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Author: Brian S McGowan, PhD

A comprehensive model to build improvement capability in a pediatric academic medical center.

Cincinnati Children’s Hospital Medical Center developed a comprehensive model to build quality improvement (QI) capability to support its goal to transform its delivery system through a series of training courses. Two online modules orient staff to basic concepts and terminology and prepare them to participate more effectively in QI teams. The basic program (Rapid Cycle Improvement Collaborative, RCIC) is focused on developing the capability to use basic QI tools and complete a narrow-scoped project in approximately 120 days. The Intermediate Improvement Science Series (I(2)S(2)) program is a leadership course focusing on improvement skills and developing a broader and deeper understanding of QI in the context of the organization and external environment. The Advanced Improvement Methods (AIM) course and Quality Scholars Program stimulate the use of more sophisticated methods and prepare Cincinnati Children’s Hospital Medical Center (CCHMC) and external faculty to undertake QI research. The Advanced Improvement Leadership Systems (AILS) sessions enable interprofessional care delivery system leadership teams to effectively lead a system of care, manage a portfolio of projects, and to deliver on CCHMC’s strategic plan. Implementing these programs has shown us that 1) a multilevel curricular approach to building improvement capability is pragmatic and effective, 2) an interprofessional learning environment is critical to shifting mental models, 3) repetition of project experience with coaching and feedback solidifies critical skills, knowledge and behaviors, and 4) focusing first on developing capable interprofessional improvement leaders, versus engaging in broad general QI training across the whole organization, is effective.

via A comprehensive model to build improvem… [Acad Pediatr. 2014 Jan-Feb] – PubMed – NCBI.

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Neurohospitalists: perceived need and training requirements in academic neurology.

BACKGROUND AND PURPOSE:
We sought to determine the current practices and plans for departmental hiring of neurohospitalists at academic medical centers and to identify the core features of a neurohospitalist training program.
METHODS:
We surveyed department chairs or residency program directors at 123 Accreditation Council for Graduate Medical Education (ACGME)-accredited US adult neurology training programs.
RESULTS:
Sixty-three(51% response rate) responded, 76% of whom were program directors. In all, 24 (38%) academic neurology departments reported employing neurohospitalists, and an additional 10 departments have plans to hire neurohospitalists in the next year. In all, 4 academic neurology departments have created a neurohospitalist training program, and 10 have plans to create a training program within the next 2 years. Hospitals were the most frequent source of funding for established and planned programs (93% of those reporting). Most (n = 39; 65%) respondents felt that neurohospitalist neurology should be an ACGME-accredited fellowship. The highest priority neurohospitalist training elements among respondents included stroke, epilepsy, and consult neurology as well as patient safety and cost-effective inpatient care. The most important procedural skills for a neurohospitalist, as identified by respondents, include performance of brain death evaluations, lumbar punctures, and electroencephalogram interpretation.
CONCLUSIONS:
Neurohospitalists have emerged as subspecialists within neurology, growing both in number and in scope of responsibilities in practice. Neurohospitalists are in demand among academic departments, with many departments developing their existing presence or establishing a new presence in the field. A neurohospitalist training program may encompass training in stroke, epilepsy, and consult neurology with additional focus on patient safety and cost-effective care.

via Neurohospitalists: perceived need and train… [Neurohospitalist. 2014] – PubMed – NCBI.

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Quality improvement in childhood obesity management through the maintenance of certification process.

To assess the Health and Obesity: Prevention and Education (HOPE) Curriculum Project, a web-based clinician education program that promotes appropriate screening, prevention, and management of weight among youth by pediatric practitioners, based on the 2007 Expert Committee recommendations. The project currently provides Maintenance of Certification (MOC) Part 4 credit through the American Board of Pediatrics.
STUDY DESIGN:
Participants identified themselves to the HOPE MOC Part 4 program. Enrollees were required to complete all continuing medical education modules (10.5 hours). Knowledge acquisition and self-reported confidence levels related to screening, prevention, and management practices of pediatric obesity were measured using preknowledge and postknowledge questionnaires. Participants were also required to perform a quality improvement project and submit practice performance data from repeated medical chart reviews over time. Knowledge acquisition, self-efficacy, and practice performance data were analyzed using repeated-measures analyses.
RESULTS:
The 51 participants demonstrated significant improvements in knowledge acquisition and self-efficacy scores after viewing individual modules. In addition, participants demonstrated significant improvements in measured clinical compliance with recommended practices over time.
CONCLUSIONS:
Participation in the HOPE MOC Part 4 program appeared to improve knowledge acquisition, self-efficacy, and physician compliance with recommended practice recommendations for the screening, prevention, and management of pediatric obesity. Further data are required to determine whether such practice-based improvements translate into actual reduction in patient weight and/or reduction in health-related costs related to overweight and obesity in youth.

via Quality improvement in childhood obesity managemen… [J Pediatr. 2013] – PubMed – NCBI.

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Improving the effect of FDA-mandated drug safety alerts with Internet-based continuing medical education.

The US Food and Drug Administration (FDA) requires risk communication as an element of Risk Evaluation and Mitigation Strategies (REMS) to alert and educate healthcare providers about severe toxicities associated with approved drugs. The educational effectiveness of this approach has not been evaluated. To support the communication plan element of the ipilimumab REMS, a Medscape Safe Use Alert (SUA) letter was distributed by Medscape via email and mobile device distribution to clinicians specified in the REMS. This alert contained the FDA-approved Dear Healthcare Provider (DHCP) letter mandated for distribution. A continuing medical education (CME) activity describing ipilimumab toxicities and the appropriate management was simultaneously posted on the website and distributed to Medscape members. Data were collected over a 6-month period regarding the handling of the letter and the responses to pre- and post-test questions for those who participated in the CME activity. Analysis of the answers to the pre- and posttest questions showed that participation in the CME activity resulted in an improvement in correct answer responses of 47%. Our experience shows that there are likely distinct information sources that are utilized by different HCP groups. The ready availability of a brief CME activity was utilized by 24,063 individuals, the majority of whom showed enhanced understanding of ipilimumab toxicity by improvement in post-test scores, educational data that are not available via implementation of standard safety alert communications. These results demonstrate that improvement in understanding of specific drug toxicities is enhanced by a CME intervention.

via Improving the effect of FDA-mandated drug safe… [Curr Drug Saf. 2013] – PubMed – NCBI.

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Study Skills Science: Investigating Memory Mnemonics

Have you ever needed to remember a long list of words, such as state capitals or items on a shopping list? Even if a list can be full of interesting facts, it can still be hard to remember. But there are some memory techniques that can help a person to better recall a list. In this science activity youll try out a technique called mnemonics—a memory boosting strategy. Youll investigate whether using mnemonics can help you and your friends or family members remember lists of words.

via Study Skills Science: Investigating Memory Mnemonics: Scientific American.

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Personal Learning Network (PLN): A How To Guide

I have spoken a lot about personal learning networks over the years, in fact I wax poetic about them in my book, #socialQI: Simple Solutions for Improving Your Healthcare. More recently as part of an EdTech session that I am participating in early next year I was asked to put together a set of ‘how to’ videos that explore how I structure my lifelong learning and my own PLN. This video resource set is intended to be distributed as a ‘flipped resource’ for that meeting, but I thought, since the content might be useful to those not attending the January meeting, that there may be some benefit in posting the resource set here too.

As you work through the videos think about whether there are other technologies that I might add (I have a few in mind) and I will append the series over time.

Enjoy!

Personal Learning Network Introduction

How to use  Twitter and Hootsuite to Enhance Your PLN

How to use  Google Alerts to Enhance Your PLN

How to use  PubMed and MyNCBI to Enhance Your PLN

How to use  a Blog Archive to Enhance Your PLN

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RESOURCE: Age of Distraction: Why It’s Crucial for Students to Learn to Focus

Digital classroom tools like computers, tablets and smartphones offer exciting opportunities to deepen learning through creativity, collaboration and connection, but those very devices can also be distracting to students. Similarly, parents complain that when students are required to complete homework assignments online, it’s a challenge for students to remain on task. The ubiquity of digital technology in all realms of life isn’t going away, but if students don’t learn how to concentrate and shut out distractions, research shows they’ll have a much harder time succeeding in almost every area.“The real message is because attention is under siege more than it has ever been in human history, we have more distractions than ever before, we have to be more focused on cultivating the skills of attention,” said Daniel Goleman, a psychologist and author of Focus: The Hidden Driver of Excellence and other books about social and emotional learning on KQED’s Forum program.“Children I’m particularly worried about because the brain is the last organ of the body to become anatomically mature. It keeps growing until the mid-20s,” Goleman said. If young students don’t build up the neural circuitry that focused attention requires, they could have problems controlling their emotions and being empathetic.

via Age of Distraction: Why It’s Crucial for Students to Learn to Focus | MindShift.

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ABSTRACT: Critical pedagogy in health education

Objective: This review investigated how the three-phase model of critical pedagogy, based on the writings of Paulo Freire, can be put into practice in health education.
Design: The study considers literature related to the fields of health education, health promotion and critical pedagogy.
Setting: The study is a scholarly review completed as part of a larger academic study.
Method: A library search was conducted of relevant books, journal articles and theses using keyword searches including health education, health promotion, critical pedagogy and Freire. Ideas from the literature and from teaching experience were integrated to consider how the three-phase model of critical pedagogy might be of benefit to health education.
Result: The review makes a case for the use of critical pedagogy in health education and discusses how Freire’s ideas can be combined with pedagogical techniques to overcome the difficulties of encouraging students and teachers to be co-learners in a power sharing arrangement, negotiating the content of the learning, ensuring that discussion is inclusive of a range of voices, perspectives and points of view, and dealing with the conflict which may be caused by the political nature of the teaching and learning.
Conclusion: The three-phase model of critical pedagogy, based on the writings of Freire, is advocated for use in health education because it ensures that learners have an opportunity to critically engage with health information rather than to simply be passive recipients of it. It aims to focus learning on the problems, issues and real world experience of the learners, facilitates problem-posing education, and challenges the learner to question practices that support inequality. The three phases are: listening and naming; dialogue and reflection; the promoting of transformative social action.

via Critical pedagogy in health education.

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RESOURCE: 20 Options for Real-Time Collaboration Tools

Real-time collaboration has become an essential component of working and learning online, since these tasks are never complete without collaboration.

There are many times, when collaborating online in real-time becomes a necessity to keep people involved, make them work together and to keep teams focused to accomplish business goals. With real-time collaboration you get the opportunity to work with people located in different parts of the world at the same time on the same document and see the changes in an instant. There are numerous tools available for the purpose.

I have shortlisted 20 options for real-time collaboration tools for you to select from, they are as follows:

Neat Chat: It is one of the easiest and fastest ways to have online conversations with a group of friends or colleagues. It provides a clean, fast and robust chat room where you can share files, send private messages and even access conversations that happened in your absence.

Today’s Meet: Allows you to have quick conversations in private online chat rooms. It has a back channel which gives you the ability to adjust your audience’s needs and emotions. In your chat room you can use live stream to make comments, ask questions and use that feedback to tailor your presentations to address your audience’s needs

Zoho Writer: Is a powerful rich text-editor for Android devices, which allows you to create documents seamlessly with a rich feature-set. You can either save these docs in local devices or cloud devices like Zoho Docs. Zoho Docs workspace is a collaboration tool, which allows you to share work on the same doc with other people in real-time.

via 20 Options for Real-Time Collaboration Tools – EdTechReview™ (ETR).

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RESOURCE: How Technology Supports Self-Directed Learning

Self-directed learning is a type of learning in which learners are allowed to work on authentic problems and tasks of their own choice, and are still provided learning support in context to their problems.

Self-directed learning is an essential skill required in the 21st century educational world. This learning approach increases the motivation of students to learn, since they are the makers of their own knowledge, they experience a sense of independence while learning. This process keeps them engaged, since now they have to acquire knowledge on their own, and apply it along with their skills to find solutions to their problems, evolve their learning and be encouraged for life-long learning.

Self-directed learning can be facilitated through scaffolded instructions. Scaffolds are supporting elements which aid learners in developing knowledge and skills. These instructions can be imparted by; modeling desired behavior, providing explanations about concepts with illustrations, inviting learners to participate in a task in which the instructor acts more like a guide, and gradually withdrawing instructor support to pave way for learner independence.

We know that, technology supports learning and teaching of all kinds, and there in nothing today, which cannot be attained or aided by technology. Learning through self-direction can be refined and amplified with the use of technology. Technology can support lifelong, self-directed learning beyond the regular classroom…

via How Technology Supports Self-Directed Learning – EdTechReview™ ETR.

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