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Author: Brian S McGowan, PhD

ABSTRACT: Young Physicians’ Recall about Pediatric Training in Ethics and Professionalism and Its Practical Utility.

OBJECTIVE:
To assess the adequacy of ethics and professionalism education in residency by examining the recollections of young pediatricians in practice.
STUDY DESIGN:
We surveyed a random sample of members of the American Academy of Pediatrics Section on Young Physicians between February and June 2012.
RESULTS:
The majority of young pediatricians reported that ethics and professionalism were taught ad hoc in their training programs. Compared with physicians in practice for >5 years, those in practice for ≤5 years were significantly more likely to report having had an organized curriculum (72 of 181 [40%] vs 27 of 113 [24%]; P < .01) and that the ethics and professionalism training in their program was adequate (124 of 180 [69%] vs 62 of 113 [55%]). Of the topics encountered in practice by at least two-thirds of pediatricians, more than two-thirds of the respondents stated that residency training adequately prepared them to address issues of consent, privacy, truth-telling, and child abuse/neglect, but less than one-third felt adequately prepared to address conduct on social media and requests for prescriptions by family, friends, and colleagues outside of clinical encounters.
CONCLUSION:
The majority of recent graduates from pediatric training programs described themselves as competent to address the ethical and professionalism issues faced in practice, but nonetheless reported gaps in their education. As pediatric residency programs adopt more structured curricula for ethics and professionalism education, issues commonly faced by practitioners should be incorporated.

via Young Physicians’ Recall about Pediatric Training … [J Pediatr. 2013] – PubMed – NCBI.

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ABSTRACT: Usage and appraisal of educational media by homeopathic therapists – a cross sectional survey

BACKGROUND:
During recent years the market for homeopathic education media has increasingly diversified with old (books, seminars) and new media (video-seminars, pc-programs, homeo-wiki and internet-courses). However, little is known about homeopaths’ preferences in using educational media and their requirements of this topic.
AIM:
This survey was designed to gain a better understanding of the usage and appraisal of educational media by homeopaths.
METHODS:
192 homeopathic practitioners (GPs and health practitioners) at a educational conference were asked to answer a standardized questionnaire covering the topics “formal education and context of work” (9 items), “homeopathic practise and usage (24 items), “utilization of educational media” (9 items) and “favoured attributes for educational media” (11 items).
RESULTS:
Out of 192 homeopaths who attended the conference, 118 completed the questionnaire (response rate 61.5%). For their continuing homeopathic education they predominantly indicated to use books (scale value from 0 = never to 2 = always: 1.72) and seminars (1.54) whereas journals (0.98) and the internet (0.65) were used less often. The most favoured attributes concerning medical education media were reliability (1.76), relevance for clinical practice (1.74) and user friendliness (1.6). Less favoured attributes were inexpensiveness (1.1), graphical material (0.92) and interactivity (0.88).
CONCLUSIONS:
The survey illustrates the current situation of medical education media in homeopathy. Although there are parallels to earlier research conducted in conventional GPs, homeopaths are more likely to refer to classical media. New education tools should be designed according to these preferences.

via Usage and appraisal of educational… [BMC Complement Altern Med. 2012] – PubMed – NCBI.

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ABSTRACT: Profiling undergraduates’ generic learning skills on entry to medical school; an international study.

BACKGROUND:
Medical education faces challenges posed by widening access to training, a demand for globally competent healthcare workers and progress towards harmonisation of standards.
AIM:
To explore potential challenges arising from variation in diversity and educational background of medical school entrants.
METHOD:
This study investigated the reported experience and confidence, in a range of 31 generic skills underpinning learning, of 2606 medical undergraduates entering 14 medical schools in England and South Africa, using a validated questionnaire.
RESULTS:
Responses suggest that there is considerable similarity in prior educational experience and confidence skills profiles on entry to South African and English medical schools. South African entrants reported significantly more experience in ‘Technical skills’, ‘Managing their own Learning’, and ‘Presentation’, while English students reported increased experience in ‘IT’ skills. South African undergraduates reported more confidence in ‘Information Handling’, while English students were more confident in ‘IT’ skills. The most noticeable difference, in ‘IT’ skills, is probably due to documented differences in access to computer facilities at high school level. Differences between individual schools within each country are noticeable.
CONCLUSIONS:
Educators need to acquire a good understanding of their incoming cohorts, and ensure necessary tailored support for skills development

via Profiling undergraduates’ generic learning skills … [Med Teach. 2012] – PubMed – NCBI.

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MANUSCRIPT: Quality of outpatient clinical notes: a stakeholder definition derived through qualitative research

BACKGROUND:
There are no empirically-grounded criteria or tools to define or benchmark the quality of outpatient clinical documentation. Outpatient clinical notes document care, communicate treatment plans and support patient safety, medical education, medico-legal investigations and reimbursement. Accurately describing and assessing quality of clinical documentation is a necessary improvement in an increasingly team-based healthcare delivery system. In this paper we describe the quality of outpatient clinical notes from the perspective of multiple stakeholders.
METHODS:
Using purposeful sampling for maximum diversity, we conducted focus groups and individual interviews with clinicians, nursing and ancillary staff, patients, and healthcare administrators at six federal health care facilities between 2009 and 2011. All sessions were audio-recorded, transcribed and qualitatively analyzed using open, axial and selective coding.
RESULTS:
The 163 participants included 61 clinicians, 52 nurse/ancillary staff, 31 patients and 19 administrative staff. Three organizing themes emerged: 1) characteristics of quality in clinical notes, 2) desired elements within the clinical notes and 3) system supports to improve the quality of clinical notes. We identified 11 codes to describe characteristics of clinical notes, 20 codes to describe desired elements in quality clinical notes and 11 codes to describe clinical system elements that support quality when writing clinical notes. While there was substantial overlap between the aspects of quality described by the four stakeholder groups, only clinicians and administrators identified ease of translation into billing codes as an important characteristic of a quality note. Only patients rated prioritization of their medical problems as an aspect of quality. Nurses included care and education delivered to the patient, information added by the patient, interdisciplinary information, and infection alerts as important content.
CONCLUSIONS:
Perspectives of these four stakeholder groups provide a comprehensive description of quality in outpatient clinical documentation. The resulting description of characteristics and content necessary for quality notes provides a research-based foundation for assessing the quality of clinical documentation in outpatient health care settings.

via Quality of outpatient clinical notes: a … [BMC Health Serv Res. 2012] – PubMed – NCBI.

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ABSTRACT: Prevention screening and counseling: strategy for integration into medical education and practice.

Providing optimal preventive services across the life span is integral to improving the nation’s health. However, teaching future health professionals evidence-based prevention screening and counseling has notable limitations. Applying the U.S. Preventive Services Task Force (Task Force) preventive services recommendations is necessary but not sufficient to teach comprehensive and practical preventive services delivery. Certain important health topics have not yet been investigated by the Task Force; other Task Force health topics have insufficient evidence or nonspecific recommendations. The purpose of the current paper is to provide a strategy and develop a tool to educate future healthcare professionals in recommendations for prevention screening and counseling. Age-specific preventive history charts for children and adults were created using a total of 60 recommendations from the following sources (with number of recommendations shown): the Task Force (n=37); four primary care professional organizations (n=15); and a representative panel of experts (n=8). Using a systematic approach that incorporates other accredited organizations and inclusion criteria (as described) yielded a practical tool that is applicable in both educational and clinical settings.

via Prevention screening and counseling: strategy … [Am J Prev Med. 2013] – PubMed – NCBI.

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ABSTRACTS: Incorporating iPads into a preclinical curriculum: a pilot study

BACKGROUND:
The incorporation of technology into medical education is critical for learners. Little is known about the effect of integrating iPad technology into undergraduate medical education.
AIMS:
We introduced iPads into the first-year curriculum in 2011-2012. We aimed to evaluate students’ use of, and attitudes toward, the iPad.
METHODS:
We administered two surveys to students during the 2011-2012 academic year. Additionally, we conducted focus groups to further evaluate the effectiveness of iPad integration into the curriculum.
RESULTS:
Survey data reflect mixed attitudes toward the use of the iPad in the preclinical curriculum. While a vast majority of students agree “the iPad has value in the medical curriculum” (79% in the first survey; 65% in the second survey), there was a decrease over time in the view that “the iPad is a positive addition to the curriculum” (75% in the first survey; 49% in the second survey). Focus group data indicate students appreciate certain aspects of iPad use in the curriculum, including improved curriculum interactivity, but the majority believe it cannot replace printed handouts at this time.
DISCUSSION:
The iPad provides some benefits in undergraduate medical education. More studies are necessary to determine how the iPad is best incorporated into medical education.

via Incorporating iPads into a preclinical curriculum:… [Med Teach. 2013] – PubMed – NCBI.

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ABSTRACT: Introducing technology into medical education: Two pilot studies.

OBJECTIVES:
Educators are integrating new technology into medical curriculum. The impact of newer technology on educational outcomes remains unclear. We aimed to determine if two pilot interventions, (1) introducing iPads into problem-based learning (PBL) sessions and (2) online tutoring would improve the educational experience of our learners.
METHODS:
We voluntarily assigned 26 second-year medical students to iPad-based PBL sessions. Five students were assigned to Skype for exam remediation. We performed a mixed-method evaluation to determine efficacy.
RESULTS:
Pilot 1: Seventeen students completed a survey following their use of an iPad during the second-year PBL curriculum. Students noted the iPad allows for researching information in real time, annotating lecture notes, and viewing sharper images. Data indicate that iPads have value in medical education and are a positive addition to the curriculum. Pilot 2: Students agreed that online tutoring is at least or more effective than in-person tutoring.
CONCLUSIONS:
In our pilot studies, students experienced that iPads and Skype are beneficial in medical education and can be successfully employed in areas such as PBL and remediation.
PRACTICE IMPLICATIONS:
Educators should continue to further examine innovative opportunities for introducing technology into medical education.

via Introducing technology into medical educa… [Patient Educ Couns. 2013] – PubMed – NCBI.

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ABSTRACT: The Impact of Lecture Attendance and Other Variables on How Medical Students Evaluate Faculty in a Preclinical Program

PURPOSE:High-quality audiovisual recording technology enables medical students to listen to didactic lectures without actually attending them. The authors wondered whether in-person attendance affects how students evaluate lecturers.METHOD:This is a retrospective review of faculty evaluations completed by first- and second-year medical students at the Ohio State University College of Medicine during 2009-2010. Lecture-capture technology was used to record all lectures. Attendance at lectures was optional; however, all students were required to complete lecturer evaluation forms. Students rated overall instruction using a five-option response scale. They also reported their attendance. The authors used analysis of variance to compare the lecturer ratings of attendees versus nonattendees. The authors included additional independent variables-year of student, student grade/rank in class, and lecturer degree-in the analysis.RESULTS:The authors analyzed 12,092 evaluations of 220 lecturers received from 358 students. The average number of evaluations per lecturer was 55. Seventy-four percent (n = 8,968 evaluations) of students attended the lectures they evaluated, whereas 26% (n = 3,124 evaluations) viewed them online. Mean lecturer ratings from attendees was 3.85 compared with 3.80 by nonattendees (P≤ .05; effect size: 0.055). Student’s class grade and year, plus lecturer degree, also affected students’ evaluations of lecturers (effect sizes: 0.055-0.3).CONCLUSIONS:Students’ attendance at lectures, year, and class grade, as well as lecturer degree, affect students’ evaluation of lecturers. This finding has ramifications on how student evaluations should be collected, interpreted, and used in promotion and tenure decisions in this evolving medical education environment.

via The Impact of Lecture Attendance and Other Variable… [Acad Med. 2013] – PubMed – NCBI.

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ABSTRACT: Advancing Faculty Development in Medical Education: A Systematic Review.

PURPOSE:
To (1) provide a detailed account of the nature and scope of faculty development (FD) programs in medical education, (2) assess the quality of FD studies, and (3) identify in what areas and through what means future research can purposefully build on existing knowledge.
METHOD:
The authors searched MEDLINE, CINAHL, and ERIC for articles reporting evaluations of FD initiatives published between 1989 and 2010. They applied standard systematic review procedures for sifting abstracts, scrutinizing full texts, and abstracting data, including program characteristics, evaluation methods, and outcomes. They used a modified Kirkpatrick model to guide their data abstraction.
RESULTS:
The authors included 22 articles reporting on 21 studies in their review. The most common program characteristics included a series/longitudinal format, intended for individuals, and offered to physicians only. Although the most common aim was to improve teaching effectiveness, several programs had multiple aims, including scholarship and leadership. Program evaluation focused on quantitative approaches. A number of studies employed longitudinal designs and included some follow-up component. Surveys were the most popular data collection method, participants the most common data source, and self-reported behavior changes the most commonly reported outcome.
CONCLUSIONS:
Although the authors’ findings showed some recent expansion in the scope of the FD literature, they also highlighted areas that require further focus and growth. Future research should employ more rigorous evaluation methods, explore the role of interprofessional teams and communities of practice in the workplace, and address how different organizational and contextual factors shape the success of FD programs.

via Advancing Faculty Development in Medical Education:… [Acad Med. 2013] – PubMed – NCBI.

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ABSTRACT: Evidence-Based Medicine Training in Undergraduate Medical Education: A Review and Critique of the Literature Published 2006-2011

PURPOSE:To characterize recent evidence-based medicine EBM educational interventions for medical students and suggest future directions for EBM education.METHOD:The authors searched the MEDLINE, Scopus, Educational Resource Information Center, and Evidence-Based Medicine Reviews databases for English-language articles published between 2006 and 2011 that featured medical students and interventions addressing multiple EBM skills. They extracted data on learner and instructor characteristics, educational settings, teaching methods, and EBM skills covered.RESULTS:The 20 included articles described interventions delivered in 12 countries in classroom 75%, clinic 25%, and/or online 20% environments. The majority 60% focused on clinical students, whereas 30% targeted preclinical students and 10% included both. EBM skills addressed included recognizing a knowledge gap 20%, asking a clinical question 90%, searching for information 90%, appraising information 85%, applying information 65%, and evaluating practice change 5%. Physicians were most often identified as instructors 60%; co-teachers included librarians 20%, allied health professionals 10%, and faculty from other disciplines 10%. Many studies 60% included interventions at multiple points during one year, but none were longitudinal across students tenures. Teaching methods varied. Intervention efficacy could not be determined.CONCLUSIONS:Settings, learner levels and instructors, teaching methods, and covered skills differed across interventions. Authors writing about EBM interventions should include detailed descriptions and employ more rigorous research methods to allow others to draw conclusions about efficacy. When designing EBM interventions, educators should consider trends in medical education e.g., online learning, interprofessional education and in health care e.g., patient-centered care, electronic health records.

via Evidence-Based Medicine Training in Undergraduate M… [Acad Med. 2013] – PubMed – NCBI.

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