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Author: Brian S McGowan, PhD

ABSTRACT: Twitter in urology and other surgical specialties at global conferences

BACKGROUND:
Over recent years, Twitter has demonstrated an expanding role in scientific discussion, surgical news and conferences. This study evaluates the role of Twitter in urological conferences, with comparison to other surgical specialties.
METHODS:
A retrospective analysis of Twitter metrics during the two largest recent English-speaking conferences for each surgical specialty was performed. Using www.symplur.com, all ‘tweets’ under the official conference hashtag from 0000 hour the first day to 24.00 hour the final day were assessed. The number of impressions, ‘tweeters’ and rates of ‘tweeting’ were analysed.
RESULTS:
Nine of 18 conferences examined had official hashtags registered with Symplur Healthcare Hashtags. Plastic and urological surgery had both major conferences registered. Only one of two conferences for each cardiothoracic, general, orthopaedic, otolaryngology and paediatric was registered. Both major neurosurgical and vascular conferences were unregistered. Urological conferences were associated with significantly more Twitter activity than non-urological surgical conferences in all parameters, with greater than triple the number of impressions, tweets and ‘tweeters’. Urological surgical conferences were associated with 337% more tweets and 164% more impressions per conference day, than non-urological surgical conferences.
CONCLUSION:
Twitter has been used to supplement surgical conferences. In this regard, the urological community leads the way compared to the remainder of surgical specialty communities

via Twitter in urology and other surgical specialties at global conferences. – PubMed – NCBI.

ABSTRACT: Instant Messaging in Dental Education.

Instant messaging (IM) is when users communicate instantly via their mobile devices, and it has become one of the most preferred choices of tools to communicate amongst health professions students. The aim of this study was to understand how dental students communicate via IM, faculty members’ perspectives on using IM to communicate with students, and whether such tools are useful in the learning environment. After free-associating themes on online communication, two draft topic guides for structured interviews were designed that focussed on mobile device-related communication activities. A total of 20 students and six faculty members at the University of Birmingham School of Dentistry agreed to take part in the interviews. Students were selected from years 1-5 representing each year group. The most preferred communication tools were emails, social networking, and IM. Emails were used for more formal messages, and IM and social networking sites were used for shorter messages. WhatsApp was the most used IM app because of its popular features such as being able to check if recipients have read and received messages and group work. The students reported that changes were necessary to improve their communication with faculty members. The faculty members reported having mixed feelings toward the use of IM to communicate with students. The students wished to make such tools a permanent part of their learning environment, but only with the approval of faculty members. The faculty members were willing to accept IM as a communication tool only if it is monitored and maintained by the university and has a positive effect on learning.

via Instant Messaging in Dental Education. – PubMed – NCBI.

ABSTRACT: How can we improve teaching of ECG interpretation skills? Findings from a prospective randomised trial.

BACKGROUND:
There is an ongoing debate on how ECG interpretation should be taught during undergraduate medical training. This study addressed the impact of teaching format, examination consequences and student motivation on skills retention.
METHODS:
A total of 493 fourth-year medical students participated in a six-group, partially randomised trial. Students received three levels of teaching intensity: self-directed learning (2 groups), lectures (2 groups) or small-group peer-teaching (2 groups). On each level of teaching intensity, end-of-course written examinations (ECG exit exam) were summative in one group and formative in the other. Learning outcome was assessed in a retention test two months later.
RESULTS:
Retention test scores were predicted by summative assessments (adjusted beta 4.08; 95% CI 1.39-6.78) but not by the type of teaching. Overall performance levels and motivation did not predict performance decrease or skills retention.
CONCLUSIONS:
Summative assessments increase medium-term retention of ECG interpretation skills, irrespective of instructional format.

via How can we improve teaching of ECG interpretation skills? Findings from a prospective randomised trial. – PubMed – NCBI.

MANUSCRIPT: Knowledge and Perceptions of College Students Regarding the Physician Assistant Profession

Purpose: Physician assistants (PAs) are nationally certified and state-licensed medical professionals who practice medicine on healthcare teams with physicians and other providers. Despite the increasing popularity and utility of the profession, knowledge of the role of PAs remains scarce among many segments of the population. The purpose of this study was to determine the knowledge and perceptions of the PA profession among undergraduate college students, as well as what factors are associated with better knowledge and perception of the profession. Methods: Using a cross-sectional survey, information was gathered regarding knowledge and perception of PAs. A total of 364 students were surveyed from randomly selected undergraduate courses at a Connecticut public university. Results: Knowledge scores were significantly higher (p<0.05) in older students, female students, those with plans to pursue a healthcare career, those majoring in health and human services, and those satisfied with care received from a PA. Significantly better perceptions (p<0.05) of PAs were found in older students, those with plans for a future career in healthcare, those majoring in health and human services, those who received prior care from a PA, and those who were satisfied with prior care from a PA. After a short educational intervention, improvements in perceptions were statistically significant (p<0.001) in the surveyed population. Conclusion: This study identifies areas of needed improvement in knowledge and perception of PAs and also provides impetus for educational and marketing-based interventions to improve knowledge and perception of the PA profession in the college student population.

via Knowledge and Perceptions of College Students Regarding the Physician Assistant Profession. – PubMed – NCBI.

MANUSCRIPT: Curriculum Mapping with Academic Analytics in Medical and Healthcare Education.

BACKGROUND:
No universal solution, based on an approved pedagogical approach, exists to parametrically describe, effectively manage, and clearly visualize a higher education institution’s curriculum, including tools for unveiling relationships inside curricular datasets.
OBJECTIVE:
We aim to solve the issue of medical curriculum mapping to improve understanding of the complex structure and content of medical education programs. Our effort is based on the long-term development and implementation of an original web-based platform, which supports an outcomes-based approach to medical and healthcare education and is suitable for repeated updates and adoption to curriculum innovations.
METHODS:
We adopted data exploration and visualization approaches in the context of medical curriculum innovations in higher education institutions domain. We have developed a robust platform, covering detailed formal metadata specifications down to the level of learning units, interconnections, and learning outcomes, in accordance with Bloom’s taxonomy and direct links to a particular biomedical nomenclature. Furthermore, we used selected modeling techniques and data mining methods to generate academic analytics reports from medical curriculum mapping datasets.
RESULTS:
We present a solution that allows users to effectively optimize a curriculum structure that is described with appropriate metadata, such as course attributes, learning units and outcomes, a standardized vocabulary nomenclature, and a tree structure of essential terms. We present a case study implementation that includes effective support for curriculum reengineering efforts of academics through a comprehensive overview of the General Medicine study program. Moreover, we introduce deep content analysis of a dataset that was captured with the use of the curriculum mapping platform; this may assist in detecting any potentially problematic areas, and hence it may help to construct a comprehensive overview for the subsequent global in-depth medical curriculum inspection.
CONCLUSIONS:
We have proposed, developed, and implemented an original framework for medical and healthcare curriculum innovations and harmonization, including: planning model, mapping model, and selected academic analytics extracted with the use of data mining.

via Curriculum Mapping with Academic Analytics in Medical and Healthcare Education. – PubMed – NCBI.

ABSTRACT: Playing in the “Gutter”: Cultivating Creativity in Medical Education and Practice.

In comics, “gutters” are the empty spaces between panels that readers must navigate to weave disjointed visual sequences into coherent narratives. A gutter, however, is more than a blank space-it represents a creative zone for making connections and for constructing meaning from disparate ideas, values, and experiences.Over the course of medical training, learners encounter various “gutters” created by the disconnected subject blocks and learning experiences within the curriculum, the ambiguity and uncertainty of medical practice, and the conflicts and tensions within clinical encounters. Navigating these gutters requires not only medical knowledge and skills but also creativity, defined as the ability to make connections between disparate fragments to create meaningful, new configurations.To cultivate medical students’ creative capacity, the authors developed the Integrated Clinical Arts (ICA) program, a required component of the first-year curriculum at the Warren Alpert Medical School of Brown University. ICA workshops are designed to place students in a metaphorical gutter, wherein they can practice making connections between medicine and arts-based disciplines. By playing in the gutter, students have opportunities to broaden their perspectives, gain new insights into both medical practice and themselves, and explore different ways of making meaning. Student feedback on the ICA program highlights an important role for creativity and the arts in medicine: to transform gutters from potential learning barriers into opportunities for discovery, self-reflection, and personal growth.

via Playing in the “Gutter”: Cultivating Creativity in Medical Education and Practice. – PubMed – NCBI.

ABSTRACT: Contextual Errors in Medical Decision Making: Overlooked and Understudied

Although it is widely recognized that effective clinical practice requires attending to the circumstances and needs of individual patients-their life context-rather than just treating disease, the implications of not doing so are rarely assessed. What are, for instance, the consequences of prescribing a medication that is appropriate for treating a clinical condition but inappropriate for a particular individual either because she or he cannot afford it, lacks the skills to administer it correctly, or is unable to adhere to the regimen because of competing responsibilities such as working the night shift? Conversely, what are the gains to health and health care when such contextual factors are addressed? Finally, can performance measures be employed and developed for the clinician behaviors associated with contextualizing care to guide improvements in care? The authors have explored these questions through observational and experimental studies to define the parameters of patient context, introduce strategies for measuring clinician attention to patient context, and assess the impact of that attention on care planning, patient health care outcomes, and costs. The authors suggest that inattention to patient context is an underrecognized cause of medical error (“contextual error”), that detecting its presence usually requires listening in on the visit, and that it has significant implications for quality of care. Also described is preliminary work to reduce contextual errors. Evidence suggests that this nascent area of research has significant implications for performance assessment and medical education in addressing deficits in quality of care.

via Contextual Errors in Medical Decision Making: Overlooked and Understudied. – PubMed – NCBI.

ABSTRACT: In Pursuit of Meaningful Use of Learning Goals in Residency

PURPOSE:
Medical education aims to equip physicians for lifelong learning, an objective supported by the conceptual framework of self-regulated learning (SRL). Learning goals have been used to develop SRL skills in learners across the medical education continuum. This study’s purpose was to elicit residents’ perspectives on learning goal use and to develop explanations suggesting how aspects of the learning environment may facilitate or hinder the meaningful use of learning goals in residency.
METHOD:
Resident focus groups and program director interviews were conducted in 2012-2013, audio-recorded, and transcribed. Programs were selected to maximize diversity of size, geographic location, type of program, and current use of learning goals. Data were analyzed using the constant comparative method associated with grounded theory. Further analysis compared themes frequently occurring together to strengthen the understanding of relationships between the themes. Through iterative discussions, investigators built a grounded theory.
RESULTS:
Ninety-five third-year residents and 12 program directors at 12 pediatric residency programs participated. The analysis identified 21 subthemes grouped into 5 themes: program support, faculty roles, goal characteristics and purposes, resident attributes, and accountability and goal follow-through. Review of relationships between the themes revealed a pyramid of support with program support as the foundation that facilitates the layers above it, leading to goal follow-through.
CONCLUSIONS:
Program support facilitates each step of the SRL process that leads to meaningful use of learning goals in residency. A strong foundation of program support should include attention to aspects of the implicit curriculum as well as the explicit curriculum.

via In Pursuit of Meaningful Use of Learning Goals in Residency: A Qualitative Study of Pediatric Residents. – PubMed – NCBI.

ABSTRACT: Entrustment Decision Making in Clinical Training.

The decision to trust a medical trainee with the critical responsibility to care for a patient is fundamental to clinical training. When carefully and deliberately made, such decisions can serve as significant stimuli for learning and also shape the assessment of trainees. Holding back entrustment decisions too much may hamper the trainee’s development toward unsupervised practice. When carelessly made, however, they jeopardize patient safety. Entrustment decision-making processes, therefore, deserve careful analysis.Members (including the authors) of the International Competency-Based Medical Education Collaborative conducted a content analysis of the entrustment decision-making process in health care training during a two-day summit in September 2013 and subsequently reviewed the pertinent literature to arrive at a description of the critical features of this process, which informs this article.The authors discuss theoretical backgrounds and terminology of trust and entrustment in the clinical workplace. The competency-based movement and the introduction of entrustable professional activities force educators to rethink the grounds for assessment in the workplace. Anticipating a decision to grant autonomy at a designated level of supervision appears to align better with health care practice than do most current assessment practices. The authors distinguish different modes of trust and entrustment decisions and elaborate five categories, each with related factors, that determine when decisions to trust trainees are made: the trainee, supervisor, situation, task, and the relationship between trainee and supervisor. The authors’ aim in this article is to lay a theoretical foundation for a new approach to workplace training and assessment.

via Entrustment Decision Making in Clinical Training. – PubMed – NCBI.

ABSTRACT: Professional dermatology societies in the USA: an overview

This is a concise overview in a table format for the current membership-based dermatology societies in the USA. The primary objective of these societies is to provide continuous medical education. These societies serve all health care providers in dermatology care, including physician assistants and nurses. There is a clear need for establishing more societies which focus on different aspect of dermatology. There is always a potential for improving the educational activities of these societies.

via Professional dermatology societies in the USA: an overview. – PubMed – NCBI.