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Author: Brian S McGowan, PhD

ABSTRACT: Quality Improvement in Childhood Obesity Management through the Maintenance of Certification Process

OBJECTIVE:
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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MANUSCRIPT: Family Doctors Seen through the Eyes of Specialists: A Qualitative Study

Germany is facing a shortage of young family doctors. In search of possible reasons the aim of this study was to explore the perception of specialists on family doctors. Within a qualitative study 16 medical specialists from different fields in hospital and outpatient care setting were interviewed. Interviews were analysed using qualitative content analysis according to Mayring. Most of the interviewed specialists have a positive view on family doctors although a certain depreciative assumption is resonated in a number of statements. According to the specialists, family doctors enjoy a high status in public, even if social processes of change may have a negative influence on their rather old-fashioned image. Specialists find that family medicine is underrepresented in university education suffering from an upgrading of specialized disciplines. Altogether the majority of the interviewed specialists certify family doctors in Germany a positive image. Lecturer in medical education and training should be aware of their key role in the career choices of young trainees and avoid degradation or upgrading of certain medical disciplines. Interlinked measures on different levels focusing on the improvement of working conditions and representation at the universities would be needed to regain attractiveness for the family doctor’s profession as a career choice for young doctors.

via Family Doctors Seen through the Eyes of Spe… [Int J Family Med. 2013] – PubMed – NCBI.

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ABSTRACT: Medical Applications for Pharmacists Using Mobile Devices

BACKGROUND:Mobile devices (eg, smartphones, tablet computers) have become ubiquitous and subsequently there has been a growth in mobile applications (apps). Concurrently, mobile devices have been integrated into health care practice due to the availability and quality of medical apps. These mobile medical apps offer increased access to clinical references and point-of-care tools. However, there has been little identification of mobile medical apps suitable for the practice of pharmacy.OBJECTIVE:To address the shortage of recommendations of mobile medical apps for pharmacists in daily practice.DATA SOURCES:Mobile medical apps were identified via the iTunes and Google Play Stores via the “Medical” app categories and key word searches (eg, drug information, medical calculators). In addition, reviews provided by professional mobile medical app review websites were used to identify apps.STUDY SELECTION AND DATA EXTRACTION:Mobile medical apps were included if they had been updated in the previous 3 months, were available in the US, used evidence-based information or literature support, had dedicated app support, and demonstrated stability. Exclusion criteria included apps that were not available in English, had advertisement bias, used nonreferenced sources, were available only via an institution-only subscription, and were web-based portals.DATA SYNTHESIS:Twenty-seven mobile apps were identified and reviewed that involved general pharmacy practice, including apps that involved drug references, clinical references, medical calculators, laboratory references, news and continuing medical education, and productivity.CONCLUSIONS:Mobile medical apps have a variety of features that are beneficial to pharmacy practice. Individual clinicians should consider several characteristics of these apps to determine which are suitable to incorporate into their daily practice.

via Medical Applications for Pharmacists Using … [Ann Pharmacother. 2013] – PubMed – NCBI.

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ABSTRACT: A Qualitative Analysis of an Interactive Online Discussion by Health Professions Educators on Education Research

Introduction: In view of increasing demand for reforms in medical education in India, it is important to generate evidence through education research to increase the relevance and improve the quality of medical education. Education research is still at a nascent stage in India for a number of reasons. This study elicited health professions educators’ views about the dearth of education research in Southeast Asia and what is needed to improve it. Methods: Qualitative content analysis of an interactive, online discussion on ‘education research’ between PSG-FAIMER Regional Institute fellows and faculty was carried out.

Results and Discussion: Forty-four health professionals exchanged approximately 492 email messages during the discussion. One main concern expressed within the group was that the medical curriculum was not in tune with the health care needs of the society and reforms in the curriculum should be based on research. Most fellows felt that their work in education research was not appreciated in their schools. Participants felt that education research was done for altruistic reasons and only by self-motivated faculty. Participants also said that regulatory bodies were not concerned about the quality of education and its related research. Measures that could improve education research also emerged during the discussions. Interactive online discussions elicited important issues about education research in India. Participants noted that there is no recognition or rewards to encourage faculty to conduct education research. They also said that there is need to educate faculty about changes elsewhere in medical education and to make them more aware of education research generally.

via A Qualitative Anal… [Educ Health (Abingdon). 2012 September-December] – PubMed – NCBI.

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ABSTRACT: Facilitating Students’ Reflective Practice in a Medical Course: Literature Review

Introduction : Reflection and reflective practice is of increasing importance in medical education curricula. The aim of this review is to summarise the literature published around facilitating reflection in a medical course, and to answer the question : W0 hat is the current evidence regarding learning and development moments across the medical curriculum in developing students’ reflective practice? Methods : A review of the literature was undertaken using defined databases and the search terms ‘medical students’, ‘medical education’, ‘reflection’, ‘reflectFNx01’ and ‘medicine’. The search was limited to peer-reviewed published material in English and between the years 2001 and 2011, and included research, reviews and opinion pieces. Results : Thirty-six relevant articles were found, identifying enhancing factors and barriers to effectively teaching reflective practice within medical curricula, relating to: The breadth of the meaning of reflection; facilitating reflection by medical educators; using written or web-based portfolios to facilitate reflection; and assessing the reflective work of students. Discussion : A variety of reflective purposes was found in this literature review. Evidence indicates that, if students are unclear as to the purpose of reflection and do not see educators modelling reflective behaviours, they are likely to undervalue this important skill regardless of the associated learning and development opportunities embedded in the curriculum.

via Facilitating Stude… [Educ Health (Abingdon). 2012 September-December] – PubMed – NCBI.

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ABSTRACT: Case vignette: A promising complement to clinical case presentations in teaching

Introduction: Case studies are widely used in medical education. They help students recognise and interpret important data coming from the patient’s problem thereby enabling students to arrive at a correct diagnosis and best treatment course. We have used the case vignette method, a variant of the case study method, for teaching family medicine residents, and here we assess their perceptions of its advantages and limitations. Methods: In the case vignette method, residents studied a particular case of interest from the community. Before presenting it to peers, they prepared and circulated a brief case vignette outlining the salient features of the case, the preferred line of management and suggested discussion probes. Structured notes were taken by programme faculty during the presentations, and feedback was obtained from residents. Results: Major advantages perceived by residents were that the case vignette method demanded their active participation in the preparation and presentation of the case. The need to prepare a vignette helped them better organise their thinking and experience peer teaching. However, some felt that the exercise was time consuming and the discussion sometimes wandered from the intended course. Conclusions: The case vignette method helps meet specific learning objectives in teaching sessions. Residents feel that it improves their skills as physicians and teachers. This study finds that case vignettes are a promising complement to existing methods of teaching medicine. Further research is required to more firmly establish this method’s value.

via Case vignette: A promis… [Educ Health (Abingdon). 2013 January-April] – PubMed – NCBI.

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ABSTRACT: Doctor role modelling in medical education

Aim: The aim of this review is to summarise the evidence currently available on role modelling by doctors in medical education. Methods: A systematic search of electronic databases was conducted (PubMed, Psyc- Info, Embase, Education Research Complete, Web of Knowledge, ERIC and British Education Index) from January 1990 to February 2012. Data extraction was completed by two independent reviewers and included a quality assessment of each paper. A thematic analysis was conducted on all the included papers. Results: Thirty-nine studies fulfilled the inclusion criteria for the review. Six main themes emerged from the content of high and medium quality papers: 1) the attributes of positive doctor role models; 2) the personality profiles of positive role models; 3) the influence of positive role models on students’ career choice; 4) the process of positive role modelling; 5) the influence of negative role modelling; 6) the influence of culture, diversity and gender in the choice of role model. Conclusions: This systematic review highlights role modelling as an important process for the professional development of learners. Excellence in role modelling involves demonstration of high standards of clinical competence, excellence in clinical teaching skills and humanistic personal qualities. Positive role models not only help to shape the professional development of our future physicians, they also influence their career choices. This review has highlighted two main challenges in doctor role modelling: the first challenge lies in our lack of understanding of the complex phenomenon of role modelling. Second, the literature draws attention to negative role modelling and this negative influence requires deeper exploration to identify ways to mitigate adverse effects. This BEME review offers a preliminary guide to future discovery and progress in the area of doctor role modelling.

via Doctor role modelling in medical education: BEME G… [Med Teach. 2013] – PubMed – NCBI.

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ABSTRACT: Creating context: Making sense of geo-location and social media data for health.

Information that is persistently collected, unrelated to direct clinical care may be a Pandora’s Box for health improvement and monitoring. The use and linkage of disparate data sources, particularly those relating to geo-location and social media present enormous opportunities and challenges for healthcare. To date these sources have been difficult to harness and make sense of, yet they are now beginning to be exploited. It is the innovation in analytic methodology that may hold the key if the issues that may confound the results can be addressed. These issues are encompassed in privacy, and with the scientific quality and completeness of the data. The future for alternative application of geo-location and social media data is here and now, and if they can be harnessed carefully, healthcare may be the biggest beneficiary.

via Creating context: Making sense of… [Stud Health Technol Inform. 2013] – PubMed – NCBI.

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ABSTRACT: Investigating the purpose of an online discussion group for health professionals: a case example from forensic occupational therapy.

BACKGROUND:
Thousands of health-related online discussion groups are active world-wide however, very little is known about the purpose and usefulness of such groups. In 2003 an online discussion group called ‘forensic occupational therapy’ was established in the United Kingdom. This group was examined to gain an understanding of the purpose and use of online discussion groups for health professionals who may be practically and geographically isolated from others in similar areas of practice.
METHODS:
Following a case study design, descriptive characteristics on members’ locations and number of posts were collected from the forensic occupational therapy online discussion group. Eight years of posts (2003–2011) were examined using a theoretical thematic analysis process to identify and describe the purposes for which members were using the group.
RESULTS:
Members from 20 countries contributed to the discussion group; the vast majority of posts being from members in the United Kingdom. Activity within the group was consistently high for the first five years however, activity within the group declined in the final three years. Six purposes for which members use the online discussion group were identified: seeking and giving advice, networking, requesting and sharing material resources, service development, defining the role of occupational therapists, and student learning.
CONCLUSIONS:
Findings suggest that health professionals in specialized and often isolated areas of practice are keen to connect with colleagues and learn from each other’s experiences. The main purposes for which the online discussion group was used could be summarized as communication, information sharing and networking; though activity within the group declined significantly during the last three years of the data collection period. This raises questions about the sustainability of online discussion groups within the rapidly developing social media environment

via Investigating the purpose of an online d… [BMC Health Serv Res. 2013] – PubMed – NCBI.

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MANUSCRIPT: Learning styles and preferences for live and distance education: an example of a specialisation course in epidemiology

Background
Distance learning through the internet is increasingly popular in higher education. However, it is unknown how participants in epidemiology courses value live vs. distance education.

Methods
All participants of a 5-day specialisation course in epidemiology were asked to keep a diary on the number of hours they spent on course activities (both live and distance education). Attendance was not compulsory during the course and participants were therefore also asked for the reasons to attend live education (lectures and practicals). In addition, the relation between participants? learning styles (Index of Learning Styles) and their participation in live and distance education was studied.

Results
All 54 (100%) participants in the course completed the questionnaire on attendance and 46 (85%) completed the questionnaire on learning styles. The number of hours attending live education was negatively correlated with the number of hours going studying distance learning materials (Pearson correlation ?0.5; p?<?0.001). The most important reasons to attend live education was to stay focused during lectures (50%), and to ask questions during practicals (50%). A lack of time was the most important reason not to attend lectures (52%) or practicals (61%). Learning styles were not association with the number of hours spent on live or distance education.

Conclusion
Distance learning may play an important role in epidemiology courses, since it allows participants to study whenever and wherever they prefer, which provides the opportunity to combine courses with clinical duties. An important requirement for distance learning education appears to be the possibility to ask questions and to interact with instructors.

via BMC Medical Education | Abstract | Learning styles and preferences for live and distance education: an example of a specialisation course in epidemiology.

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