MENUCLOSE

 

Connect with us

Author: Brian S McGowan, PhD

ABSTRACT: Simulation techniques in the anatomy curriculum: review of literature

Modern medical education faces a problem of combining the latest technology, procedures and information with classic teaching methods. Simulation is a technique, which replaces or amplifies doctor-patient experiences in controlled conditions and therefore evokes or replicates substantial aspects of the real world in a fully interactive manner. The basic course of anatomy in medical education could be recognised as the best example of implementing new educational techniques such as simulation, into the traditional medical curriculum. The PubMed database was searched using specific key words. Finally 72 articles were accepted and were divided into 3 basic categories of teaching methods: Category 1 – cadaveric dissection, Category 2 – simulator based education and Category 3 – other. A state of the art anatomical curriculum offers numerous possibilities and solutions including the oldest like cadaveric dissection and newest like simulators. Different simulation techniques are used with different intensity; however cadaveric dissection is still the most popular method. The second most frequent method is simulation-based training, in which North America is the leading country. The identification of anatomical structures during virtual surgical procedures or laparoscopic robotic procedures can be integrated into the traditional anatomy course. New technologies are supportive and beneficial in anatomy teaching however each excitement of new technologies sometimes should be tempered and evaluated for its usefulness in making the learning process constructive for students and their future practice.

via Simulation techniques in the anatomy c… [Folia Morphol (Warsz). 2014] – PubMed – NCBI.

ABSTRACT: Using activity theory to study cultural complexity in medical education.

There is a growing need for research on culture, cultural differences and cultural effects of globalization in medical education, but these are complex phenomena to investigate. Socio-cultural activity theory seems a useful framework to study cultural complexity, because it matches current views on culture as a dynamic process situated in a social context, and has been valued in diverse fields for yielding rich understandings of complex issues and key factors involved. This paper explains how activity theory can be used in (cross-)cultural medical education research. We discuss activity theory’s theoretical background and principles, and we show how these can be applied to the cultural research practice by discussing the steps involved in a cross-cultural study that we conducted, from formulating research questions to drawing conclusions. We describe how the activity system, the unit of analysis in activity theory, can serve as an organizing principle to grasp cultural complexity. We end with reflections on the theoretical and practical use of activity theory for cultural research and note that it is not a shortcut to capture cultural complexity: it is a challenge for researchers to determine the boundaries of their study and to analyze and interpret the dynamics of the activity system.

via Using activity theory to study cultural co… [Perspect Med Educ. 2014] – PubMed – NCBI.

ABSTRACT: Designing and evaluating an effective theory-based continuing interprofessional education program to improve sepsis care by enhancing healthcare team collaboration

Continuing interprofessional education (CIPE) differs from traditional continuing education (CE) in both the learning process and content, especially when it occurs in the workplace. Applying theories to underpin the development, implementation, and evaluation of CIPE activities informs educational design, encourages reflection, and enhances our understanding of CIPE and collaborative practice. The purpose of this article is to describe a process of design, implementation, and evaluation of CIPE through the application of explicit theories related to CIPE and workplace learning. A description of an effective theory-based program delivered to faculty and clinicians to enhance healthcare team collaboration is provided. Results demonstrated that positive changes in provider perceptions of and commitment to team-based care were achieved using this theory-based approach. Following this program, participants demonstrated a greater appreciation for the roles of other team members by indicating that more responsibility for implementing the Surviving Sepsis guideline should be given to nurses and respiratory therapists and less to physicians. Furthermore, a majority (86%) of the participants made commitments to demonstrate specific collaborative behaviors in their own practice. The article concludes with a discussion of our enhanced understanding of CIPE and a reinterpretation of the learning process which has implications for future CIPE workplace learning activities.

via Designing and evaluating an effective theor… [J Interprof Care. 2014] – PubMed – NCBI.

ABSTRACT: Cognitive Load Theory: Implications for medical education: AMEE Guide No. 86

Cognitive Load Theory (CLT) builds upon established models of human memory that include the subsystems of sensory, working and long-term memory. Working memory (WM) can only process a limited number of information elements at any given time. This constraint creates a “bottleneck” for learning. CLT identifies three types of cognitive load that impact WM: intrinsic load (associated with performing essential aspects of the task), extraneous load (associated with non-essential aspects of the task) and germane load (associated with the deliberate use of cognitive strategies that facilitate learning). When the cognitive load associated with a task exceeds the learner’s WM capacity, performance and learning is impaired. To facilitate learning, CLT researchers have developed instructional techniques that decrease extraneous load (e.g. worked examples), titrate intrinsic load to the developmental stage of the learner (e.g. simplify task without decontextualizing) and ensure that unused WM capacity is dedicated to germane load, i.e. cognitive learning strategies. A number of instructional techniques have been empirically tested. As learners’ progress, curricula must also attend to the expertise-reversal effect. Instructional techniques that facilitate learning among early learners may not help and may even interfere with learning among more advanced learners. CLT has particular relevance to medical education because many of the professional activities to be learned require the simultaneous integration of multiple and varied sets of knowledge, skills and behaviors at a specific time and place. These activities possess high “element interactivity” and therefore impose a cognitive load that may surpass the WM capacity of the learner. Applications to various medical education settings (classroom, workplace and self-directed learning) are explored.

via Cognitive Load Theory: Implications for medical ed… [Med Teach. 2014] – PubMed – NCBI.

MANUSCRIPT: Medical students’ perception of their educational environment

Background: Students’ perception of the environment within which they study has shown to have a significant impact on their behavior, academic progress and sense of well-being. This study was undertaken to evaluate the students’ perception of their learning environment in an Indian medical school following traditional curricula and to study differences, if any, between the students according to the stages of medical education, i.e., the pre-clinical and clinical stages. Methodology: In the present study, the Dundee Ready Education Environment Measure (DREEM) inventory was administered to undergraduate medical students of first (n = 227), third (n = 175), fifth (n = 171) and seventh (n = 123) semesters. Scores obtained were expressed as mean ± Standard Deviation (SD) and analyzed using one-way ANOVA and Dunnett’s test. P-value < 0.05 was considered as significant. Results: The mean DREEM score for our medical school was 123/200.The first-year students were found to be more satisfied with learning environment (indicated by their higher DREEM score) compared to other semester students. Progressive decline in scores with each successive semester was observed. Evaluating the sub-domains of perception, the registrars in all semesters had a more positive perception of learning (Average mean score: 29.44), their perception of course organizers moved in the right direction (Average mean score: 26.86), their academic self-perception was more on the positive side (Average mean score: 20.14), they had a more positive perception of atmosphere (Average mean score: 29.07) and their social self-perception could be graded as not too bad (Average mean score: 17.02). Conclusion: The present study revealed that all the groups of students perceived their learning environment positively. However, a few problematic areas of learning environment were perceived such as: students were stressed more often; they felt that the course organizers were authoritarian and emphasized factual learning. Implementing more problem-based learning, student counseling and workshops on teaching-learning for educators might enable us to remedy and enrich our learning environment.

via Medical students’ perception of their educa… [J Clin Diagn Res. 2014] – PubMed – NCBI.

ABSTRACT: Cognitive processes in anesthesiology decision making

The quality and safety of health care are under increasing scrutiny. Recent studies suggest that medical errors, practice variability, and guideline noncompliance are common, and that cognitive error contributes significantly to delayed or incorrect diagnoses. These observations have increased interest in understanding decision-making psychology.Many nonrational (i.e., not purely based in statistics) cognitive factors influence medical decisions and may lead to error. The most well-studied include heuristics, preferences for certainty, overconfidence, affective (emotional) influences, memory distortions, bias, and social forces such as fairness or blame.Although the extent to which such cognitive processes play a role in anesthesia practice is unknown, anesthesia care frequently requires rapid, complex decisions that are most susceptible to decision errors. This review will examine current theories of human decision behavior, identify effects of nonrational cognitive processes on decision making, describe characteristic anesthesia decisions in this context, and suggest strategies to improve decision making.

via Cognitive processes in anesthesiology decisio… [Anesthesiology. 2014] – PubMed – NCBI.

ABSTRACT: Medical student views on the use of Facebook profile screening by residency admissions committees.

PURPOSE:
Previous research has shown that >50% of residency programmes indicate that inappropriate Facebook postings could be grounds for rejecting a student applicant. This study sought to understand medical students’ views regarding the impact of their Facebook postings on the residency admissions process.
STUDY DESIGN:
In 2011-2012, we conducted a national survey of 7144 randomly selected medical students representing 10% of current enrollees in US medical schools. Students were presented with a hypothetical scenario of a residency admissions committee searching Facebook and finding inappropriate pictures of a student, and were asked how the committee ought to regard these pictures.
RESULTS:
The response rate was 30% (2109/7144). Respondents did not differ from medical students nationally with regard to type of medical school and regional representation. Of the three options provided, the majority of respondents (63.5%) indicated ‘the pictures should be considered along with other factors, but should not be grounds for automatic rejection of the application’. A third (33.7%) believed ‘the pictures should have no bearing on my application; the pictures are irrelevant’. A small minority of respondents (2.8%) felt ‘the pictures should be grounds for automatic rejection of the application’.
CONCLUSIONS:
That the views of students regarding the consequences of their online activity differ so greatly from the views of residency admissions committees speaks to the need for better communication between these parties. It also presents opportunities for medical schools to help students in their residency application process by increasing awareness of social media screening strategies used by some residency programmes, and fostering self-awareness around the use of social media during medical school and especially during the residency application process.

via Medical student views on the use of Facebook … [Postgrad Med J. 2014] – PubMed – NCBI.

MANUSCRIPT: Social media guidelines and best practices: recommendations from the council of residency directors social media task force

Social media has become a staple of everyday life among over one billion people worldwide. A social networking presence has become a hallmark of vibrant and transparent communications. It has quickly become the preferred method of communication and information sharing. It offers the ability for various entities, especially residency programs, to create an attractive internet presence and “brand” the program. Social media, while having significant potential for communication and knowledge transfer, carries with it legal, ethical, personal, and professional risks. Implementation of a social networking presence must be deliberate, transparent, and optimize potential benefits while minimizing risks. This is especially true with residency programs. The power of social media as a communication, education, and recruiting tool is undeniable. Yet the pitfalls of misuse can be disastrous, including violations in patient confidentiality, violations of privacy, and recruiting misconduct. These guidelines were developed to provide emergency medicine residency programs leadership with guidance and best practices in the appropriate use and regulation of social media, but are applicable to all residency programs that wish to establish a social media presence.

via Social media guidelines and best practices:… [West J Emerg Med. 2014] – PubMed – NCBI.

ABSTRACT: A mixed-methods study of research dissemination across practice-based research networks

Practice-based research networks may be expanding beyond research into rapid learning systems. This mixed-methods study uses Agency for Healthcare Research and Quality registry data to identify networks currently engaged in dissemination of research findings and to select a sample to participate in qualitative semistructured interviews. An adapted Diffusion of Innovations framework was used to organize concepts by characteristics of networks, dissemination activities, and mechanisms for rapid learning. Six regional networks provided detailed information about dissemination strategies, organizational context, role of practice-based research network, member involvement, and practice incentives. Strategies compatible with current practices and learning innovations that generate observable improvements may increase effectiveness of rapid learning approaches.

via A mixed-methods study of researc… [J Ambul Care Manage. 2014 Apr-Jun] – PubMed – NCBI.

ABSTRACT: Barriers and facilitators to self-care communication during medical appointments in the United States for adults with type 2 diabetes

OBJECTIVEDiabetes self-care is challenging and requires effective patient-provider communication to achieve optimal treatment outcomes. This study explored perceptions of barriers and facilitators to diabetes self-care communication during medical appointments.DesignQualitative study using in-depth interviews with a semistructured interview guide.ParticipantsThirty-four patients with type 2 diabetes and 19 physicians who treat type 2 diabetes. RESULTSPhysicians described some patients as reluctant to discuss their self-care behaviors primarily because of fear of being judged, guilt, and shame. Similarly, patients described reluctant communication resulting from fear of being judged and shame, particularly shame surrounding food intake and weight. Physicians and patients recommended trust, nonjudgmental acceptance, open/honest communication, and providing patients hope for living with diabetes as important factors for improving self-care communication. Further, patients stressed the clinical benefits of physicians directly addressing poor self-care behaviors while physicians described having few strategies to address these difficulties. CONCLUSIONSPhysician-patient self-care communication barriers included patients’ reluctance to discuss self-care behaviors and physicians’ perceptions of few options to address this reluctance. Treatment recommendations stressed the importance of establishing trusting, nonjudgmental and open patient-provider communication for optimal diabetes treatment. Medical education is needed to improve physicians’ strategies for addressing self-care communication during medical appointments.

via Barriers and facilitators to self-care communic… [Chronic Illn. 2014] – PubMed – NCBI.