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Author: Brian S McGowan, PhD

ABSTRACT: A scoping review of undergraduate ambulatory care education

BACKGROUND:
Since a disproportionate amount of medical education still occurs in hospitals, there are concerns that medical school graduates are not fully prepared to deliver efficient and effective care in ambulatory settings to increasingly complex patients.
AIMS:
To understand the current extent of scholarship in this area.
METHOD:
A scoping review was conducted by searching electronic databases and grey literature sources for articles published between 2001 and 2011 that identified key challenges and models of practice for undergraduate teaching of ambulatory care. Relevant articles were charted and assigned key descriptors, which were mapped onto Canadian recommendations for the future of undergraduate medical education.
RESULTS:
Most of the relevant articles originated in the United States, Australia, or the United Kingdom. Recommendations related to faculty development, learning contexts and addressing community needs had numerous areas of scholarly activity while scholarly activity was lacking for recommendations related to inter-professional practice, the use of technology, preventive medicine, and medical leadership.
CONCLUSIONS:
Systems should be established to support education and research collaboration between medical schools to develop best practices and build capacity for change. This method of scoping the field can be applied using best practices and recommendations in other countries.

via A scoping review of undergraduate ambulatory care … [Med Teach. 2013] – PubMed – NCBI.

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ABSTRACT: A global model for effective use and evaluation of e-learning in health

Healthcare systems worldwide face a wide range of challenges, including demographic change, rising drug and medical technology costs, and persistent and widening health inequalities both within and between countries. Simultaneously, issues such as professional silos, static medical curricula, and perceptions of “information overload” have made it difficult for medical training and continued professional development (CPD) to adapt to the changing needs of healthcare professionals in increasingly patient-centered, collaborative, and/or remote delivery contexts. In response to these challenges, increasing numbers of medical education and CPD programs have adopted e-learning approaches, which have been shown to provide flexible, low-cost, user-centered, and easily updated learning. The effectiveness of e-learning varies from context to context, however, and has also been shown to make considerable demands on users’ motivation and “digital literacy” and on providing institutions. Consequently, there is a need to evaluate the effectiveness of e-learning in healthcare as part of ongoing quality improvement efforts. This article outlines the key issues for developing successful models for analyzing e-health learning.

via A global model for effective use and eval… [Telemed J E Health. 2013] – PubMed – NCBI.

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ABSTRACT: Promoting health behaviours in medical education

BACKGROUND:
In light of the global trends of increasing obesity, the education of doctors and other health professionals warrants greater attention to promoting effective weight management through health behaviours related to eating and exercise.
CONTEXT:
Gaps in training in these areas have been identified related to weight management and wellness. Diverse benefits of healthy lifestyle interventions have been noted.
INNOVATION:
Recommendation for developing immersion programmes for medical students and other health professionals involving practical experience in weight management through lifestyle modification, addressing nutritional and caloric intake and energy expenditure through exercise.
IMPLICATIONS:
Integrating healthy lifestyle programmes into medical and health professional education could yield several benefits. Enhancing curriculum and educational processes by promoting medical and health professional students’ awareness of, participation and immersion in, healthy lifestyle interventions may ultimately lead to better health outcomes for health professionals and their patients.

via Promoting health behaviours in medical education. [Clin Teach. 2013] – PubMed – NCBI.

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ABSTRACT: Faculty development activities in family medicine: in search of innovation

OBJECTIVE:
To describe the Accreditation Council for Graduate Medical Education’s (ACGME) faculty development requirements, explore the range of faculty development activities and support currently used by family medicine residencies to meet these requirements, and describe one innovative approach to satisfy this need.
METHOD:
An electronic survey of faculty development activities and support offered to faculty by residency programs was sent to a random sample of 40 medical school and community based family medicine residency programs across the United States. Data were examined using t-tests, Fisher’s exact tests, and Analysis of Variance.
RESULTS:
Faculty development, beyond traditional clinical CME, was strongly encouraged or required by a large proportion of the sample (73%). Only 58% of programs reported having discussed the ACGME’s faculty development component areas (clinical, educational, administrative, leadership, research, and behavioral). In each component area except the “clinical” area, the absence of discussing the ACGME component areas with residency faculty was associated with fewer faculty development activities and support being offered by the program.
CONCLUSIONS:
These results, although preliminary, suggest that family medicine residency programs may value and encourage faculty development. The majority of programs use traditional activities and strategies such as CME, faculty meetings, faculty conferences and workshops; and a smaller number of programs are exploring the utility of mentoring programs, faculty discussion groups, and technology based learning systems. The challenge is to develop faculty development activities tailored to individual program and faculty needs and resources

via Faculty development activities in famil… [Int J Psychiatry Med. 2013] – PubMed – NCBI.

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MANUSCRIPT: Transparency in medical error disclosure: the need for formal teaching in undergraduate medical education curriculum

As ‘practice makes perfect’, we believe that the incorporation of formal teaching of transparent medical error disclosure in medical curricula is greatly needed. Medical schools play central roles in cultivating the significance and developing the communication skills needed for proficient and effective medical error disclosure. Moreover, they play key roles in resolving all barriers that may hinder transparency and full disclosure of medical errors. Such an approach is expected to educate a safe physician workforce where intrinsic drives and capabilities to remain transparent at all times – regardless of consequences – will serve as the basis for enhancing patient–doctor relationships, limiting further harm and improving overall healthcare safety

via Transparency in medical error disclosure: the need for formal teaching in undergraduate medical education curriculum.

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MANUSCRIPT: New frontiers in medical education: simulation technology at Campbell University School of Osteopathic Medicine

Campbell University School of Osteopathic Medicine is using a variety of medical simulation systems in the training of its medical students. The simulators allow students to learn and practice skills in a controlled environment, and they enable faculty to challenge students with a broader range of conditions than might ordinarily be encountered during medical training.

via New frontiers in medical education: simula… [N C Med J. 2014 Jan-Feb] – PubMed – NCBI.

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ABSTRACT: A novel approach to needs assessment in curriculum development: Going beyond consensus methods

Background: Needs assessment should be the starting point for curriculum development. In medical education, expert opinion and consensus methods are commonly employed. Aim: This paper showcases a more practice-grounded needs assessment approach. Methods: A mixed-methods approach, incorporating a national survey, practice audit, and expert consensus, was developed and piloted in thrombosis medicine; Phase 1: National survey of practicing consultants, Phase 2: Practice audit of consult service at a large academic centre and Phase 3: Focus group and modified Delphi techniques vetting Phase 1 and 2 findings. Results: Phase 1 provided information on active curricula, training and practice patterns of consultants, and volume and variety of thrombosis consults. Phase 2’s practice audit provided empirical data on the characteristics of thrombosis consults and their associated learning issues. Phase 3 generated consensus on a final curricular topic list and explored issues regarding curriculum delivery and accreditation. Conclusions: This approach offered a means of validating expert and consensus derived curricular content by incorporating a novel practice audit. By using this approach we were able to identify gaps in training programs and barriers to curriculum development. This approach to curriculum development can be applied to other postgraduate programs.

via A novel approach to needs assessment in curriculum… [Med Teach. 2014] – PubMed – NCBI.

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ABSTRACT: Internal medicine rounding practices and the accreditation council for graduate medical education core competencies

BACKGROUND:
The Accreditation Council for Graduate Medical Education (ACGME) has established the requirement for residency programs to assess trainees’ competencies in 6 core domains (patient care, medical knowledge, practice-based learning, interpersonal skills, professionalism, and systems-based practice). As attending rounds serve as a primary means for educating trainees at academic medical centers, our study aimed to identify current rounding practices and attending physician perceived capacity of different rounding models to promote teaching within the ACGME core competencies.
METHODS:
We disseminated a 24-question survey electronically using educational and hospital medicine leadership mailing lists. We assessed attending physician demographics and the frequency with which they used various rounding models, as defined by the location of the discussion of the patient and care plan: bedside rounds (BR), hallway rounds (HR), and card-flipping rounds (CFR). Using the ACGME framework, we assessed the perceived educational value of each model.
RESULTS:
We received 153 completed surveys from attending physicians representing 34 institutions. HR was used most frequently for both new and established patients (61% and 43%), followed by CFR for established patients (36%) and BR for new patients (22%). Most attending physicians indicated that BR and HR were superior to CFR in promoting the following ACGME competencies: patient care, systems-based practice, professionalism, and interpersonal skills.
CONCLUSIONS:
HR is the most commonly employed rounding model. BR and HR are perceived to be valuable for teaching patient care, systems-based practice, professionalism, and interpersonal skills. CFR remains prevalent despite its perceived inferiority in promoting teaching across most of the ACGME core competencies

via Internal medicine rounding practices and the accr… [J Hosp Med. 2014] – PubMed – NCBI.

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ABSTRACT: How we implemented a resident-led medical simulation curriculum in a large internal medicine residency program

Abstract Mannequin-based simulation in graduate medical education has gained widespread acceptance. Its use in non-procedural training within internal medicine (IM) remains scant, possibly due to the logistical barriers to implementation of simulation curricula in large residency programs. We report the Massachusetts General Hospital Department of Medicine’s scale-up of a voluntary pilot program to a mandatory longitudinal simulation curriculum in a large IM residency program (n = 54). We utilized an eight-case curriculum implemented over the first four months of the academic year. An intensive care unit curriculum was piloted in the spring. In order to administer a comprehensive curriculum in a large residency program where faculty resources are limited, thirty second-year and third-year residents served as session facilitators and two senior residents served as chairpersons of the program. Post-session anonymous survey revealed high learner satisfaction scores for the mandatory program, similar to those of the voluntary pilot program. Most interns believed the sessions should continue to be mandatory. Utilizing residents as volunteer facilitators and program leaders allowed the implementation of a well-received mandatory simulation program in a large IM residency program and facilitated program sustainability.

via How we implemented a resident-led medical simulati… [Med Teach. 2014] – PubMed – NCBI.

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ABSTRACT: Developing an electronic teaching and training portfolio

Technological advances, in particular the rise of the internet, have led to dramatic changes in medical education. The recent global financial crisis and issues with medical staffing have meant that training programs and universities are increasingly exploring electronic means to provide efficient and cost effective education techniques. In this article, we explore methods by which orthopedic trainees can develop their educational portfolio through electronic resources and similarly, how training or residency programs can utilize these advances in technology to both increase efficiency and enhance their teaching reputation. Finally, we explore the merits of trainees keeping track of their careers through electronic portfolios.

via Developing an electronic teaching… [Curr Rev Musculoskelet Med. 2014] – PubMed – NCBI.

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