MENUCLOSE

 

Connect with us

Author: Brian S McGowan, PhD

ABSTRACT: The effect of physician continuing medical education on patient-reported outcomes for identifying and optimally managing obstructive sleep apnea.

STUDY OBJECTIVE:
To evaluate the effect of continuing medical education (CME) activities on patient reported outcomes with regard to (1) screening for excessive sleepiness (ES) and obstructive sleep apnea (OSA) and (2) appropriate referral and treatment.
METHODS:
A total of 725 patients were recruited from 75 providers who either participated or did not participate in Transtheoretical Model (TTM)-based OSA CME activities. Patient reported outcomes from participating (n = 36) and non-participating providers (n = 39) were compared using generalized estimating equations examining random effects of provider as unit of assignment.
RESULTS:
Patients’ reports demonstrate that participating physicians were 1.7 times more likely to initiate discussion of sleep problems than non-participating physicians (t1,411 = 3.71, p = 0.05) and 2.25-2.86 times more likely to administer validated measures for OSA (Epworth Sleepiness Scale and STOP-BANG). Patient reports also indicated that participating clinicians (79.9%) were significantly more likely to recommend seeing a sleep specialist compared to non-participating clinicians (60.7%; t1,348 = 9.1, p < 0.01, OR = 2.6). Furthermore, while 89.4% of participating clinicians recommended a sleep study, only 73.2% of the non-participating physicians recommended one (t1,363 = 11.46, p < 0.001, OR = 3.1).
CONCLUSIONS:
Participation in TTM-based OSA CME activities was associated with improved patient reported outcomes compared to the non-participating clinicians.

via The effect of physician continuing medical education on patient-reported outcomes for identifying and optimally managing obstructive sleep apnea. – PubMed – NCBI.

ABSTRACT: The effect of using an audience response system on learning, motivation and information retention in the orthodontic teaching of undergraduate dental students: a cross-over trial.

OBJECTIVE:
New methods of teaching and learning are constantly being sought in the adult learning environment. Audience Response Systems (ARS) have been used in many different learning environments, especially in the field of medical education. The objective of this investigation was to ascertain the effect of ARS use in undergraduate teaching in a UK dental school.
DESIGN:
A cross-over clustered randomized educational trial.
SETTING:
Leeds Dental Institute.
PARTICIPANTS:
Year 4 undergraduate dental students in orthodontics.
METHODS:
Students at Leeds Dental Institute were taught two different topics within the curriculum to test the use of ARS in a cross-over trial. A questionnaire was delivered to the test (ARS) and control (non-ARS) groups.
RESULTS:
The response rate to the questionnaires was 89·5% (test group) and 82·9% (control group). The ARS enabled students to perform better as shown by knowledge retention (P = 0·013). Students found the seminar more interesting (P = 0·013), easier to concentrate (P = 0·025) and easier to participate in (P = 0·020) when ARS was used. When ARS was used, students were more able to answer questions (P<0·0001), were more likely to prepare for the seminar (P<0·0001) and significantly preferred using ARS (P<0·0001).
CONCLUSIONS:
ARS was found to significantly improve student concentration and participation in small group seminar teaching and significantly improved knowledge retention. ARS may be useful in facilitating orthodontic teaching in the future.

via The effect of using an audience response system on learning, motivation and information retention in the orthodontic teaching of undergraduate dent… – PubMed – NCBI.

ABSTRACT: Impact of medical education program on COPD patients: a cohort prospective study

BACKGROUND:
The main objective of this study was to assess the effects of intensive medical education courses on chronic obstructive pulmonary disease (COPD)-related rehospitalizations and emergency department visits and the secondary aim was to monitor quality of life.
METHODS:
This cohort prospective study included 76 group D COPD patients (pts.). Patients from the intervention group (IG, 52 pts.) underwent a program comprising two components: a comprehensive medical education program (1h/day for 5 days) and a specific drug therapy. Control group (CG, 24 pts.) received only drug therapy. Patients underwent spirometry and completed St. George’s Respiratory Questionnaire (SGRQ) at the time of inclusion and at periodical evaluations performed every three months for a year.
RESULTS:
Patients included in a medical education program showed significant decrease of exacerbation rate compared with the CG. Patients from the IG group had fewer emergency department visits within a year compared with the CG. Patients from the IG had significantly better quality of life scores (both at 3 and 6 months) compared with the CG.
CONCLUSIONS:
This study reveals that an adequate medical education program is associated with a decreased rate of COPD-related hospitalizations. The implementation of a medical education program as an integrated part of therapy could lead to a more accurate self-management of the disease.

via Impact of medical education program on COPD patients: a cohort prospective study. – PubMed – NCBI.

MANUSCRIPT: Social media beliefs and usage among family medicine residents and practicing family physicians.

BACKGROUND AND OBJECTIVES:
Incorporation of social media (SM) use in medicine is gaining support. The Internet is now a popular medium for people to solicit medical information. Usage of social networks, such as Facebook and Twitter, is growing daily and provides physicians with nearly instantaneous access to large populations for both marketing and patient education. The benefits are myriad, but so are the inherent risks. We investigated the role providers’ age and medical experience played in their beliefs and use of SM in medicine.
METHODS:
Using multiple state-wide and national databases, we assessed social media use by family medicine residents, faculty, and practicing family physicians with a 24-question online survey. Descriptive data is compared by age and level of medical experience.
RESULTS:
A total of 61 family medicine residents and 192 practicing family physicians responded. There is a trend toward higher SM utilization in the younger cohort, with 90% of resident respondents reporting using SM, half of them daily. A total of 64% of family physician respondents over the age of 45 have a SM account. An equal percentage of senior physicians use SM daily or not at all. Practicing physicians, more than residents, agree that SM can be beneficial in patient care. The vast majority of residents and physicians polled believe that SM should be taught early in medical education.
CONCLUSIONS:
The high utilization of SM by younger providers, high prevalence of patient use of the Internet, and the countless beneficial opportunities SM offers should be catalysts to drive curriculum development and early implementation in medical education. This curriculum should focus around four pillars: professional standards for SM use, SM clinical practice integration, professional networking, and research.

via Social media beliefs and usage among family medicine residents and practicing family physicians. – PubMed – NCBI.

TeamSTEPPS Improves Operating Room Efficiency and Patient Safety

The objective was to evaluate the effect of TeamSTEPPS on operating room efficiency and patient safety. TeamSTEPPS consisted of briefings attended by all health care personnel assigned to the specific operating room to discuss issues unique to each case scheduled for that day. The operative times, on-time start rates, and turnover times of all cases performed by the urology service during the initial year with TeamSTEPPS were compared to the prior year. Patient safety issues identified during postoperative briefings were analyzed. The mean case time was 12.7 minutes less with TeamSTEPPS (P < .001). The on-time first-start rate improved by 21% with TeamSTEPPS (P < .001). The mean room turnover time did not change. Patient safety issues declined from an initial rate of 16% to 6% at midyear and remained stable (P < 0.001). TeamSTEPPS was associated with improved operating room efficiency and diminished patient safety issues in the operating room.

via TeamSTEPPS Improves Operating Room Efficiency and Patient Safety.

ABSTRACT: Social media for lifelong learning

Learning is ongoing, and can be considered a social activity. In this paper we aim to provide a review of the use of social media for lifelong learning. We start by defining lifelong learning, drawing upon principles of continuous professional development and adult learning theory. We searched Embase and MEDLINE from 2004-2014 for search terms relevant to social media and learning. We describe examples of lifelong learners using social media in medical education and healthcare that have been reported in the peer-reviewed literature. Medical or other health professions students may have qualities consistent with being a lifelong learner, yet once individuals move beyond structured learning environments they will need to recognize their own gaps in knowledge and skills over time and be motivated to fill them, thereby incorporating lifelong learning principles into their day-to-day practice. Engagement with social media can parallel engagement in the learning process over time, to the extent that online social networking fosters feedback and collaboration. The use of social media and online networking platforms are a key way to continuously learn in today’s information sharing society. Additional research is needed, particularly rigorous studies that extend beyond learner satisfaction to knowledge, behaviour change, and outcomes.

via Social media for lifelong learning. – PubMed – NCBI.

ABSTRACT: Social media, medicine and the modern journal club

Medical media is changing along with the rest of the media landscape. One of the more interesting ways that medical media is evolving is the increased role of social media in medical media’s creation, curation and distribution. Twitter, a microblogging site, has become a central hub for finding, vetting, and spreading this content among doctors. We have created a Twitter journal club for nephrology that primarily provides post-publication peer review of high impact nephrology articles, but additionally helps Twitter users build a network of engaged people with interests in academic nephrology. By following participants in the nephrology journal club, users are able to stock their personal learning network. In this essay we discuss the history of medical media, the role of Twitter in the current states of media and summarize our initial experience with a Twitter journal club.

via Social media, medicine and the modern journal club. – PubMed – NCBI.

ABSTRACT: Globalization of Continuing Professional Development by Journal Clubs via Microblogging: A Systematic Review. – PubMed – NCBI

BACKGROUND:
Journal clubs are an essential tool in promoting clinical evidence-based medical education to all medical and allied health professionals. Twitter represents a public, microblogging forum that can facilitate traditional journal club requirements, while also reaching a global audience, and participation for discussion with study authors and colleagues.
OBJECTIVE:
The aim of the current study was to evaluate the current state of social media-facilitated journal clubs, specifically Twitter, as an example of continuing professional development.
METHODS:
A systematic review of literature databases (Medline, Embase, CINAHL, Web of Science, ERIC via ProQuest) was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of Twitter, the followers of identified journal clubs, and Symplur was also performed. Demographic and monthly tweet data were extracted from Twitter and Symplur. All manuscripts related to Twitter-based journal clubs were included. Statistical analyses were performed in MS Excel and STATA.
RESULTS:
From a total of 469 citations, 11 manuscripts were included and referred to five Twitter-based journal clubs (#ALiEMJC, #BlueJC, #ebnjc, #urojc, #meded). A Twitter-based journal club search yielded 34 potential hashtags/accounts, of which 24 were included in the final analysis. The median duration of activity was 11.75 (interquartile range [IQR] 19.9, SD 10.9) months, with 7 now inactive. The median number of followers and participants was 374 (IQR 574) and 157 (IQR 272), respectively. An overall increasing establishment of active Twitter-based journal clubs was observed, resulting in an exponential increase in total cumulative tweets (R2=.98), and tweets per month (R2=.72). Cumulative tweets for specific journal clubs increased linearly, with @ADC_JC, @EBNursingBMJ, @igsjc, @iurojc, and @NephJC, and showing greatest rate of change, as well as total impressions per month since establishment. An average of two tweets per month was estimated for the majority of participants, while the “Top 10” tweeters for @iurojc showed a significantly lower contribution to overall tweets for each month (P<.005). A linearly increasing impression:tweet ratio was observed for the top five journal clubs.
CONCLUSIONS:
Twitter-based journal clubs are free, time-efficient, and publicly accessible means to facilitate international discussions regarding clinically important evidence-based research.

via Globalization of Continuing Professional Development by Journal Clubs via Microblogging: A Systematic Review. – PubMed – NCBI.

ABSTRACT: Social media and dentistry: some reflections on e-professionalism.

The proliferation of digital technology is impacting on the training and development of healthcare professionals. Research on the online behaviour of medical and pharmacy students indicates that social media poses a number of risks to the professional practice of healthcare professionals. General Dental Council guidelines on the use of social media also suggest that it has the potential to expose dental professionals to a variety of breaches of professional conduct. This paper explores the various ways social media can help, as well as hinder, the practice of dental professionalism. However, the lack of primary research on the social media behaviour of dental students and qualified dental practitioners alike acts as a barrier to increasing social media awareness within dentistry. The paper concludes by calling for more research-led discussion on the role social media plays in shaping our understanding of dental professionalism in the twenty-first century.

via Social media and dentistry: some reflections on e-professionalism. – PubMed – NCBI.

ABSTRACT: The role of cognitive function in the relationship between age and health literacy: a cross-sectional analysis of older adults in Chicago, USA.

OBJECTIVES:To investigate how 3 measures of health literacy correlate with age and the explanatory roles of fluid and crystallised cognitive abilities in these relationships among older adults.DESIGN:Cross-sectional baseline analysis of the ‘LitCog’ cohort study.SETTING:1 academic internal medicine clinic and 5 federally qualified health centres in Chicago, USA.PARTICIPANTS:English-speaking adults (n=828) aged 55-74 years, recruited from August 2008 through October 2011.OUTCOME MEASURES:Health literacy was measured by the Test of Functional Health Literacy in Adults (TOFHLA) and the Newest Vital Sign (NVS), both of which assess reading comprehension and numeracy in health contexts, and by the Rapid Estimate of Adult Literacy in Medicine (REALM), which assesses medical vocabulary. Fluid cognitive ability was assessed through the cognitive domains of processing speed, inductive reasoning, and working, prospective and long-term memories, and crystallised cognitive ability through the verbal ability domain.RESULTS:TOFHLA and NVS scores were lower at ages 70-74 years compared with all other age groups (p<0.05 for both tests). The inverse association between age and TOFHLA score was attenuated from β=-0.39 (95% CI -0.55 to -0.22) to β=-0.06 (95% CI -0.20 to 0.08) for ages 70-74 vs 55-59 years when fluid cognitive ability was added to the model (85% attenuation). Similar results were seen with NVS scores (68% attenuation). REALM scores did not differ by age group (p=0.971). Crystallised cognitive ability was stable across age groups, and did not influence the relationships between age and TOFHLA or NVS performance.CONCLUSIONS:Health literacy skills show differential patterns of age-related change, which may be explained by cognitive ageing. Researchers should select health literacy tests appropriate for their purposes when assessing the health literacy of older adults. Clinicians should be aware of this issue to ensure that health self-management tasks for older patients have appropriate cognitive and literacy demands

via The role of cognitive function in the relationship between age and health literacy: a cross-sectional analysis of older adults in Chicago, USA. – PubMed – NCBI.