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Author: Brian S McGowan, PhD

ABSTRACT: Effect of Medical Education on Students’ Attitudes Toward Psychiatry and Individuals With Mental Disorders

OBJECTIVE This study aimed to explore the effect of medical education on students’ attitudes toward psychiatry and psychiatric patients, and examined the usefulness of a new evaluation tool: the Psychiatric Experience, Attitudes, and Knowledge: 6 Items (PEAK-6). METHOD Authors studied the attitudes of 116 medical students toward psychiatry and individuals with mental disorders, using two questionnaires before and after a 12-week module of “psychosocial medicine.” Results of the questionnaire Attitudes Toward Psychiatry: 30 Items (ATP-30) were compared with the results of PEAK-6. RESULTS With the ATP-30, no change in attitudes toward psychiatry was observed at the end of the module. With the PEAK-6, the item “attitude toward psychiatry” significantly improved. Knowledge of and experience with psychiatry as well as knowledge of and experience with individuals with mental disorders improved significantly; however, attitudes toward individuals with mental disorders did not improve. CONCLUSION PEAK-6 seems to be a promising tool with regard to nuanced information about psychiatric learning experiences. Participation in a psychiatric module may be associated with a positive effect on students’ knowledge about, experience with, and attitudes toward psychiatry, but not attitudes toward psychiatric patients.

via Effect of Medical Education on Students’ Att… [Acad Psychiatry. 2013] – PubMed – NCBI.

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MANUSCRIPT: The transformation of continuing medical education (CME) in the United States

This article describes five major themes that inform and highlight the transformation of continuing medical education in the USA. Over the past decade, the Institute of Medicine (IOM) and other national entities have voiced concern over the cost of health care, prevalence of medical errors, fragmentation of care, commercial influence, and competence of health professionals. The recommendations from these entities, as well as the work of other regulatory, professional, academic, and government organizations, have fostered discussion and development of strategies to address these challenges. The five themes in this paper reflect the changing expectations of multiple stakeholders engaged in health care. Each theme is grounded in educational, politico-economic priorities for health care in the USA. The themes include (1) a shift in expectation from simple attendance or a time-based metric (credit) to a measurement that infers competence in performance for successful continuing professional development (CPD); (2) an increased focus on interprofessional education to augment profession-specific continuing education; (3) the integration of CPD with quality improvement; (4) the expansion of CPD to address population and public health issues; and (5) identification and standardization of continuing education (CE) professional competencies. The CE profession plays an essential role in the transformation of the US CPD system for health professionals. Coordination of the five themes described in this paper will foster an improved, effective, and efficient health system that truly meets the needs of patients.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791543/pdf/amep-4-171.pdf

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ABSTRACT: Impact of an Online Survivorship Primer on Clinician Knowledge and Intended Practice Changes

The number of adult cancer survivors in the USA is expected to double by the year 2050. A call for increased survivorship care and provider training came from the Institute of Medicine (IOM) in the form of a landmark report in 2006. A shortage of physicians complicates the burden of survivorship care. The purpose of this effort was to design, develop, and evaluate a fully accredited, evidence-based continuing medical education (CME) and continuing education (CE) intervention to address the established knowledge gap for breast cancer, prostate cancer, colorectal cancer, and non-Hodgkin lymphoma survivorship education. Delivered through the Medscape Education (WebMD) platform, the course covered epidemiology, survivor issues, and currently available guidelines using illustrative patient cases. Knowledge gain was evaluated using a pretest-posttest design. Program evaluation was assessed by survey. Additional areas examined included post-intervention inquiry regarding expected changes to clinical practice. The results of this educational intervention demonstrated the effectiveness of internet-based CME/CE for cancer survivorship. Learning gain was significant (p < 0.0005). Effect size (d = 1.71) suggested extremely high practical significance, as the difference between the means was larger than 1 standard deviation. Significant knowledge gains were observed for each survivorship knowledge question across all clinical specialties studied. Nearly 100 % of participants agreed that the course contributed to survivorship care and was organized effectively. Participants reported that the course was designed effectively (97.2 %), and 68.1 % responded in favor of adopting alternative communication strategies with patients and families upon completion of the course.

via Impact of an Online Survivorship Primer on Cli… [J Cancer Educ. 2013] – PubMed – NCBI.

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ABSTRACT: Multidisciplinary Team Training to Enhance Family Communication in the ICU

OBJECTIVES::
Current guidelines from the U.S. Society for Critical Care Medicine state that training in “good communication skills…should become a standard component of medical education and … available for all ICU caregivers”. We sought to train multidisciplinary teams of ICU caregivers in communicating with the families of critically ill patients to improve staff confidence in communicating with families, as well as family satisfaction with their experiences in the ICU.
DESIGN::
Pre- and postintervention design.
SETTING::
Community hospital medical and surgical ICUs.
PATIENTS::
All patients admitted to ICU during the two time periods.
INTERVENTION::
Ninety-eight caregivers in multidisciplinary teams of five to eight individuals trained in a standardized approach to communicating with families of ICU patients using the Setup, Perception, Invitation, Knowledge, Emotions, Strategy (or Subsequent) (SPIKES) protocol followed by participation in a simulated family conference.
MEASUREMENTS::
Staff confidence in communicating with family members of critically ill patients was measured immediately before and 6-8 weeks after training sessions using a validated tool. Family satisfaction using seven items measuring effectiveness of communication from the Family Satisfaction in the ICU (24) tool in surveys received from family members of 121 patients admitted to the ICU before and 121 patients admitted to the ICU after trainings was completed.
MAIN RESULTS::
Using 46 matched pre- and postsurveys, staff confidence in communicating with family members of critically ill patients increased significantly (p < 0.001) in each of 21 separate measures. Family satisfaction with communication showed significant (p < 0.05 or better) improvement in three of seven individual items compared with those same items pretraining. There was no decline in any individual item.
CONCLUSIONS::
A simple intervention resulted in improvement in staff confidence, as well as in multiple measures of family satisfaction with communication. This intervention is easily reproduced.

via Multidisciplinary Team Training to Enhance Fam… [Crit Care Med. 2013] – PubMed – NCBI.

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ABSTRACT: The Value of Bedside Rounds: A Multicenter Qualitative Study

Background: Bedside rounds have decreased on teaching services, raising concern about trainees’ clinical skills and patient-physician relationships. Purpose: We sought to identify recognized bedside teachers’ perceived value of bedside rounds to assist in the promotion of bedside rounds on teaching services. Methods: Authors used a grounded theory, qualitative study design of telephone semistructured interviews with bedside teachers (n = 34) from 10 U.S. institutions (2010-2011). Main outcomes were characteristics of participants, themes pertaining to the perceived value of bedside rounds, and quotations highlighting each respective theme. Results: The mean years in academic medicine was 13.7, and 51% were associate or full professors. Six main themes emerged: (a) skill development for learners (e.g., physical examination, communication, and clinical decision-making skills); (b) observation and feedback; (c) role-modeling; (d) team building among trainees, attending, and patient; (e) improved patient care delivery through combined clinical decision-making and team consensus; and (f) the culture of medicine as patient-centered care, which was embodied in all themes. Conclusions: Bedside teachers identify potential benefits of bedside rounds, many of which align with national calls to change our approach to medical education. The practice of bedside rounds enables activities essential to high-quality patient care and education.

via The Value of Bedside Rounds… [Teach Learn Med. 2013 October-December] – PubMed – NCBI.

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ABSTRACT: Professional Identity in Medical Students: Pedagogical Challenges to Medical Education

Background: Professional identity, or how a doctor thinks of himself or herself as a doctor, is considered to be as critical to medical education as the acquisition of skills and knowledge relevant to patient care. Summary: This article examines contemporary literature on the development of professional identity within medicine. Relevant theories of identity construction are explored and their application to medical education and pedagogical approaches to enhancing students’ professional identity are proposed. The influence of communities of practice, role models, and narrative reflection within curricula are examined. Conclusions: Medical education needs to be responsive to changes in professional identity being generated from factors within medical student experiences and within contemporary society.

via Professional Identity in Me… [Teach Learn Med. 2013 October-December] – PubMed – NCBI.

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ABSTRACT: The use of simulation in teaching the basic sciences

PURPOSE OF REVIEW:To assess the current use of simulation in medical education, specifically, the teaching of the basic sciences to accomplish the goal of improved integration.RECENT FINDINGS:Simulation is increasingly being used by the institutions to teach the basic sciences. Preliminary data suggest that it is an effective tool with increased retention and learner satisfaction.SUMMARY:Medical education is undergoing tremendous change. One of the directions of that change is increasing integration of the basic and clinical sciences to improve the efficiency and quality of medical education, and ultimately to improve the patient care. Integration is thought to improve the understanding of basic science conceptual knowledge and to better prepare the learners for clinical practice. Simulation because of its unique effects on learning is currently being successfully used by many institutions as a means to produce that integration through its use in the teaching of the basic sciences. Preliminary data indicate that simulation is an effective tool for basic science education and garners high learner satisfaction.

via The use of simulation in teaching the… [Curr Opin Anaesthesiol. 2013] – PubMed – NCBI.

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FREE WEBINAR: “New Data on Clinician Learning: What does it mean for your programs?”

Please join me!

I have accepted an invitation by the team over at DLC Solutions to participate in an interview/webinar later this month. The goal of the webinar is to explore the various research questions I have been pursuing over the past 2 years and to specifically share some of the more recent data that the ArcheMedX team has collected.

For more information on the webinar click here – but in the meantime here are our highlights:

Abstract:

Research exploring clinician learning is of little value if it is not shared and leveraged broadly by those within the CME community to drive innovation and improve educational planning. This session will introduce three new and emerging data sets that have been collected by Brian S. McGowan, PhD. Dr McGowan will structure each data set to highlight the problem, the methods of exploration, and the data or conclusion that could be drawn. These new ideas will then be put into the context of the educational planning process with the goal of allowing those within the CME community to effectively leverage these data and lessons to immediately impact their planning processes.

Learning objectives:

  1. Explore recent data describing how physicians are beginning to adopt social media as an element of the lifelong learning
  2. Compare and contrast new data illustrating emerging trends in clinician preferences for different CME formats
  3. Devise a plan to leverage new data describing the learning actions that physicians use to structure new ideas and practices such that they are effectively learned and adopted into practice

Register today for this free Webinar to be held on Thursday October 24, 2013 at 2pm EST

Wordle - is learning theory enought cutom color palette

 

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RESOURCE: Improving Motivation in eLearning

Motivation has been and continues to be a widely studied area across many of life’s domains. Motivation is said to be the energizing force that initiates and sustains behavior and ultimately produces results. Many motivation theories focus on the amount of motivation, with a larger quantity said to result in improved outcomes. However, as educators we should not focus on generating more motivation from our learners but instead focus on creating conditions that facilitate the internalization of motivation from within our learners.

via elearn Magazine: Improving Motivation in eLearning.

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MANUSCRIPT: A randomized controlled pilot trial comparing the impact of access to clinical endocrinology video demonstrations with access to usual revision resources on medical student performance of clinical endocrinology skills

Background Demonstrating competence in clinical skills is key to course completion for medical students. Methods of providing clinical instruction that foster immediate learning and potentially serve as longer-term repositories for on-demand revision, such as online videos demonstrating competent performance of clinical skills, are increasingly being used. However, their impact on learning has been little studied. The aim of this study was to determine the value of adjunctive on-demand video-based training for clinical skills acquisition by medical students in endocrinology.

Methods Following an endocrinology clinical tutorial program, 2nd year medical students in the pre-assessment revision period were recruited and randomized to either a set of bespoke on-line clinical skills training videos TV, or to revision as usual RAU. The skills demonstrated on video were history taking in diabetes mellitus DMH, examination for diabetes lower limb complications LLE, and examination for signs of thyroid disease TE. Students were assessed on these clinical skills in an observed structured clinical examination two weeks after randomization. Assessors were blinded to student randomization status.

Results For both diabetes related clinical skills assessment tasks, students in the TV group performed significantly better than those in the RAU group. There were no between group differences in thyroid examination performance. For the LLE, 91.7% n?=?11/12 of students randomized to the video were rated globally as competent at the skill compared with 40% n?=?4/10 of students not randomized to the video p?=?0.024. For the DMH, 83.3% n?=?10/12 of students randomized to the video were rated globally as competent at the skill compared with 20% n?=?2/10 of students not randomized to the video p?=?0.007.

Conclusion Exposure to high quality videos demonstrating clinical skills can significantly improve medical student skill performance in an observed structured clinical examination of these skills, when used as an adjunct to clinical skills face-to-face tutorials and deliberate practice of skills in a blended learning format. Video demonstrations can provide an enduring, on-demand, portable resource for revision, which can even be used at the bedside by learners. Such resources are cost-effectively scalable for large numbers of learners.

via BMC Medical Education | Abstract | A randomized controlled pilot trial comparing the impact of access to clinical endocrinology video demonstrations with access to usual revision resources on medical student performance of clinical endocrinology skills.

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