encouraged performed best. Physiological and subjective measures indicated that the criticized participants experienced the highest level of stress and anxiety.
CONCLUSION:
Even though providing constructive criticism to trainees is inevitable during the course of teaching, an exceedingly critical and negative mentoring style by attending physicians could be detrimental to trainees’ acquisition of surgical skills.

via The effect of stress on learning in surgical skill acquisition. – PubMed – NCBI.

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MANUSCRIPT: Evaluating the effectiveness of a peer-led education intervention to improve the patient safety attitudes of junior pharmacy students: a cross-sectional study using a latent growth curve modelling approach.

OBJECTIVE:
Despite the recognition that educating healthcare students in patient safety is essential, changing already full curricula can be challenging. Furthermore, institutions may lack the capacity and capability to deliver patient safety education, particularly from the start of professional practice studies. Using senior students as peer educators to deliver practice-based education can potentially overcome some of the contextual barriers in training junior students. Therefore, this study aimed to evaluate the effectiveness of a peer-led patient safety education programme for junior pharmacy students.
DESIGN:
A repeat cross-sectional design utilising a previously validated patient safety attitudinal survey was used to evaluate attitudes prior to, immediately after and 1 month after the delivery of a patient safety education programme. Latent growth curve (LGC) modelling was used to evaluate the change in attitudes of first-year students using second-year students as a comparator group.
SETTING:
Undergraduate university students in Sydney, Australia.
PARTICIPANTS:
175 first-year and 140 second-year students enrolled in the Bachelor of Pharmacy programme at the University of Sydney.
INTERVENTION:
An introductory patient safety programme was implemented into the first-year Bachelor of Pharmacy curriculum at the University of Sydney. The programme covered introductory patient safety topics including teamwork, communication skills, systems thinking and open disclosure. The programme consisted of 2 lectures, delivered by a senior academic, and a workshop delivered by trained final-year pharmacy students.
RESULTS:
A full LGC model was constructed including the intervention as a non-time-dependent predictor of change (χ(2) (51)=164.070, root mean square error of approximation=0.084, comparative fit index=0.913, standardised root mean square=0.056). First-year students’ attitudes significantly improved as a result of the intervention, particularly in relation to internalising errors (p=0.010), questioning behaviours (p<0.001) and open disclosure (p=0.008).
CONCLUSIONS:
Peer-led education is an effective method that can be adopted to improve junior pharmacy students’ attitudes towards patient safety.

via Evaluating the effectiveness of a peer-led education intervention to improve the patient safety attitudes of junior pharmacy students: a cross-sect… – PubMed – NCBI.

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MANUSCRIPT: Review of Simulation in Pediatrics: The Evolution of a Revolution.

Recent changes in medical education have highlighted the importance of experiential learning. Simulation is one model that has gained significant attention in the last decade and has been widely adopted as a training and assessment tool in medical education. Pediatric simulation has been utilized to teach various skills including resuscitation and trauma management, procedural skills, and team training. It is also a valuable tool for health care educators, as it allows learners to achieve competence without putting patients at risk. Recent literature demonstrates increased retention of knowledge and skills after simulation-based training. Further research is required to improve current simulation curriculums, develop validated assessment tools, and to demonstrate improved clinical outcomes after simulation-based training. We conducted an online search of original and review articles related to simulation and pediatric medical education and provide an overview of the role and utility of simulation in pediatrics. Key PointsSimulation in pediatrics has been widely accepted and adapted as a training and assessment tool in medical education.Simulation in pediatrics has been utilized to teach various skills including resuscitation and trauma management, procedural skills, and team training.Further research is required to improve current simulation curriculums, to develop validated assessment tools, and to demonstrate improved clinical outcomes after simulation-based training.

via Review of Simulation in Pediatrics: The Evolution of a Revolution. – PubMed – NCBI.

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ABSTRACT: ndividualized Performance Feedback to Surgical Residents Improves Appropriate Venous Thromboembolism Prophylaxis Prescription and Reduces Potentially Preventable VTE: A Prospective Cohort Study.

OBJECTIVE:To investigate the effect of providing personal clinical effectiveness performance feedback to general surgery residents regarding prescription of appropriate venous thromboembolism (VTE) prophylaxis.BACKGROUND:Residents are frequently charged with prescribing medications for patients, including VTE prophylaxis, but rarely receive individual performance feedback regarding these practice habits.METHODS:This prospective cohort study at the Johns Hopkins Hospital compared outcomes across 3 study periods: (1) baseline, (2) scorecard alone, and (3) scorecard plus coaching. All general surgery residents (n = 49) and surgical patients (n = 2420) for whom residents wrote admission orders during the first 9 months of the 2013-2014 academic year were included. Outcomes included the proportions of patients prescribed appropriate VTE prophylaxis, patients with preventable VTE, and residents prescribing appropriate VTE prophylaxis for every patient, and results from the Accreditation Council for Graduate Medical Education resident survey.RESULTS:At baseline, 89.4% of patients were prescribed appropriate VTE prophylaxis and only 45% of residents prescribed appropriate prophylaxis for every patient. During the scorecard period, appropriate VTE prophylaxis prescription significantly increased to 95.4% (P < 0.001). For the scorecard plus coaching period, significantly more residents prescribed appropriate prophylaxis for every patient (78% vs 45%, P = 0.0017). Preventable VTE was eliminated in both intervention periods (0% vs 0.35%, P = 0.046). After providing feedback, significantly more residents reported receiving data about practice habits on the Accreditation Council for Graduate Medical Education resident survey (87% vs 38%, P < 0.001).CONCLUSIONS:Providing personal clinical effectiveness feedback including data and peer-to-peer coaching improves resident performance, and results in a significant reduction in harm for patients.

via Individualized Performance Feedback to Surgical Residents Improves Appropriate Venous Thromboembolism Prophylaxis Prescription and Reduces Potentia… – PubMed – NCBI.

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