Myers, Christopher G; Pronovost, Peter J
Physicians are being called upon to engage in greater leadership and management in increasingly complex and dynamic health care organizations. Yet, management skills are largely undeveloped in medical education. Without formal management training in the medical curriculum, physicians are left to cultivate their leadership and management abilities through a haphazard array of training programs or simply through trial and error, with consequences that may range from frustration among staff to reduced quality of care and increased risk of patient harm. To address this issue, the authors posit that medical education needs a more systematic focus on topics related to management and organization, such as individual decision making, interpersonal communication, team knowledge sharing, and organizational culture. They encourage medical schools to partner with business school faculty or other organizational scholars to offer a "Management 101" course in the medical curriculum to provide physicians-in-training with an understanding of these topics and raise the quality of physician leadership and management in modern health care organizations.
Shapiro, Shauna L.; Shapiro, Daniel E.; Schwartz, Gary E. R.
Review of clinical studies providing empirical data on stress management programs in medical education found that student participants in such programs demonstrated improved immunologic functioning, decreased depression and anxiety, increased spirituality and empathy, enhanced knowledge of alternative therapies, improved knowledge of stress…
Moser, Marvin; And Others
The management of patients with primary hypertension remains a significant problem for the medical profession. In spite of this, specific programs for education in hypertensive vascular disease have been poorly organized. A survey to determine the level of training in this discipline is discussed. (MLW)
Poole, Traci M; Kodali, Leela; Pace, Adam C
Objective. To describe the design of a core course directed at improving confidence and competence of students to perform medication therapy management (MTM) services. Design. Using the American Pharmacists Association (APhA) certificate training program framework, a core course was developed to teach MTM concepts to third-year student pharmacists. Using deep learning and authentic assignments, course instructors attempted to improve student confidence and readiness to provide MTM services. Assessment. Student ability to meet course objectives was evaluated by examinations and the APhA MTM program self-assessment. Students had an overall success rate of 93% on all three assessments. Student perceptions of confidence, competence, and importance of performing MTM services were measured using a survey instrument with 56 Likert-type items. Students completing both surveys reported significantly increased confidence and competence. Conclusion. Integrating MTM-specific education into the core curriculum increased student pharmacists' perceived competence and confidence to perform MTM services.
Kodali, Leela; Pace, Adam C.
Objective. To describe the design of a core course directed at improving confidence and competence of students to perform medication therapy management (MTM) services. Design. Using the American Pharmacists Association (APhA) certificate training program framework, a core course was developed to teach MTM concepts to third-year student pharmacists. Using deep learning and authentic assignments, course instructors attempted to improve student confidence and readiness to provide MTM services. Assessment. Student ability to meet course objectives was evaluated by examinations and the APhA MTM program self-assessment. Students had an overall success rate of 93% on all three assessments. Student perceptions of confidence, competence, and importance of performing MTM services were measured using a survey instrument with 56 Likert-type items. Students completing both surveys reported significantly increased confidence and competence. Conclusion. Integrating MTM-specific education into the core curriculum increased student pharmacists’ perceived competence and confidence to perform MTM services. PMID:27293237
Medication management is an important component of medical education, particularly in the field of geriatrics. The Association of American Medical Colleges has put forth 26 minimum geriatrics competencies under eight domains for graduating medical students; medication management is one of these domains. The Portal of Geriatric Online education (www.POGOe.org) is an online public repository of geriatrics educational materials and modules developed by geriatrics educators and academicians in the United States, freely available for use by educators and learners in the field. The three POGOe materials presented in this review showcase pearls of medication management for medical and other professional students in novel learning formats that can be administered without major prior preparation. The review compares and contrasts the three materials in descriptive and tabular formats to enable its appropriate use by educators in promoting self-learning or group learning among their learners.
Borus, Jonathan F; Alexander, Erik K; Bierer, Barbara E; Bringhurst, F Richard; Clark, Christopher; Klanica, Kaley E; Stewart, Erin C; Friedman, Lawrence S
Concerns about the influence of industry support on medical education, research, and patient care have increased in both medical and political circles. Some academic medical centers, questioning whether industry support of medical education could be appropriate and not a conflict of interest, banned such support. In 2009, a Partners HealthCare System commission concluded that interactions with industry remained important to Partners' charitable academic mission and made recommendations to transparently manage such relationships. An Education Review Board (ERB) was created to oversee and manage all industry support of Partners educational activities.Using a case review method, the ERB developed guidelines to implement the commission's recommendations. A multi-funder rule was established that prohibits industry support from only one company for any Partners educational activity. Within that framework, the ERB established guidelines on industry support of educational conferences, clinical fellowships, and trainees' expenses for attending external educational programs; gifts of textbooks and other educational materials; promotional opportunities associated with Partners educational activities; Partners educational activities under contract with an industry entity; and industry-run programs using Partners resources.Although many changes have resulted from the implementation of the ERB guidelines, the number of industry grants for Partners educational activities has remained relatively stable, and funding for these activities declined only moderately during the first three full calendar years (2011-2013) of ERB oversight. The ERB continually educates both the Partners community and industry about the rationale for its guidelines and its openness to their refinement in response to changes in the external environment.
Ghamari Zare, Zohre; Adib-Hajbaghery, Mohsen
Background Pharmacological knowledge and medication management skills of student nurses greatly depend on the clinical nurse educators’ performance in this critical issue. However, the Iranian nurse educators’ performance in teaching pharmacology and medication management are not adequately studied. Objectives The current study aimed to investigate the nursing students’ perceptions on the status of clinical pharmaceutical and medication management education. Materials and Methods A cross-sectional study was conducted on all 152 nursing students registered in the seventh and eighth semesters at the Qom and Naragh branches of Islamic Azad University, and Kashan University of Medical Sciences in 2013 - 2014 academic year. The students’ perceptions on the performance of clinical nurse educators in teaching pharmacology and medication management were assessed using a researcher made questionnaire. The questionnaire consisted of 31 items regarding clinical educators’ performance in teaching pharmacology and medication management and two questions about students’ satisfaction with their level of knowledge and skills in pharmacology and medication management. Descriptive statistics was employed and analysis of variance was performed to compare the mean of scores of teaching pharmacology and medication management in the three universities. Results Among a total of 152 subjects, 82.9% were female and their mean age was 22.57 ± 1.55 years. According to the students, instructors had the weakest performance in the three items of teaching pharmacology and medication management based on the students’ learning needs, teaching medication management through a patient-centered method and teaching pharmacology and medication management based on the course plan. The students’ satisfaction regarding their own knowledge and skill of pharmacology and medication management was at medium level. Conclusions Nursing students gave a relatively low score in several aspects of
Mafe, Cecilia; Menyah, Effie; Nkere, Munachi
Health care management and leadership education is an important gap in the undergraduate medical curriculum. Lack of training promotes poor decision making and may lead to inadequate health services, adversely affecting patients. We propose an integrated approach to health care management and leadership education at undergraduate level, to enable doctors to be effective leaders and manage resources appropriately and to ultimately improve patient care. PMID:26929680
Gullion, David S.; And Others
A randomized control trial was used to evaluate a physician education program designed to improve physician management of patients' hypertension, hypertension-related behaviors, and diastolic blood pressure. It was suggested that more intensive continuing medical education programs are needed to improve physician performance and patient outcome.…
Williams, Stephen J.; Poss, W. Bradley; Cupp, Craig L.
A cooperative educational program with the U.S. military is described to illustrate a unique opportunity that confronted a graduate healthcare management program. The resulting degree program supported the military's operational medical mission but also presented interesting and unexpected challenges resulting from the wars in Iraq and…
Dieter, Peter Erich
The Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany, was founded in 1993 after the reunification of Germany. In 1999, a reform process of medical education was started together with Harvard Medical International. The traditional teacher and discipline-centred curriculum was replaced by a student-centred, interdisciplinary and integrative curriculum which has been named DIPOL (Dresden Integrative Patient/Problem- Oriented Learning). The reform process was accompanied and supported by a parallel-ongoing Faculty Development Program. In 2004, a Quality Management Program in medical education was implemented, and in 2005 medical education received DIN EN ISO 9001:2000 certification. Quality Management Program and DIN EN ISO 9001:2000 certification were/are unique for the 34 medical schools in Germany. The students played a very important strategic role in all processes. They were/are members in all committees like the Faculty Board, the Board of Study Affairs (with equal representation) and the ongoing audits in the Quality Management Program. Students are the only ones who experience all years of the curriculum and are capable of detecting, for example gaps, overlaps, inconsistencies of the curriculum and assessments. Therefore, the in-depth knowledge of students about the medical school's curriculum is a very helpful and essential tool in curriculum reform processes and Quality Management Programs of medical education. The reform in medical education, the establishment of the Quality Management program and the certification resulted in an improvement of quality and output of medical education and medical research.
Kanter, S L
Quality in the design and management of a medical school education program depends on the ability to access and analyze relevant information in a timely fashion. The components of medical-education information system should support learning and instruction as well as the administrative and research responsibilities of the program. A system capable of meeting these needs requires core, operational, and strategic components. This article discusses a conceptual schema of the medical school environment and reports the results of 3 1/2 years' experience developing core, operational, and strategic components as the University of Pittsburgh School of Medicine. The value of a simple conceptual schema as a design and development instrument was confirmed. Limitations of the system are discussed along with potential solutions. PMID:8653446
Djalali, Ahmadreza; Hosseinijenab, Vahid; Hasani, Azadeh; Shirmardi, Kianoush; Castrén, Maaret; Ohlén, Gunnar; Panahi, Farzad
During disasters, especially following earthquakes, health systems are expected to play an essential role in reducing mortality and morbidity. The most significant naturally occurring disaster in Iran is earthquakes; they have killed >180,000 people in the last 90 years. According to the current plan in 2007, the disaster management system of Iran is composed of three main work groups: (1) Prevention and risk management, (2) Education, and (3) Operation. This organizational separation has resulted in lack of necessary training programs for experts of specialized organizations, e.g., the Ministry of Health and Medical Education (MOHME).The National Board of MOHME arranged a training program in the field of medical disaster management. A qualified training team was chosen to conduct this program in each collaborating center, based on a predefined schedule. All collaborating centers were asked to recall 5-7 experts from each member university. Working in medical disaster management field for greater than or equal to 2 years was an inclusion criterion. The training programs lasted three days, consisted of all relevant aspects of medical disaster management, and were conducted over a six-month period (November 2007-April 2008). Pre-test and post-tests were used to examine the participants' knowledge regarding disaster management; the mean score on the pretest was 67.1 +/-11.6 and 88.1 +/-6.2, respectively. All participants were asked to hold the same training course for their organizations in order to enhance knowledge of related managers, stakeholders, and workers, and build capacity at the local and provincial levels. The next step was supposed to be developing a comprehensive medical disaster management plan for the entire country. Establishing nine disaster management regional collaborating centers in the health system of Iran has provided an appropriate base for related programs to be rapidly and easily accomplished throughout the country. This tree-shaped model is
Ewen, Shaun C; Hollinsworth, David
Introduction Attention to Aboriginal health has become mandatory in Australian medical education. In parallel, clinical management has increasingly used Aboriginality as an identifier in both decision making and reporting of morbidity and mortality. This focus is applauded in light of the gross inequalities in health outcomes between indigenous people and other Australians. Methods A purposive survey of relevant Australian and international literature was conducted to map the current state of play and identify concerns with efforts to teach cultural competence with Aboriginal people in medical schools and to provide “culturally appropriate” clinical care. The authors critically analyzed this literature in light of their experiences in teaching Aboriginal studies over six decades in many universities to generate examples of iatrogenic effects and possible responses. Results and discussion Understanding how to most effectively embed Aboriginal content and perspectives in curriculum and how to best teach and assess these remains contested. This review canvasses these debates, arguing that well-intentioned efforts in medical education and clinical management can have iatrogenic impacts. Given the long history of racialization of Aboriginal people in Australian medicine and the relatively low levels of routine contact with Aboriginal people among students and clinicians, the review urges caution in compounding these iatrogenic effects and proposes strategies to combat or reduce them. Conclusion Long overdue efforts to recognize gaps and inadequacies in medical education about Aboriginal people and their health and to provide equitable health services and improved health outcomes are needed and welcome. Such efforts need to be critically examined and rigorously evaluated to avoid the reproduction of pathologizing stereotypes and reductionist explanations for persistent poor outcomes for Aboriginal people. PMID:27313485
Abrusch, Jasmin; Marienhagen, Jörg; Böckers, Anja; Gerhardt-Szép, Susanne
Introduction: In 2008, the German Council of Science had advised universities to establish a quality management system (QMS) that conforms to international standards. The system was to be implemented within 5 years, i.e., until 2014 at the latest. The aim of the present study was to determine whether a QMS suitable for electronic learning (eLearning) domain of medical education to be used across Germany has meanwhile been identified. Methods: We approached all medical universities in Germany (n=35), using an anonymous questionnaire (8 domains, 50 items). Results: Our results (response rate 46.3%) indicated very reluctant application of QMS in eLearning and a major information deficit at the various institutions. Conclusions: Authors conclude that under the limitations of this study there seems to be a considerable need to improve the current knowledge on QMS for eLearning, and that clear guidelines and standards for their implementation should be further defined. PMID:26038685
Breer, M. Lynn; Pohl, Joanne M.; Stommel, Manfred; Barkauskas, Violet H.; Schillo, Barbara; Oakley, Deborah
Attitudes toward managed care of 431 medical residents and 153 advanced practice nursing students were compared. Medical students were more likely to agree that managed care emphasizes cost over quality and threatens autonomy. Nursing students were more likely to agree that it encourages preventive care. Medical students were less enthusiastic…
Chandran, Latha; Fleit, Howard B; Shroyer, A Laurie
Stony Brook University School of Medicine (SBU SOM) used a Liaison Committee on Medical Education (LCME) site visit to design a change management approach that engaged students, revitalized faculty, and enabled significant, positive institutional transformation while flexibly responding to concurrent leadership transitions. This "from-the-trenches" description of novel LCME site-visit-related processes may provide an educational program quality improvement template for other U.S. medical schools. The SBU SOM site visit processes were proactively organized within five phases: (1) planning (4 months), (2) data gathering (12 months), (3) documentation (6 months), (4) visit readiness (2 months), and (5) visit follow-up (16 months). The authors explain the key activities associated with each phase.The SBU SOM internal leadership team designed new LCME-driven educational performance reports to identify challenging aspects of the educational program (e.g., timeliness of grades submitted, midcourse feedback completeness, clerkship grading variability across affiliate sites, learning environment or student mistreatment incidents). This LCME process increased institutional awareness, identified the school's LCME vulnerabilities, organized corrective actions, engaged key stakeholders in communication, ensured leadership buy-in, and monitored successes. The authors' strategies for success included establishing a strong internal LCME leadership team, proactively setting deadlines for all phases of the LCME process, assessing and communicating vulnerabilities and action plans, building multidisciplinary working groups, leveraging information technology, educating key stakeholders through meetings, retreats, and consultants, and conducting a mock site visit. The urgency associated with an impending high-stakes LCME site visit can facilitate positive, local, educational program quality improvement.
Petersdorf, R G
The cost of a medical education may dissuade qualified young people from entering the medical profession or may so load them with debt that they cannot pursue relatively low-paid careers in primary care or clinical investigation. Three aspects of this problem are examined: (1) the cost of medical school, (2) the magnitude of student indebtedness, and (3) the effects of this indebtedness on career choices. High tuition and fees require many students to assume sizable educational debts, some of which are so large that the trainees will be unable to repay them unless they enter highly remunerative specialties. Also, high levels of indebtedness may increase default levels once graduates feel the full impact of scheduled repayments. Several steps would help to alleviate this problem, but are unlikely to solve it. First, medical schools should lower tuition or at least declare a moratorium on increases. Second, limits should be imposed on the amount of total education debt a student is allowed to assume. Third, hospitals with extensive residency programs should assume some responsibility for helping trainees manage their finances. Fourth, the government should institute a loan forgiveness program that addresses the need for physician-investigators, primary care physicians, those willing to practice in underserved areas, and those from underrepresented minorities. And fifth, all institutions involved in medical training and its finance should work together to advise students on managing their debts.
Thayer, Erin K.; Rathkey, Daniel; Miller, Marissa Fuqua; Palmer, Ryan; Mejicano, George C.; Pusic, Martin; Kalet, Adina; Gillespie, Colleen; Carney, Patricia A.
Issue Medical educators and educational researchers continue to improve their processes for managing medical student and program evaluation data using sound ethical principles. This is becoming even more important as curricular innovations are occurring across undergraduate and graduate medical education. Dissemination of findings from this work is critical, and peer-reviewed journals often require an institutional review board (IRB) determination. Approach IRB data repositories, originally designed for the longitudinal study of biological specimens, can be applied to medical education research. The benefits of such an approach include obtaining expedited review for multiple related studies within a single IRB application and allowing for more flexibility when conducting complex longitudinal studies involving large datasets from multiple data sources and/or institutions. In this paper, we inform educators and educational researchers on our analysis of the use of the IRB data repository approach to manage ethical considerations as part of best practices for amassing, pooling, and sharing data for educational research, evaluation, and improvement purposes. Implications Fostering multi-institutional studies while following sound ethical principles in the study of medical education is needed, and the IRB data repository approach has many benefits, especially for longitudinal assessment of complex multi-site data. PMID:27443407
Thayer, Erin K; Rathkey, Daniel; Miller, Marissa Fuqua; Palmer, Ryan; Mejicano, George C; Pusic, Martin; Kalet, Adina; Gillespie, Colleen; Carney, Patricia A
Issue Medical educators and educational researchers continue to improve their processes for managing medical student and program evaluation data using sound ethical principles. This is becoming even more important as curricular innovations are occurring across undergraduate and graduate medical education. Dissemination of findings from this work is critical, and peer-reviewed journals often require an institutional review board (IRB) determination. Approach IRB data repositories, originally designed for the longitudinal study of biological specimens, can be applied to medical education research. The benefits of such an approach include obtaining expedited review for multiple related studies within a single IRB application and allowing for more flexibility when conducting complex longitudinal studies involving large datasets from multiple data sources and/or institutions. In this paper, we inform educators and educational researchers on our analysis of the use of the IRB data repository approach to manage ethical considerations as part of best practices for amassing, pooling, and sharing data for educational research, evaluation, and improvement purposes. Implications Fostering multi-institutional studies while following sound ethical principles in the study of medical education is needed, and the IRB data repository approach has many benefits, especially for longitudinal assessment of complex multi-site data.
Mullen, P D; Mullen, L R
Asthma self-management education has the potential to improve the health and quality of life for children and to reduce use of acute care services. The preparation of parents and children to prevent asthma attacks and to ameliorate acute episodes when they do occur can best be accomplished with the support of medical care providers. This analysis addresses policy issues relevant to that acceptance: the degree of integration into medical practice that is desirable; the most hospitable clinical settings; and the incentives for providers, consumers, and payers that would result in appropriate supply and use of ASME:. The analysis commences with a discussion of the costs and benefits of making ASME a part of medical care. It then turns to a description of the trends that led to the current array of institutions, services, and incentives within the health care sector. Future changes in family context, financing, and other determinants of the use of medical services by children and youth are forecast. The framework for the analysis of incentives is diffusion of innovation. ASME is analyzed according to the attributes that generally facilitate the acceptance of a new procedure. In its current form and with current incentives, ASME is fairly complex and difficult to communicate, has little relative advantage, and is not necessarily compatible with the usual provider goals. The motivating factors for three interrelated groups-providers, consumers, and third-party payers-and leverage points for the application of incentives are identified. The latter include reimbursement, standards of practice, information generation and flow, insurance regulation, institutional development, and research funding. Important information to potential adopters includes the definition of the service, its optimal intensity and mix of providers, and its effects on net costs and quality of life.
Henrich, Natalie; Tsao, Nicole; Gastonguay, Louise; Lynd, Larry
Background: The BC Medication Management Project (BCMMP) was developed by the BC Ministry of Health and the BC Pharmacy Association. This pilot project ran from September 2010 to January 2012. Pharmacists reviewed patients’ medication histories, discussed best use of medications, provided education and monitored for adverse effects, developed a plan to deal with medication issues and created a best possible medication history. Methods: To evaluate the experience of participating in the BCMMP, challenges and strengths of the project and the alignment of these experiences with the overarching goals, focus groups and interviews were conducted with 6 stakeholder groups. Themes were compared within and across stakeholder type and descriptively analyzed. Results: A total of 88 people participated in the focus groups/interviews. Pharmacists stated that providing BCMMP services was professionally satisfying and concurred with patients that the service did benefit them. However, participating in the BCMMP was not seen as financially sustainable by pharmacy owners, and there were concerns about patient selection. Physicians expressed concerns about increased workload associated with the BCMMP, for which they were not compensated. The computer system and burden of documentation were identified as the greatest problems. Conclusions: The BCMMP pilot project was enthusiastically received by pharmacists and patients who felt that it benefited patients and moved the pharmacy profession in a positive direction. It was widely felt that the BCMMP could be successful and sustainable if the identified challenges are addressed. PMID:25983759
Wu, Shwu-Jiuan; Yeh, Yu-Ting; Li, Chun-Chuan; Chiu, Yuan-Ting; Huang, Juei-Fen; Liu, Chien-Tsai
Diabetic patients need long-term treatment and follow-up exams as well as appropriate self-care pharmaceutical education to get the disease under control and to prevent possible complications. Pharmaceutical treatment plays an essential role in diabetes. If patients don't understand the medicines and dosages they take, their blood glucose control may be affected. In addition, the possibility of developing hypoglycemia may be increased. In this paper, we enhance the POEM system, previously developed for diabetic patient education, by providing diabetic patients' pharmaceutical education. The new system integrates both diabetic patients' pharmaceutical education information and medical care information to provide them with more comprehensive personalized medication information so that they can access the on-line system afterwards. It also strengthens patients' understanding of pharmaceutical functions, side-effects and relevant knowledge thus increasing patients' adherence of medication orders and having better control in their blood glucose levels.
Slipp, Marlene; Burnham, Robert
Background: The prevalence of chronic pain is high and increasing. Medication management is an important component of chronic pain management. There is a shortage of physicians who are available and comfortable providing this service. In Alberta, pharmacists have been granted an advanced scope of practice. Given this empowerment, their availability, training and skill set, pharmacists are well positioned to play an expanded role in the medication management of chronic pain sufferers. Objective: To compare the effectiveness and cost of a physician-only vs a pharmacist-physician team model of medication management for chronic nonmalignant pain sufferers. Method: Data was analyzed for 89 patients who had received exclusively medication management at a rural Alberta multidisciplinary clinic. 56 were managed by a sole physician. 33 were managed by a team (pharmacist + physician). In the team model, the physician did the medical assessment, diagnosis, and established a treatment plan in consultation with the patient and pharmacist. The pharmacist then provided the ongoing follow-up including education, dose titration and side effect management and consulted with the physician as needed. Change in pain (Numerical Rating Scale) and disability (Pain Interference Questionnaire) over the course of treatment were recorded. The treatment duration and number of visits were used to calculate cost of care. Results: Both models of medication management resulted in significant and comparable improvements in pain, disability and patient perception of medication effectiveness. Patients in the physician-only group were seen more frequently and at a greater cost. The pharmacist-physician team approach was markedly more cost-effective, and patients expressed a high level of satisfaction with their medication management. Conclusions: The pharmacist-physician team model of medication management results in significant reductions of pain and disability for chronic nonmalignant pain sufferers
Pretzer, S D
When dystocia is diagnosed in the bitch or queen, two forms of treatment exist: medical or surgical therapy. Medical management of dystocia has the advantage of aiding completion of the parturition process without surgery or anesthesia. However, since not all cases of dystocia can be managed medically, educated and careful decision making is required prior to instituting medical management in cases of dystocia. Improper medical treatment, especially when surgical management is clinically indicated, can result in compromise and even death of the dam and fetuses. This paper focuses on the decision making necessary prior to instituting medical management for cases of dystocia in both bitches and queens, and describes available therapeutics.
Antman, Karen H; Berman, Harris A; Flotte, Terence R; Flier, Jeffrey; Dimitri, Dennis M; Bharel, Monica
Drug overdose has become the leading cause of injury death in the United States. More than half of those deaths involve prescription drugs, specifically opioids. A key component of addressing this national epidemic is improving prescriber practices.A review of the curricula at the four medical schools in Massachusetts revealed that, although they taught components of addiction medicine, no uniform standard existed to ensure that all students were taught prevention and management strategies for prescription drug misuse. To fill this gap, the governor and the secretary of health and human services invited the deans of the state's four medical schools to convene to develop a common educational strategy for teaching safe and effective opioid-prescribing practices. With leadership from the Department of Public Health and Massachusetts Medical Society, the deans formed the Medical Education Working Group in 2015. This group reviewed the relevant literature and current standards for treating substance use disorders and defined 10 core competencies for the prevention and management of prescription drug misuse.The medical schools have incorporated these competencies into their curricula and have committed to assessing students' competence in these areas. The members of the Medical Education Working Group have agreed to continue to work together on key next steps, including connecting these competencies to those for residents, equipping interprofessional teams to address prescription drug misuse, and developing materials in pain management and opioid misuse for practicing physicians. This first-in-the-nation partnership has yielded cross-institutional competencies that aim to address a public health emergency in real time.
Windfeld, Elliott Steen; Brooks, Marianne Su-Ling
This paper examines medical waste management, including the common sources, governing legislation and handling and disposal methods. Many developed nations have medical waste legislation, however there is generally little guidance as to which objects can be defined as infectious. This lack of clarity has made sorting medical waste inefficient, thereby increasing the volume of waste treated for pathogens, which is commonly done by incineration. This review highlights that the unnecessary classification of waste as infectious results in higher disposal costs and an increase in undesirable environmental impacts. The review concludes that better education of healthcare workers and standardized sorting of medical waste streams are key avenues for efficient waste management at healthcare facilities, and that further research is required given the trend in increased medical waste production with increasing global GDP.
Masters, Ken; Ellaway, Rachel
With e-learning now part of the medical education mainstream, both educational and practical technical and informatics skills have become an essential part of the medical teacher's portfolio. The Guide is intended to help teachers develop their skills in working in the new online educational environments, and to ensure that they appreciate the wider changes and developments that accompany this 'information revolution'. The Guide is divided into two parts, of which this is the second. The first part introduced the basic concepts of e-learning, e-teaching, and e-assessment, the day-to-day issues of e-learning, looking both at theoretical concepts and practical implementation issues. This second part covers topics such as practical knowledge of the forms of technology used in e-learning, the behaviours of teachers and learners in online environments and the design of e-learning content and activities. It also deals with broader concepts of the politics and psychology of e-learning, as well as many of its ethical, legal and economical dimensions, and it ends with a review of emerging forms and directions in e-learning in medical education.
Lane, Todd W.; VanderNoot, Victoria A.
This plan describes the process for managing research generated medical waste at Sandia National Laboratories/California. It applies to operations at the Chemical and Radiation Detection Laboratory (CRDL), Building 968, and other biosafety level 1 or 2 activities at the site. It addresses the accumulation, storage, treatment and disposal of medical waste and sharps waste. It also describes the procedures to comply with regulatory requirements and SNL policies applicable to medical waste.
Zhang, Qin; Lee, Liming; Gruppen, Larry D; Ba, Denian
As medical education undergoes significant internationalization, it is important for the medical education community to understand how different countries structure and provide medical education. This article highlights the current landscape of medical education in China, particularly the changes that have taken place in recent years. It also examines policies and offers suggestions about future strategies for medical education in China. Although many of these changes reflect international trends, Chinese medical education has seen unique transformations that reflect its particular culture and history.
Han, Heeyoung; Resch, David S; Kovach, Regina A
This article aims to review the past practices of educational technology and envision future directions for medical education. The discussion starts with a historical review of definitions and perspectives of educational technology, in which the authors propose that educators adopt a broader process-oriented understanding of educational technology. Future directions of e-learning, simulation, and health information technology are discussed based on a systems view of the technological process. As new technologies continue to arise, this process-oriented understanding and outcome-based expectations of educational technology should be embraced. With this view, educational technology should be valued in terms of how well the technological process informs and facilitates learning, and the acquisition and maintenance of clinical expertise.
Martins e Silva, João
Is briefly analyzed the evolution that the objectives, strategies and models of medical education have had since their presentation and subsequent implementation of the famous model of Abraham Flexner, is now 103 years. Although globally accepted in their original pedagogical principles and instruments, that model does not have avoided the continuing dissatisfaction by the medical community and students and, most markedly in recent decades, the demanding of a most efficient health care by society, in general, and by patients in particular. In response to these ambitions, the medical community felt that it was essential to review the traditional criteria of medical professionalism, adapting them to a new paradigm of society and an appropriate and more efficient model of medical education. In this respect, are analyzed strategies and methodologies, apparently more suitable proposals for the inclusion of the principles and responsibilities of medical professionalism since the early period of pre-graduated medical education. It is assumed that the emphasis in teaching and practice of reflection throughout the course will have positive and lasting repercussions during active working life. However, the author believes that the success of the measures to be introduced in medical education programs to a new model of professionalism continues to depend, above all, of the humanistic and cognitive attributes of the students to be chosen, and the pedagogical quality, professional and academic of their teachers.
This paper offers a medical-education perspective that I will hope complement other disciplinary perspectives in examining the value of reflection for learning in tertiary education. The paper outlines some of the theoretical strands of reflective practice facilitated in a unique course subject for professionalism and patient safety, within the…
Lindgren, Stefan; Brännström, Thomas; Hanse, Eric; Ledin, Torbjörn; Nilsson, Gunnar; Sandler, Stellan; Tidefelt, Ulf; Donnér, Jakob
Undergraduate medical education in Sweden has moved from nationally regulated, subject-based courses to programmes integrated either around organ systems or physiological and patho-physiological processes, or organised around basic medical science in conjunction with clinical specialities, with individual profiles at the seven medical schools. The national regulations are restricted to overall academic and professional outcomes. The 5½ year long university undergraduate curriculum is followed by a mandatory 18 months internship, delivered by the County Councils. While quality control and accreditation for the university curriculum is provided by the Swedish National Agency for Higher Education, no such formal control exists for the internship; undergraduate medical education is therefore in conflict with EU directives from 2005. The Government is expected to move towards 6 years long university undergraduate programmes, leading to licence, which will facilitate international mobility of both Swedish and foreign medical students and doctors. Ongoing academic development of undergraduate education is strengthened by the Bologna process. It includes outcome (competence)-based curricula, university Masters level complying with international standards, progression of competence throughout the curriculum, student directed learning, active participation and roles in practical clinical education and a national assessment model to assure professional competence. In the near future, the dimensioning of Swedish undergraduate education is likely to be decided more by international demands and aspects of quality than by national demands for doctors.
Is the art of medical education just making sure to provide sufficient up to date medical knowledge and a lot of clinical experience? It is much more. The art of medical education is about a teaching program that is designed to serve the community of the near future. The program is the result of a thorough evaluation of societal needs and is capable of influencing the properties of future care. New care professionals who are trained in the program will -become instrumental in solving complex problems in health systems. The art of medical education is about the change of traditional ideas of how to cope with these health systems. This change will raise anger and resistance. Effective change management is essential to survive attacks from laggards and to maintain enthusiasm to invest in the health care of the future. Educationalist science provides several important insights that help us find the optimal shape of the program. Good role models and a learning environment that is an example of the intended professional and organisational behaviour, learning by doing, simulation programs, educational tools like e-learning systems, a good assessment and feedback system, and a portfolio to prove and discuss professional progress are all pivotal components of the ideal program. To achieve mastery within the art of medical education, a quality improvement program will be the crown of the process. Medical education is a multifaceted process and so the quality improvement should be. The art of medical education is a great challenge. The health care of your future deserves it.
De Ocampo, Anna C; Jacobs, Jeannine M
The primary care physician should be knowledgeable about the medical issues that children with ASD encounter and also be aware of available treatment options. Included among these are: identification of seizures, treatment of sleep problems, aggressive management of chronic constipation and GERD as well as timely referral for preventive dental care. Due to the scarcity of sub-specialists (Pediatric Neurologist, Developmental Pediatrician, Child Psychiatrist/ Psychologist) managing children with ASD, the primary care physician should likewise be familiar with medication options for challenging behaviors. More importantly, there needs to be a close collaboration and communication between the family, the sub-specialist and the child's primary care physician.
Tham, Kum Ying
The Observer-Reporter-Interpreter-Manager-Educator (ORIME) is adapted from RIME, an intuitive, self-explanatory and "synthetic" framework that assesses formatively, a student's ability to synthesise knowledge, skills and attitude during a clinical encounter with a patient. The "O" refers to a student's ability to pay attention and perceive with open-mindedness, people and events around him or her. The framework is suitable for definition of interim outcomes in a 5-year undergraduate programme. To align students' and clinical teachers' expectations further, selection of case complexity that is commensurate with student's seniority and competence should be guided and an adapted version of the Minnesota Complexity Assessment Tool is proposed.
Wear, Delese; Zarconi, Joseph; Kumagai, Arno; Cole-Kelly, Kathy
Slow medical education borrows from other "slow" movements by offering a complementary orientation to medical education that emphasizes the value of slow and thoughtful reflection and interaction in medical education and clinical care. Such slow experiences, when systematically structured throughout the curriculum, offer ways for learners to engage in thoughtful reflection, dialogue, appreciation, and human understanding, with the hope that they will incorporate these practices throughout their lives as physicians. This Perspective offers several spaces in the medical curriculum where slowing down is possible: while reading and writing at various times in the curriculum and while providing clinical care, focusing particularly on conducting the physical exam and other dimensions of patient care. Time taken to slow down in these ways offers emerging physicians opportunities to more fully incorporate their experiences into a professional identity that embodies reflection, critical awareness, cultural humility, and empathy. The authors argue that these curricular spaces must be created in a very deliberate manner, even on busy ward services, throughout the education of physicians.
... Thromboembolism Aortic Aneurysm More Managing High Blood Pressure Medications Updated:Jan 3,2017 When your doctor prescribes ... Download a printable medicine tracker . Quick Tips for Medication Use Understand your medication. Know what it's for, ...
Reutzel, Thomas J.; Desai, Archana; Workman, Gloria; Atkin, John A.; Grady, Sarah; Todd, Timothy; Nguyen, Nhu; Watkins, Melissa; Tran, Kim; Liu, Nian; Rafinski, Michelle; Dang, Thanh
An increasing number of students are taking medications while they are in school or are under the influence of medication during school hours. In a novel effort, clinical pharmacists and mental health therapists worked together to provide "mini-in-service" educational programs on psychological disorders and medications used to treat…
Vollmar, H C; Schürer-Maly, C-C; Lelgemann, M; Koneczny, N; Koch, M; Butzlaff, M
Effective translation of relevant knowledge into clinical practice is essential for modern health care systems. National Disease Management Guidelines (NDMG) are considered relevant instruments to support this transfer. To implement NDMG Internet-based continuing medical education (CME), modules and online case-based learning objects were designed and published. To ensure high quality the contents are based on NDMG and subjected to multi-step review processes. Presentation on the web was realized through a modified content management system. To obtain a CME certificate, completing an online questionnaire using a four-point Likert scale was mandatory. Between June 2003 and April 2005, 3,105 physicians were registered and used the platform: 95% of the physicians expressed positive feedback in the evaluation questionnaire, and 35% actually used the corresponding NDMG in practice. This prompted the development of interactive medical case-based learning objects as a second learning pathway. An Internet platform for CME including case-based learning objects can be a helpful tool to assure the provision of scientific knowledge for patient care.
Pelaccia, Thierry; Viau, Rolland
Motivation is a concept which has fascinated researchers for many decades. The field of medical education has become interested in motivation recently, having always assumed that medical students must be motivated because of their commitment to highly specific training, leading to a very specific profession. However, motivation is a major determinant of the quality of learning and success, the lack of which may well explain why teachers sometimes observe medical students who are discouraged, have lost interest or abandon their studies, with a feeling of powerlessness or resignation. After describing the importance of motivation for learning in medicine, this Guide will define the concept of motivation, setting it within the context of a social cognitive approach. In the second part of this Guide, recommendations are made, based upon the so-called "motivational dynamic model", which provides a multitude of various strategies with positive effects on students' motivation to learn.
Sabanović, Zekerijah; Mujcinagić, Alija
Medical informatics is a specific and interdisciplinary science which involves many participants of the health system like: patients, physicians, nurses, managers, administrators, computer experts, students, with the different level of education and understanding, different approaches and expectations. Education of medical informatics requests organization solutions of high quality and necessary equipment for its realization. Educational programs are also limited by student's basic knowledge of informatics from secondary schools. For assessment of this knowledge we have conducted special designed questionnaire at the first year of undergraduate study which results confirm our thesis that great number of students entered the faculty with the lack of basic knowledge from informatics area. In this paper was presented level of organization and education of medical informatics at the Medical faculty and University Clinical Center of Tuzla, with its characteristics through which this system has been passed since 1990.
Johnson, Sara S.; Castle, Patricia H.; Van Marter, Deborah; Roc, Anne; Neubauer, David; Auerbach, Sanford; DeAguiar, Emma
Study Objective: To evaluate the effect of continuing medical education (CME) activities on patient reported outcomes with regard to (1) screening for excessive sleepiness (ES) and obstructive sleep apnea (OSA) and (2) appropriate referral and treatment. Methods: A total of 725 patients were recruited from 75 providers who either participated or did not participate in Transtheoretical Model (TTM)-based OSA CME activities. Patient reported outcomes from participating (n = 36) and non-participating providers (n = 39) were compared using generalized estimating equations examining random effects of provider as unit of assignment. Results: Patients' reports demonstrate that participating physicians were 1.7 times more likely to initiate discussion of sleep problems than non-participating physicians (t1,411 = 3.71, p = 0.05) and 2.25–2.86 times more likely to administer validated measures for OSA (Epworth Sleepiness Scale and STOP-BANG). Patient reports also indicated that participating clinicians (79.9%) were significantly more likely to recommend seeing a sleep specialist compared to non-participating clinicians (60.7%; t1,348 = 9.1, p < 0.01, OR = 2.6). Furthermore, while 89.4% of participating clinicians recommended a sleep study, only 73.2% of the non-participating physicians recommended one (t1,363 = 11.46, p < 0.001, OR = 3.1). Conclusions: Participation in TTM-based OSA CME activities was associated with improved patient reported outcomes compared to the non-participating clinicians. Citation: Johnson SS, Castle PH, Van Marter D, Roc A, Neubauer D, Auerbach S, DeAguiar E. The effect of physician continuing medical education on patient-reported outcomes for identifying and optimally managing obstructive sleep apnea. J Clin Sleep Med 2015;11(3):197–204. PMID:25845903
Community-orientated medicine is a topical area for debate in the current discussions about medical education, but it can be argued that medical education has always been in the community because medical practice is located therein. It is widely accepted that community settings provide a wealth of learning opportunities for students and trainees…
Zayapragassarazan, Z.; Kumar, Santosh
The ongoing pedagogical advancements in medical education across the globe have gained the attention of academicians for the preparation of well-educated and competent physicians to address the healthcare issues facing today. The integration of technology into medical pedagogy has proved effective in many ways. This has made the medical education…
Lloyd, J W; Covert, B R
Most veterinary students enrolled at AAVMC member institutions take at least 1 VPM course prior to graduation. These courses are characterized by widespread involvement of outside lecturers with business expertise, which likely adds to their strength. However, it remains that wide variation in VPM education exists across the AAVMC with regard to the topics addressed, the specific business expertise of faculty and administrative course specifics. As such, the situation provides several key opportunities. Foremost among these is the immediate need for profession-wide discourse on VPM education to define reasonable expectations with regard to the business skills of veterinary graduates. In addition, outcomes assessment would provide information on which of the widely varying approaches to VPM education is most likely to produce successful graduates. The opportunity also exists for development of academic research programs to support VPM education directly by strengthening the related disciplinary knowledge base. Effective leadership for these efforts will be crucial to their success.
Patients (n=672) were screened and instructed about osteoporosis; 53 of their physicians attended lectures, a control group did not. A survey of 258 patients showed doctor-ordered screening tests increased regardless of lecture attendance. Increased patient-initiated discussions about osteoporosis suggest that patient education is effective.…
Deng, Sutong; Wang, Miao; Jiang, Xiali
Management of medical consumables is an important part of modern hospital management. In modern medical behavior, drugs and medical devices act directly on the patient, and are important factors affecting the quality of medical practice. With the increasing use of medical materials, based on practical application, this article proposes the management model of medical consumables, and discusses the essence of medical materials logistics management.
Monif, G R; Severin, M J
A crisis exists in medical education. Changes in methodology have diverted attention from synthesis to mass accumulation of factual data. The response to this crisis has been largely focused on a shell game involving new pathways and curriculum changes without addressing the critical issue of what constitutes education. The ultimate problem in medical education is a crisis of leadership. Until education is given a priority status and the obligations to teach on the part of medical educators and to learn on the part of students are translated into a creative policy by those who can lead, the wheels of learning will continue to spin without significant progress.
Baum, Eric W.
Rosacea is a common inflammatory facial dermatosis seen in adults that exhibits considerable variety in clinical presentation. Multiple medical therapeutic options are available including topical and oral treatments. Optimal medical management of rosacea includes assessment of subtype and disease severity and use of appropriate skin care to reduce epidermal barrier dysfunction. This article provides an overall discussion of the medical management of rosacea and reviews interim results from a study evaluating the role of designated skin care in rosacea treatment. PMID:21103305
Freeman, Elizabeth; Lischka, Terri A
The information provided in the present report on osteopathic graduate medical education (OGME) is based primarily on annual data provided through the American Osteopathic Association (AOA) Intern/Resident Registration Program (ie, the AOA Match) and the AOA Trainee Information, Verification, and Registration Audit reporting system. In 2007, the number of osteopathic medical graduates totaled 3103, surpassing 3000 for the first time. In 2008, the total reached 3462 graduates. Statistics on the Match in this article are reported for both 2007 and 2008. A total of 1267 (41%) and 1316 (38%) graduates and previous graduates participated and matched in 2007 and 2008, respectively. With post-Match scramble data, the number of graduates and previous graduates in AOA-approved internships and first-year residency positions rose to 1645 (53%) for the 2007-2008 academic year and is estimated to be 1828 (51%) for the 2008-2009 academic year. The response of students through the Match and the increased attention to innovative OGME development activities--particularly the internship restructuring and OGME Development Initiative--are evidence of a positive momentum in OGME in recent years.
Kumar, Santosh; Zayapragassarazan, Z.
Modern curricula have both compulsory portions and electives or portions chosen by students. Electives have been a part of graduate and postgraduate general higher education. Electives are included in various standards for graduate medical education and are also included in proposed Medical Council of India Regulations on Graduate Medical…
Ten Cate, Olle
This paper aims to draw a picture of current medical education in The Netherlands. Based on strong historical roots in the seventeenth century, Dutch medical education has adapted to changing circumstances through the ages. Nowadays, medical education in The Netherlands may be called "modern", according to international standards and schools such as the one in Maastricht serve as examples, nationally and internationally. After considerable redesign of undergraduate education in the 1980s and 1990s, the first decade of the new century shows a revolutionary development of postgraduate medical education, with the introduction of nationwide competency-based training, and mandatory in-training assessments and portfolios for residents. The high level of activity in medical education development is reflected in high research productivity, measured as Dutch articles in international journals. Despite these strengths, several critical issues around medical education are in debate, ranging from entrance selection, small group tutoring, the two-cycle bachelor-master model and the relevance of basic sciences to the planning of enrolment numbers and working hours for residents. Medical education in The Netherlands is a dynamic field.
Jackson, Valerie P
The education of radiology residents and fellows is a vitally important but costly process. This paper reviews the most common methods of funding graduate medical education. The majority of graduate medical education in the United States is funded by Medicare, but there are caps on the number of trainees allowed, and the government is cutting payments. Academic medicine, particularly academic radiology, is at a point of crisis today if new methods to provide additional support are not found.
Ibrahim, Joseph Elias; Davis, Marie-Claire
Individuals with dementia carry an additional health burden of multiple comorbid conditions. Effectively assessing and treating these comorbid conditions requires the medical specialist to be aware of, understand, and manage the effects of dementia on their clinical subspecialty practice. This ecological study describes the dementia-related…
People with cancer may face major financial challenges and need help dealing with the high costs of care. Cancer treatment can be very expensive, even when you have insurance. Learn ways to manage medical information, paperwork, bills, and other records.
Alterescu, S.; Hipkins, K. R.; Friedman, C. A.
On-line interactive information processing system easily and rapidly handles all aspects of data management related to patient care. General purpose system is flexible enough to be applied to other data management situations found in areas such as occupational safety data, judicial information, or personnel records.
French, Robert, Ed.; Grey, Christopher, Ed.
This book brings together the work of practitioners actively engaged in developing new approaches to management education, and their application. The 10 chapters are: Chapter 1, "Rethinking Management Education: An Introduction" (Christopher Grey and Robert French); chapter 2, "Can Management Education be Educational?" (Alan B. Thomjas and Peter…
Shon, Kyung Hee; Park, Si Sung
An effective rehabilitation program was developed for psychiatric patients' self-management of medication and symptoms. The rehabilitation program was designed to allow the patients to understand their illness, cope with their medical regimen, and prevent a relapse by recognizing any of the symptoms when they recur. This study consisted of three phases. The first phase was to explore the extent and the specific mental health needs of psychiatric patients. Data was obtained from 82 subjects who had symptoms of a mental illness including schizophrenia, bipolar disorders, and delusional disorder. They had received medication instruction during their hospitalization. The subjects were at the time outpatients in a psychiatric hospital. In the second phase, the researchers developed an educational program focused on coping with the residual and relapse warning signs, managing the drug side effects, medication compliance, and daily routines, according to the information acquired in the first step. The developed program includes the self-efficacy method reported by Bandura, including manuals and videotapes focusing on real life situations, small group discussions, and telephone coaching. Finally, the researchers investigated the effects of this program. Thirty-eight patients were selected for this study, 18 in the experimental program and 20 as controls. The diagnoses were same as those with the first step. The results showed that the subjects who attended this educational program reported significantly more improvement in self-efficacy (p=0.014) and medication compliance (p= 0.005), and significantly less relapse warning symptom scores (p=0.000) than the controls. In conclusion, these instructional materials will be beneficial for medication and symptom management in rehabilitating psychiatric patients in Korea. In addition, the materials may be a useful psychoeducational resource for professionals in the field of clinical psychiatry.
Pollock, George P.
The basic curricular structure and courses deemed necessary to podiatric medical education are outlined and their rationale explained. Specialties appropriate to podiatric practice, such as electrophysiology and cardiovascular physiology, are noted, and the sequence of coursework suggested. (MSE)
Alterescu, Sidney; Friedman, Carl A.; Frankowski, James W.
Medical Information Management System (MIMS) computer program interactive, general-purpose software system for storage and retrieval of information. Offers immediate assistance where manipulation of large data bases required. User quickly and efficiently extracts, displays, and analyzes data. Used in management of medical data and handling all aspects of data related to care of patients. Other applications include management of data on occupational safety in public and private sectors, handling judicial information, systemizing purchasing and procurement systems, and analyses of cost structures of organizations. Written in Microsoft FORTRAN 77.
non -medical personnel by organizing military specialties into occupational groups based on their six-digit DoD Occupation Codes. Table 14 lists the...Department of Defense or the sponsoring organization . Acknowledgments Thank you to Stanley A. Horowitz, Philip M. Lurie, and Susan L. Rose for performing...requirements (e.g., requirements to staff deployable units) and non -operational requirements. The non - operational requirements constitute a substantial
Johnson, Maree; Tran, Duong Thuy; Young, Helen
The aim of this study was to define risk management behaviours related to medication safety. Mixed methods were used to analyze 318 nursing related medication incidents reported in an Australian metropolitan hospital. Most incidents did not result in patient harm (93%). Omission of medications was the most frequent often related to patient absences from the unit or nurses failing to sign for medications. Thematic analysis resulted in the Medication Safety Subscales including 29 behavioural statements within three domains-administering medications, storage and management of medications, managing adverse events related to medications. The Medication Safety Subscales can be used by managers, educators and clinicians to reinforce the importance of medication safety. Early action by nurses may reduce patient injury.
Marinkovic, Natalija Vitale, Ksenija; Holcer, Natasa Janev; Dzakula, Aleksandar; Pavic, Tomo
This article provides a review of hazardous medical waste production and its management in Croatia. Even though Croatian regulations define all steps in the waste management chain, implementation of those steps is one of the country's greatest issues. Improper practice is evident from the point of waste production to final disposal. The biggest producers of hazardous medical waste are hospitals that do not implement existing legislation, due to the lack of education and funds. Information on quantities, type and flow of medical waste are inadequate, as is sanitary control. We propose an integrated approach to medical waste management based on a hierarchical structure from the point of generation to its disposal. Priority is given to the reduction of the amounts and potential for harm. Where this is not possible, management includes reduction by sorting and separating, pretreatment on site, safe transportation, final treatment and sanitary disposal. Preferred methods should be the least harmful for human health and the environment. Integrated medical waste management could greatly reduce quantities and consequently financial strains. Landfilling is the predominant route of disposal in Croatia, although the authors believe that incineration is the most appropriate method. In a country such as Croatia, a number of small incinerators would be the most economical solution.
Leggat, Peter A.
Discusses the learning experience from both traditional and computer-assisted instructional methods. Describes the environments in which these methods are effective. Focuses on learning experiences in medical education and describes educational strategies, particularly the 'SPICES' model. Discusses the importance of mentoring in the psychosocial…
Wang, Binseng; Furst, Emanuel; Cohen, Ted; Keil, Ode R; Ridgway, Malcolm; Stiefel, Robert
Clinical engineering professionals need to continually review and improve their management strategies in order to keep up with improvements in equipment technology, as well as with increasing expectations of health care organizations. In the last 20 years, management strategies have evolved from the initial obsession with electrical safety to flexible criteria that fit the individual institution's needs. Few hospitals, however, are taking full advantage of the paradigm shift offered by the evolution of joint Commission standards. The focus should be on risks caused by equipment failure, rather than on equipment with highest maintenance demands. Furthermore, it is not enough to consider risks posed by individual pieces of equipment to individual patients. It is critical to anticipate the impact of an equipment failure on larger groups of patients, especially when dealing with one of a kind, sophisticated pieces of equipment that are required to provide timely and accurate diagnoses for immediate therapeutic decisions or surgical interventions. A strategy for incorporating multiple criteria to formulate appropriate management strategies is provided in this article.
Educational management is a field of study and practice concerned with the operation of educational organizations. The present author has argued consistently (Bush, 1986; Bush, 1995; Bush, 1999; Bush, 2003) that educational management has to be centrally concerned with the purpose or aims of education. These purposes or goals provide the crucial…
Hilty, Donald M.; Benjamin, Sheldon; Briscoe, Gregory; Hales, Deborah J.; Boland, Robert J.; Luo, John S.; Chan, Carlyle H.; Kennedy, Robert S.; Karlinsky, Harry; Gordon, Daniel B.; Yellowlees, Peter M.; Yager, Joel
Objective: This article provides an overview of how trainees, faculty, and institutions use technology for acquiring knowledge, skills, and attitudes for practicing modern medicine. Method: The authors reviewed the literature on medical education, technology, and change, and identify the key themes and make recommendations for implementing…
Dennis, K J; Elstein, M
Medical curricula have been deficient in the area of education in sexuality, and it is only over the last decade or so that medical schools in the UK and abroad have recognized the importance of teaching human sexual physiology and sexuality. Attention in this discussion of education in sexuality in the medical curricula is directed to the following: present status of sex education in British schools and in medical schools; a suggested component of human sexuality in the undergraduate medical curriculum (learning objectives and strategy for introducing education in sexuality in the medical curriculum); and postgraduate education in sexual matters. Secondary schools, whether comprehensive, grammar, or private, have been slow to develop cognitive learning in such topics as the place of sexual drive within and without marriage, variations in sexual orientation, and the technicalities of various contraceptives methods. They have done even less to encourage the development of positive responsible attitudes to human sexuality. Students at the time of arrival at a medical school will have many gaps in their knowledge of the commonplace in human sexuality and in reproduction. If they have positive, healthy, and responsible attitudes toward their own sexual drives and to the sexuality of others, it is only because they are among the minority whose parents have been able to transmit them to their offspring. The Royal Commission on Medical Education (Todd report 1965-1968) identified deficiencies in the sex education of Britain's doctors and recommended that medical students should learn about the reproductive organs and their physiology and should also have an awareness of the wide implications of the problems of fertility and infertility and know something about marital problems and their management. In the older and well established medical schools, the teaching of human sexuality, especially in the earlier preclinical part of the course, depends upon enthusiasts
The purpose of this article is to give international readers an overview of the organisation, structure and curriculum, together with important advances and problems, of undergraduate medical education in Germany. Interest in medical education in Germany has been relatively low but has gained momentum with the new "Regulation of the Licensing of Doctors" which came into effect in 2003. Medical education had required substantial reform, particularly with respect to improving the links between theoretical and clinical teaching and the extension of interdisciplinary and topic-related instruction. It takes six years and three months to complete the curriculum and training is divided into three sections: basic science (2 years), clinical science (3 years) and final clinical year. While the reorganisation of graduate medical education required by the new "Regulation of the Licensing of Doctors" has stimulated multiple excellent teaching projects, there is evidence that some of the stipulated changes have not been implemented. Indeed, whether the medical schools have complied with this regulation and its overall success remains to be assessed systematically. Mandatory external accreditation and periodic reaccreditation of medical faculties need to be established in Germany. PMID:19675742
Hilton, Sean; Southgate, Lesley
Medical professionalism in today's society requires the exhibition of a range of qualities deployed in the service of patients, rather than more traditionally defined aspects such as mastery, autonomy and self-regulation. These qualities incorporate demonstrated clinical competence; aspiring to excellence in practice while demonstrating humility…
Mecca, Stephen J.; Robertshaw, Joseph E.
Describes two formal programs in the area of energy management education: a Residential Energy Management Summer Institute (part of a faculty development program funded by the Department of Energy), and a Residential Energy Management curriculum for Energy Auditors. (CS)
The 20th century witnessed phenomenal growth in scientific medical knowledge and technology, enabling physicians to more accurately diagnose and effectively treat a wide range of diseases. However, these advances led to longer and more complex training periods for physicians and increasing specialization and dependence on the new technology. An adverse outcome of these changes has been the development of many physicians who are less able to communicate with their patients and deal with them in a humanistic and personally caring manner; ie, the development of finely trained medical technologists as opposed to caring physicians. Their behavior and their blind trust in science and technology without understanding the patients in whom illness occurs often leads to making incorrect, incomplete, or inappropriate diagnoses or to unnecessary failures of treatment. It also results in excessive costs, hazardous procedures, and ill will from patients. Unfortunately, such technologically oriented physicians are often the primary role models for students. The best hope for a remedy to the problem lies in recognizing that it exists, understanding its causes, and modifying medical education accordingly. Providing students with good role models and some rudimentary techniques can lead to significant gains, but sophisticated programs have been designed only in some schools.
Norcini, John J.; McKinley, Danette W.
Since the 1950s, there has been rapid and extensive change in the way assessment is conducted in medical education. Several new methods of assessment have been developed and implemented over this time and they have focused on clinical skills (taking a history from a patient and performing a physical examination), communication skills, procedural…
Woods, Majka; Anderson, Leslie; Rosenberg, Mark E
Traditionally, changes to medical education come from the top down, an approach that potentially misses important contributions from medical students, residents, faculty and staff. In order to provide an avenue for them to bring forward their ideas for educational improvements, the University of Minnesota Medical School sponsored the "What's the Bright Idea?" contest. Through the contest, we sought to foster a culture of innovation and collaboration among faculty, staff and students. The contest included five phases: launch, idea submission, online voting, follow-up and implementation. Seventy-six ideas were submitted, and 902 people participated in the online voting. When asked in a follow-up survey whether the submitter would have developed their idea without the contest, 27% of respondents answered "no" and 18% answered "maybe." Three-fourths stated the contest stimulated networking and collaboration. Four of the recommendations are now being implemented.
Chewning, Betty; Wiederholt, Joseph B
This article explores how the concept of concordance can help to identify gaps and opportunities for research on consumer-provider communication related to cancer medication management. The relationship of concordance, patient-centered care and shared decision making is examined. Research on unmet patient agendas, quality of life issues related to symptom management and tools to assist communication about patient somatic experience are discussed. The need for research on patient communication with pharmacists, nurses and other health team members beyond physicians is noted. Research implications for longitudinal, descriptive and intervention studies are offered.
Chalela, Julio A; Lopez, J Ivan
Hunger strikes are not infrequent occurrences in military and civilian prisons. Although practicing clinicians are familiar with the management of patients who have limited oral intake, managing hunger strikers is unfamiliar to most. The psychological, physiological, and social events that surround hunger strikes are very complex and need to be understood by those caring for hunger strike patients. To provide adequate medical care to hunger strike patients, clinicians most understand the physiological events that ensue after prolonged starvation. Careful vigilance for development of refeeding syndrome is of key importance. A multidisciplinary approach to hunger strikes is of utmost importance, and involvement of a multidisciplinary clinical team as well as prison officials is essential.
Maniscalco, P M; Christen, H T
If you had to get x amount of supplies to point A or point B, or both, in 10 minutes, how would you do it? The answer lies in the following steps: 1. Develop a logistics plan. 2. Use emergency management as a partner agency for developing your logistics plan. 3. Implement a push logistics system by determining what supplies/medications and equipment are important. 4. Place mass casualty/disaster caches at key locations for rapid deployment. Have medication/fluid caches available at local hospitals. 5. Develop and implement command caches for key supervisors and managers. 6. Anticipate the logistics requirements of a terrorism/tactical violence event based on a community threat assessment. 7. Educate the public about preparing a BLS family disaster kit. 8. Test logistics capabilities at disaster exercises. 9. Budget for logistics needs. 10. Never underestimate the importance of logistics. When logistics support fails, the EMS system fails.
Byrns, George; Burke, Thomas
Discusses the implications of the Medical Waste Management Act of 1988 for small medical facilities, public health, and the environment. Reviews health and environmental risks associated with medical waste, current regulatory approaches, and classifications. Concludes that the health risk of medical wastes has been overestimated; makes…
Cole, Ariel Forrester
The act of overt plagiarism by graduates of accredited residency programs represents a failure in personal integrity. It also indicates a lack of professionalism, one of the six Accreditation Council for Graduate Medical Education (ACGME) competencies for graduate medical education. A recent experience at one geriatric fellowship indicates that the problem of plagiarism may be more prevalent than previously recognized. A situation was discovered at the geriatric medicine fellowship at Florida Hospital Family Medicine Residency Program in Orlando, Fla, in which three of the personal statements included in a total of 26 applications to the fellowship in the past 2 years contained portions plagiarized from a single Web site. The aim in documenting this plagiarism is to raise awareness among medical educators about the availability of online sources of content and ease of electronic plagiarism. Some students and residents may not recognize copying other resources verbatim as plagiarism. Residency programs should evaluate their own need for education about plagiarism and include this in the training of the competency of professionalism.
Knezevich, Emily L; Viereck, Laura K; Drincic, Andjela T
Gender identity disorder (GID), or transsexualism, is an increasingly recognized medical condition with an expanding body of medical literature to support the use of established therapeutic guidelines. Transsexualism can be effectively managed through exogenous cross-sex hormone administration used to induce development of desired sex characteristics, as well as use of other agents, such as aldosterone antagonists, aimed at decreasing physical characteristics of the undesired sex. Many complications can arise with the use of the available therapies, and these must be considered before determining the appropriate course of action. This review describes methods, including both pharmacotherapy and surgical interventions, for effective medical management of both male and female adults with GID. In addition, specific goals of therapy as well as safety aspects with long-term use of pharmacotherapeutic agents are discussed. This review also discusses some special considerations for treating patients with significant, yet common, comorbid diseases such as human immunodeficiency virus infection, acquired immunodeficiency syndrome, and viral hepatitis, as these conditions may complicate the clinical course and preclude some patients from using certain therapies. Pharmacist involvement in the management of transsexualism can be extremely beneficial to patients and other health care providers. Pharmacists can help determine the appropriate therapy, optimize dosages, monitor for adverse effects, and educate patients on what to expect during their therapy. Pharmacists should become knowledgeable about guidelines and current literature on transsexualism, understand the monitoring parameters for safe and effective therapy, and establish themselves as partners in the collaborative management of this disorder.
Hentschke, Guilbert C.
This book is intended to acquaint students and professionals in educational management with those activities in educational organizations requiring technical, business-related competence, and with selected management tools that aid in the analysis of those activities. Part 1, Fiscal Systems, includes discussions of fund accounting, direct costing,…
Medical education and training in Australia comprises four phases: basic education, prevocational training, vocational training and continuing professional development. Between the 1860s and 1960s, eight medical schools were established in Australia, admitting school leavers to courses comprised of preclinical, paraclinical and clinical phases. Between the 1970s and the 1990s, two innovative new schools were established and all schools made major reforms to student selection, curricula and teaching, learning and assessment methods. Since 2000, student numbers expanded rapidly, both in existing medical schools and in eight new schools established to meet workforce demands, particularly in the rural sector. Prevocational training, first introduced as a compulsory internship year in the 1930s, has undergone reform and extension to subsequent years of junior doctor training through the agency of health departments and postgraduate medical education councils. Vocational training and continuing professional development, delivered by 15 specialist medical colleges, has evolved since the 1930s from a focus on specialist care of individual patients to include broader professional attributes required to manage complex health care systems. The Australian Medical Council began accreditation of basic medical education in 1985 and its remit now extends to all phases of medical education and training. With national governance of the entire system of medical education and training now achieved, mechanisms exist for flexible integration of all phases of medical education to meet the local and global challenges facing Australia's medical workforce.
Frankowski, J. W.
MIMS, Medical Information Management System is an interactive, general purpose information storage and retrieval system. It was first designed to be used in medical data management, and can be used to handle all aspects of data related to patient care. Other areas of application for MIMS include: managing occupational safety data in the public and private sectors; handling judicial information where speed and accuracy are high priorities; systemizing purchasing and procurement systems; and analyzing organizational cost structures. Because of its free format design, MIMS can offer immediate assistance where manipulation of large data bases is required. File structures, data categories, field lengths and formats, including alphabetic and/or numeric, are all user defined. The user can quickly and efficiently extract, display, and analyze the data. Three means of extracting data are provided: certain short items of information, such as social security numbers, can be used to uniquely identify each record for quick access; records can be selected which match conditions defined by the user; and specific categories of data can be selected. Data may be displayed and analyzed in several ways which include: generating tabular information assembled from comparison of all the records on the system; generating statistical information on numeric data such as means, standard deviations and standard errors; and displaying formatted listings of output data. The MIMS program is written in Microsoft FORTRAN-77. It was designed to operate on IBM Personal Computers and compatibles running under PC or MS DOS 2.00 or higher. MIMS was developed in 1987.
In the setting of clinical medical education, feedback refers to information describing students' or house officers' performance in a given activity that is intended to guide their future performance in that same or in a related activity. It is a key step in the acquisition of clinical skills, yet feedback is often omitted or handled improperly in clinical training. This can result in important untoward consequences, some of which may extend beyond the training period. Once the nature of the feedback process is appreciated, however, especially the distinction between feedback and evaluation and the importance of focusing on the trainees' observable behaviors rather than on the trainees themselves, the educational benefit of feedback can be realized. This article presents guidelines for offering feedback that have been set forth in the literature of business administration, psychology, and education, adapted here for use by teachers and students of clinical medicine.
Alexandroff, A B; Johnston, G A
Allergic and irritant contact dermatitis are important dermatological problems. Although the frequencies of positive reactions to a number of allergens have decreased during last 30 years because of better avoidance (and at least in part due to improved legislation), contact allergy to other agents is rising. The medical treatment starts from a correct identification of triggers of contact dermatitis which could allow patients to reduce or avoid exposure to these agents in future. A good clinical history, examination and immunological tests including patch testing are of crucial importance at this stage. Further management includes emollients, topical and oral corticosteroids, topical calcineurin inhibitors, azathioprine and ciclosporin. Methotrexate and alitretinoin are recent additions to the armamentarium of dermatologists who manage contact dermatitis.
Cohen, Joshua; Christensen, Kathyrn; Feldman, Lanna
Lack of medication compliance is harmful to health care systems from both a clinical and economic perspective. This study examines the methods that disease management organizations employ to identify nonadherent patients and to measure effectiveness of compliance programs for patients with diabetes, hyperlipidemia, and cystic fibrosis. In addition, this study investigates the degree to which disease managers assume risk in their contracts, and whether compliance strategies are being coordinated with payers' use of value-based insurance design, in which patient cost sharing is a function of the relative value of pharmaceuticals. This study's findings suggest that disease management may be falling short in terms of: (a) comprehensive commitment to expert-recommended at-home devices used to self-diagnose and measure health indicators; (b) early adoption of expert-recommended new technologies to measure and improve compliance; (c) intensity of use of standard tests in outpatient clinics; (d) coordination of compliance strategies with payers' use of value-based insurance design; and (e) the proportion of risk assumed in disease management contracts.
Pascarella, Luigi; Shortell, Cynthia K
Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration.
Osorio, Guido; Sayes, Nilda; Fernández, Lautaro; Araya, Ester; Poblete, Dennis
Medical audit is defined as the critical and periodical assessment of the quality of medical care, through the revision on medical records and hospital statistics. This review defines the work of the medical auditor and shows the fields of action of medical audit, emphasizing its importance and usefulness as a management tool. The authors propose that every hospital should create an audit system, should provide the necessary tools to carry out medical audits and should form an audit committee.
Van Meter, K
This article discusses the history of medical field management of the injured diver, and presents a comprehensive medical equipment list for field treatment as well as treatment protocols. Case reports are used to illustrate the principles and outcome of medical field management.
Smith, E. R.
Any educational process involves four distinct stages: the selection of goals, the selection of learning experiences, the organization of these experiences and the evaluation of achievement. If the results of evaluation are unsatisfactory, then the goals were unrealistic, the learning experiences were inadequate, or the experiences were poorly organized. The characteristics of the good physician and the recognition of these in candidates for medical education are matters of great interest. Does a student learn because he has good teachers or because he has proper motivation for success? Is it possible for one to teach another, and if so, what is the best technique of instruction? How can the student best be evaluated? Medical education is in a state of rapid change, but changes of significance will not occur until the quality of the teachers is improved and the barriers of departmental organization are removed, thus putting the students' instruction in the hands of persons unbiased by concentration on a small field of endeavour. PMID:5907585
Yong, Zhang; Gang, Xiao; Guanxing, Wang; Tao, Zhou; Dawei, Jiang
Medical waste management is of great importance due to its infectious and hazardous nature that can cause undesirable effects on humans and the environment. The objective of this study was to analyze and evaluate the present status of medical waste management in the light of medical waste control regulations in Nanjing. A comprehensive inspection survey was conducted for 15 hospitals, 3 disposal companies and 200 patients. Field visits and a questionnaire survey method were implemented to collect information regarding different medical waste management aspects, including medical waste generation, segregation and collection, storage, training and education, transportation, disposal, and public awareness. The results indicated that the medical waste generation rate ranges from 0.5 to 0.8 kg/bed day with a weighted average of 0.68 kg/bed day. The segregated collection of various types of medical waste has been conducted in 73% of the hospitals, but 20% of the hospitals still use unqualified staff for medical waste collection, and 93.3% of the hospitals have temporary storage areas. Additionally, 93.3% of the hospitals have provided training for staff; however, only 20% of the hospitals have ongoing training and education. It was found that the centralized disposal system has been constructed based on incineration technology, and the disposal cost of medical waste is about 580 US$/ton. The results also suggested that there is not sufficient public understanding of medical waste management, and 77% of respondents think medical waste management is an important factor in selecting hospital services. The problematic areas of medical waste management in Nanjing are addressed by proposing some recommendations that will ensure that potential health and environmental risks of medical waste are minimized.
Shapiro, Johanna; Cho, Beverly
Medical Readers' Theater (MRT) is an innovative and simple way of helping medical students to reflect on difficult-to-discuss topics in geriatrics medical education, such as aging stereotypes, disability and loss of independence, sexuality, assisted living, relationships with adult children, and end-of-life issues. The authors describe a required…
Pellegrino, Annette N; Martin, Michelle T; Tilton, Jessica J; Touchette, Daniel R
In the US, the Medicare Modernization Act of 2003 required that Medicare Part D insurers provide medication therapy management (MTM) services (MTMS) to selected beneficiaries, with the goals of providing education, improving adherence, or detecting adverse drug events and medication misuse. These broad goals and variety in MTM programmes available make assessment of these programmes difficult. The objectives of this article are to review the definitions of MTMS proposed by various stakeholders, and to summarize and evaluate the outcomes of MTMS consistent with those that may be offered in Medicare Part D or reimbursed by State Medicaid programmes. MTM programmes are approved by the Centers for Medicare and Medicaid Services (CMS). Pharmacy, medical and insurance organizations have provided guidelines and definitions for MTM programmes, distinguishing them from other types of community pharmacy activities. MTM has been distinguished from disease state management because of the focus on medications and multiple conditions. It differs from patient counselling because it is delivered independent of dispensing and involves collaboration with patients and providers. There is no consensus on the recommended mode of delivery (i.e. face-to-face or by telephone) for MTM. A MEDLINE search was conducted to identify articles published after 2000 using the search terms 'medication therapy management' and 'medication management'. Studies with outcomes evaluating community-based programmes consistent with MTMS, regardless of MTMS reimbursement source, were included in the review. Seven publications describing four MTMS were identified. For each of the identified articles, we describe the study design, service setting, inclusion criteria and outcomes. An additional three surveys describing multiple MTMS were identified and are summarized. Finally, ongoing efforts by CMS to evaluate the success of MTMS in the US are described. To date, there are limited outcomes available for MTMS
This document demonstrates in a simple way the depth and variety of ethical topics in medical care management, which are subjects not often addressed. Every medical administrator should be aware that all actions and decisions have ethical dimensions. Ethics applies to management of medical services according to honesty, transparency and decency. The behavior of those persons administering medical services is based on ethical values, principles and theories.
Doukas, David J; McCullough, Laurence B; Wear, Stephen
Medical education accreditation organizations require medical ethics and humanities education to develop professionalism in medical learners, yet there has never been a comprehensive critical appraisal of medical education in ethics and humanities. The Project to Rebalance and Integrate Medical Education (PRIME) I Workshop, convened in May 2010, undertook the first critical appraisal of the definitions, goals, and objectives of medical ethics and humanities teaching. The authors describe assembling a national expert panel of educators representing the disciplines of ethics, history, literature, and the visual arts. This panel was tasked with describing the major pedagogical goals of art, ethics, history, and literature in medical education, how these disciplines should be integrated with one another in medical education, and how they could be best integrated into undergraduate and graduate medical education. The authors present the recommendations resulting from the PRIME I discussion, centered on three main themes. The major goal of medical education in ethics and humanities is to promote humanistic skills and professional conduct in physicians. Patient-centered skills enable learners to become medical professionals, whereas critical thinking skills assist learners to critically appraise the concept and implementation of medical professionalism. Implementation of a comprehensive medical ethics and humanities curriculum in medical school and residency requires clear direction and academic support and should be based on clear goals and objectives that can be reliably assessed. The PRIME expert panel concurred that medical ethics and humanities education is essential for professional development in medicine.
Emiliani, M. L.
Purpose: To present an outsider's view of how management education can be significantly improved. Design/methodology/approach: Focuses on correcting several obvious deficiencies in courses and degree programs to create highly differentiated educational experiences that are more relevant to student's needs and the organizations that employ…
Bruner, Robert F.; Iannarelli, Juliane
A new study, sponsored by the Association to Advance Collegiate Schools of Business, presented a comprehensive new perspective on the globalization of management education, (AACSB International, 2011). Its findings are sobering: with regard to emerging global trends in higher education and cross-border business, the report reveals a sizable gap…
Balcioglu, Huseyin; Bilge, Ugur; Unluoglu, Ilhami
Even though there are significant developments in recent years in medical education, physicians are still needed reform and innovation in order to prepare the information society. The spots in the forefront of medical education in recent years; holistic approach in all processes, including health education, evidence-based medicine and…
Jones, Robert F.
This report presents information about the academic medical centers belonging to the Association of American Medical Colleges (AAMC) and profiles American medical education generally. Following a brief introduction, a section on institutions and resources offers information on medical schools' financial support, faculties, and faculty practice…
Sorrel, Amy Lynn
With lifestyle-related diseases on the rise, some medical schools help to arm future doctors with the nutrition knowledge they'll need. Texas medical schools and residency programs are getting ahead of the curve in addressing this public-health-meets-medical-education issue, with medical students often leading the charge.
Argues that the student-as-customer model of medical education has many failings that result in educationally dysfunctional interactions. Proposes a new model (based on Deming's 14 principles for quality in business) in which faculty are managers of instruction, students are learning workers, the product is successful learning, and the customers…
This paper explores teachers' perspectives on the management of mandated educational change in order to understand how it may be managed more effectively. A case study of teachers' responses to the introduction of a quality teaching initiative in two New South Wales schools found that while some teachers described the strong negative impact of…
The Chilean Academy of Medicine published a "Report on the Current Status of Medical Education in Chile". This report reviews the history of medical education in this country and its close relationship with the Health Care System, public and private; highlights the main changes that took place during the last 25 years in superior and medical education; provides information on the 26 currently existing Medical Schools; refers to the availability of medical doctors and specialists; discusses the mechanisms that control the quality of institutions involved and their programs; and summarizes the results of the Annual National Medical Examination. The members of the Committee on Superior Education of the Academy provided a critical analysis of medical education in Chile and recommendations on how to improve it.
Sandlow, L. J.; And Others
The educational contribution of medical care evaluation (MCE) has been portrayed as the identification of physicians' educational needs. A study of 13 MCE committees was undertaken to document the learning that occurs in these committees and to discover the conditions affecting their educational value. (Author/MLW)
Gainor, Jamie; Patel, Nilay K; George, Paul F; MacNamara, Marina M C; Dollase, Richard; Taylor, Julie Scott
Peer teaching by medical students is increasingly consid- ered an effective and efficient instructional modality with value for both teachers and learners. In 2012, twelve senior medical students participated in an inaugural, four-week Medical Education Elective at The Alpert Medical School of Brown University. The first week emphasized education theory and skills. During the remaining three weeks, participants served as a core group of instructors in a Clinical Skills Clerkship (CSC), a three-week required course transitioning rising third-year students to clinical clerkships. Senior near-peer instructors (NPIs) gained substantive experience in developing curriculum, facilitating small group sessions, teaching clinical skills, mentoring, providing feedback, and grading an Objective Structured Clinical Examination (OSCE). Based on direct observation by faculty and written anonymous evaluations by learners (n=98), NPIs demonstrated a high degree of teaching competence. This innovative, by-invitation-only, annual elective is the most substantive medical education experience for medical students described in the literature.
The development of graduate education in biostatistics and medical statistics is discussed in the context of training within a medical center setting. The need for medical researchers to employ a wide variety of statistical designs in clinical, genetic, basic science and translational settings justifies the ongoing integration of biostatistical training into medical center educational settings and informs its content. The integration of large data issues are a challenge. PMID:24472088
Benamer, Hani T S; Bakoush, Omran
The history of medical education in Libya spans over a period of 40 years. Medical schools had a good and promising start in the 1970s. The graduates of the first few classes had a good impact on the health services in Libya. However, the medical schools did not embrace the immense changes that medical education experienced over the last two decades. This article aims to give a background on the medical education in Libya and explore the challenges facing it, which may help in gaining the initial momentum that seems to have been lost.
Lerner, Susan; Magrane, Diane; Friedman, Erica
Teamwork has become a major focus in healthcare. In part, this is the result of the Institute of Medicine report entitled To Err Is Human: Building a Safer Health System, which details the high rate of preventable medical errors, many of which are the result of dysfunctional or nonexistent teamwork. It has been proposed that a healthcare system that supports effective teamwork can improve the quality of patient care and reduce workload issues that cause burnout among healthcare professionals. Few clear guidelines exist to help guide the implementation of all these recommendations in healthcare settings. In general, training programs designed to improve team skills are a new concept for medicine, particularly for physicians who are trained largely to be self-sufficient and individually responsible for their actions. Outside of healthcare, research has shown that teams working together in high-risk and high-intensity work environments make fewer mistakes than individuals. This evidence originates from commercial aviation, the military, firefighting, and rapid-response police activities. Commercial aviation, an industry in which mistakes can result in unacceptable loss, has been at the forefront of risk reduction through teamwork training. The importance of teamwork has been recognized by some in the healthcare industry who have begun to develop their own specialty-driven programs. The purpose of this review is to discuss the current literature on teaching about teamwork in undergraduate medical education. We describe the science of teams, analyze the work in team training that has been done in other fields, and assess what work has been done in other fields about the importance of team training (ie, aviation, nonmedical education, and business). Additionally, it is vital to assess what work has already been done in medicine to advance the skills required for effective teamwork. Much of this work has been done in fields in which medical professionals deal with crisis
The author argues that the student-as-customer model of medical education has many failings that result in interactions that are educationally dysfunctional. Ten "pathologies" resulting from the adoption of this model are presented (e.g., "The student-customer model seduces students into believing that they know what is best for them"). Part of the reason for the unprofessional conduct often demonstrated by students and faculty alike may be a result of the influence of this model on medical education and the consequent inappropriate empowerment of students in the role of customers, the diminishment of faculty in the role of workers who provide instruction, and the view that instruction is the service or product of medical education. The author proposes a new model of medical education in which faculty are managers of instruction, students are learning workers, the product is successful learning, and the customers are faculty, residency supervisors, patients, managed care organizations, and society. The implications of this new model are profound and are described in terms of Deming's 14 principles for achieving quality in business. The author maintains that the proposed model is the critical first step in clarifying and identifying the proper roles of all those involved in the medical education process, which in turn will diminish or eliminate the pathologies that currently plague medical education and lead to the achievement of real quality.
Jacobson, Elliott; Heard, Darryl; Isaza, Ramiro
Reptile medicine has emerged as a specialty area within the broader field of zoological medicine. It encompasses the medical needs of approximately 7,500 vertebrate species. This vertebrate class is highly diversified, having biological and medical peculiarities that differ both between and within major groups. Historically, veterinarians who have become recognized specialists with reptiles have had limited formal training in their medical management. The pet reptile trade is a multi-million-dollar business, and the popularity of reptiles as pets has resulted in a need for more veterinarians with training in their medical management. While few private practices have high volumes of reptile cases, many small-animal practices will have the opportunity to see a significant number of reptiles on an annual basis. Most practitioners with reptile medical expertise have merged their experiences as reptile pet owners with the principles of veterinary medicine taught in veterinary college. Several North American veterinary colleges have reptile medicine courses, and most have didactic and clinical courses in exotic and zoo animal medicine that include lectures and practical experience. Most accredited zoological medicine residency training programs include training in reptile medicine. The case load and interest in reptile medicine will probably never be sufficient to lead the average veterinary college to develop much more than what is currently offered. Consequently, those few colleges having more extensive course offerings, both didactic and clinical, will serve as educational centers for this discipline. Future Web-based teaching programs in reptile medicine will allow students nationally and internationally to have access to instructional material that can be continually updated.
Kho, Anna; Henderson, Laura E; Dressler, Daniel D; Kripalani, Sunil
BACKGROUND Over the past decade, handheld computers (or personal digital assistants [PDAs]) have become a popular tool among medical trainees and physicians. Few comprehensive reviews of PDA use in medicine have been published. OBJECTIVE We systematically reviewed the literature to (1) describe medical trainees' use of PDAs for education or patient care, (2) catalog popular software applications, and (3) evaluate the impact of PDA use on patient care. DATA SOURCES MEDLINE (1993 to 2004), medical education-related conference proceedings, and hand search of article bibliographies. REVIEW METHODS We identified articles and abstracts that described the use of PDAs in medical education by trainees or educators. Reports presenting a qualitative or quantitative evaluation were included. RESULTS Sixty-seven studies met inclusion criteria. Approximately 60% to 70% of medical students and residents use PDAs for educational purposes or patient care. Satisfaction was generally high and correlated with the level of handheld computer experience. Most of the studies included described PDA use for patient tracking and documentation. By contrast, trainees rated medical textbooks, medication references, and medical calculators as the most useful applications. Only 1 randomized trial with educational outcomes was found, demonstrating improved learning and application of evidence-based medicine with use of PDA-based decision support software. No articles reported the impact of PDA use on patient outcomes. CONCLUSION Most medical trainees find handhelds useful in their medical education and patient care. Further studies are needed to evaluate how PDAs impact learning and clinical outcomes. PMID:16704405
Tang, Guoping; Hu, Liang
Medical consumables material is essential supplies to carry out medical work, which has a wide range of varieties and a large amount of usage. How to manage it feasibly and efficiently that has been a topic of concern to everyone. This article discussed about how to design a medical consumable material management information system that has a set of standardized processes, bring together medical supplies administrator, suppliers and clinical departments. Advanced management mode, enterprise resource planning (ERP) applied to the whole system design process.
YAZDANI, SHAHRAM; KHOSHGOFTAR, ZOHREH; AHMADY, SOLEIMAN; RASTEGARPOUR, HASSAN; FOROUTAN, SEYED ABBAS
Introduction: Over the past few decades, two revolutionary approaches have emerged as a new form of medical education: Electronic Medical Education and Web-based Medical Education. A number of well-known medical institutions, such as Harvard and Johns Hopkins used a wide range of cyberspace capabilities to increase their competitiveness. Researchers have expressed that cyberspace will change health system’s main objective of training physicians and medical education. We conducted this study to identify the health system critical considerations on core issues, involving the development of medical education on cyberspace. Methods: In order to conduct this study, we observed the steps of a critical literature review, combined with the ‘Four-phase method’ adopted by Carnwell and Daly. We focused on particular literature on health and cyber system functions; it was associated with systemic approach. Results: We developed a six-level taxonomy, Cyber level, Governance level, Ministerial level, Organizational level, Program level and Performance level, as a key solution that can be applied for the success of medical education on cyberspace. The results were summarized and appraised in more details. Conclusion: Medical education on cyberspace is a complex interdisciplinary system. It is important that all aspects of the health systems be involved as integral to the development of cyber based medical education; without this convergence, we will be confused by the decisions made by others within the system. Health system should also communicate with those external sectors that are critical to achieving better learning on cyberspace. Integrated planning, governance and management of medical education in cyberspace are pivotal elements for the promotion. PMID:28124017
Condliffe, Peter G.; Furnia, Arthur H.
This book is the second of a series of conference proceedings on problems of medical education held by the Fogarty International Center. The participants discussed the value of research in medical education, research as a teaching tool, research and the teaching of community medicine, concepts of medical education, the role of the school of…
Sohrabi, Zohreh; Kheirkhah, Masoomeh; Vanaki, Zohreh; Arabshahi, Kamran Soltani; Farshad, Mohammad Mahdi; Farshad, Fatemeh; Farahani, Mansoureh Ashgale
Introduction: High quality educational systems are necessary for sustainable development and responding to the needs of society. In the recent decades, concerns have increased on the quality of education and competency of graduates. Since graduates of medical education are directly involved with the health of society, the quality of this system is of high importance. Investigation in the lived experience of educational leaders in the medical education systems can help to promote its quality. The present research examines this issue in Iran. Methodology: The study was done using content-analysis qualitative approach and semi-structured interviews. The participants included 26 authorities including university chancellors and vice-chancellors, ministry heads and deputies, deans of medical and basic sciences departments, education expert, graduates, and students of medical fields. Sampling was done using purposive snowball method. Data were analyzed using conventional content analysis. Findings: Five main categories and 14 sub-categories were extracted from data analysis including: quantity-orientation, ambiguity in the trainings, unsuitable educational environment, personalization of the educational management, and ineffective interpersonal relationship. The final theme was identified as “Education in shadow”. Conclusion: Personalization and inclusion of personal preferences in management styles, lack of suitable grounds, ambiguity in the structure and process of education has pushed medical education toward shadows and it is not the first priority; this can lead to incompetency of medical science graduates. PMID:26925915
Marreez, Yehia M. A-H.; Willems, Luuk N. A.; Wells, Michael R.
From the early 19th century until the most recent two decades, open-space and satellite museums featuring anatomy and pathology collections (collectively referred to as "medical museums") had leading roles in medical education. However, many factors have caused these roles to diminish dramatically in recent years. Chief among these are…
World Health Organization, Geneva (Switzerland).
This paper presents an agenda for worldwide change in medical education to meet current and future requirements of society. The first of four sections offers the central arguments for change in medical education noting global patterns in the search for better use of resources for health care, describing a profound shift underway in the present…
In this article, the author described eight, distinct practices through which schools were medicalized during the last decade of the 19th century and the first three decades of the 20th century. The medicalization of education was summarized in expanding definitions of educational hygiene, encompassing mental, neoscholastic, physical, and school…
Shahabudin, S H
With globalization education has become a tradable service governed by the rules and regulations of GATS and worth trillions of dollars. International standards are rapidly being developed to facilitate cross border supply of services. In medical education, the WFME has produced International Guidelines on Quality in Medical Education which has a regional equivalent in the WHO Western Pacific Region, and the IIME has defined the minimum essential requirements of standards in medical education in seven core competences. Malaysia, having an explicit policy of making education a sector for revenue generation, has put in place regulatory frameworks and incentives to make the country a centre of educational excellence. Within the ambit of this national aspiration, medical education has grown phenomenally in the last decade. Standards and procedures for accreditation of medical schools in line with the world standards have been developed and implemented and policies are enforced to facilitate compliance to the standards. The ultimate goal is for medical schools to be self-accredited. In striving towards self-accreditation medical schools should be innovative in making changes in the three requirements of medical education. These are the intellectual and social imperatives and strategies for effective implementation.
Sawyer, Michael Gifford; Giesen, Femke; Walter, Garry
A study to review the amount of time devoted to child psychiatry in undergraduate medical education is conducted. Results conclude that relatively low priority is given to child psychiatry in medical education with suggestions for international teaching standards on the subject.
Formal education for medical library specialization was initiated only thirty-two years ago despite the fact that medical libraries received special treatment for many years before that time. The philosophy of specialized education was developed as early as 1925, and this theory was finally put into practice beginning with the medical reference and bibliography course given at Columbia in 1939. In the late 1940s the requisites for medical librarians were formalized into a certification code by the Medical Library Association, and since that time specialized education for medical librarians has grown stronger using this code as a guideline. This education consists basically of two types-formal library school courses and internship programs which offer a working-while-learning situation. Now that the established programs have a few years of history, there is a need for evaluation and restatement of goals and methods.
Gandy, W.; Greenberg, B.R.
The medical management of neutropenic enterocolitis has been associated with a 100% mortality rate according to recent reports. This report describes two cases which were successfully managed without colonic resection. In one case, /sup 67/Ga radionuclide scanning was utilized as an aid in the diagnosis. The incidence, pathogenesis, diagnosis, and previously reported cases of medical management of neutropenic enterocolitis are reviewed, and the role of granulocyte transfusions and /sup 67/Ga scanning are discussed.
Lehrmann, Jon A.; Hoop, Jinger; Hammond, Katherine Green; Roberts, Laura Weiss
Objective: Despite the acknowledged importance of ethics education in medical school, little empirical work has been done to assess the needs and preferences of medical students regarding ethics curricula. Methods: Eighty-three medical students at the University of New Mexico participated in a self-administered written survey including 41 scaled…
Miles, Steven H.; And Others
A discussion of medical ethics in the medical curriculum reviews its recent history, examines areas of consensus, and describes teaching objectives and methods, course content, and program evaluation at preclinical and clinical levels. Prerequisites for successful institutionalization of medical ethics education are defined, and its future is…
Galanter, Marc, Ed.
This book presents the state of the art of American medical education in alcohol and drug abuse, and is the culmination of a four-year collaborative effort among the medical school faculty of the Career Teacher Program in Alcohol and Drug Abuse. The first part contains reports, curricula, and survey data prepared for the medical education…
American Medical Association, Chicago, IL. Council on Medical Education.
Prepared by the Council on Medical Education of the American Medical Association with the cooperation of collaborating organizations, this document is a collection of guidelines for accredited programs for medical assistants, nuclear medicine technology, orthopedic assistants, radiation therapy technology, and radiologic technologists. The…
Blanchard, Rebecca D; Visintainer, Paul F; La Rochelle, Jeffrey
The lack of effective and consistent research mentorship and research mentor training in both undergraduate medical education (UME) and graduate medical education (GME) is a critical constraint on the development of innovative and high quality medical education research. Clinical research mentors are often not familiar with the nuances and context of conducting education research. Clinician-educators, meanwhile, often lack the skills in developing and conducting rigorous research. Mentors who are not prepared to articulate potential scholarship pathways for their mentees risk limiting the mentee's progress in early stages of their career. In fact, the relative paucity of experienced medical education research mentors arguably contributes to the perpetuation of a cycle leading to fewer well-trained researchers in medical education, a lack of high quality medical education research, and relative stagnation in medical education innovation. There is a path forward, however. Integration of doctoral-level educators, structured inter-departmental efforts, and external mentorship provide opportunities for faculty to gain traction in their medical education research efforts. An investment in medical education research mentors will ensure rigorous research for high quality innovation in medical education and patient care.
Israel, D A; McCabe, M
The purpose of this project was to design, implement, and improve a nationwide medical nutrition therapy (MNT) intervention program for nutritionally at-risk employees and their dependents and retirees (hereinafter referred to as clients) with a Fortune 100 company (Texas Instruments, Dallas, Tex) with a dispersed population of 80,000. Preferred Nutrition Therapists (PNT), a network of registered dietitians, with the assistance of the Texas Instruments Health Promotion and Benefits Department, identified International Classification of Diseases, 9th ed (ICD-9), codes for which MNT intervention was appropriate. PNT then negotiated a contract with the Texas Instruments Health Promotion and Benefits Department and implemented clients' self-referral process. The main challenge was to promote utilization of a new service from an outside vendor (PNT) and to measure outcomes in meaningful ways. The goal was to use MNT as a tool to prevent the progression of clients' diseases to states that require more costly treatments. PNT used a continuous quality improvement process to refine the system and improve information gathering and reporting, by providing quarterly reports to the Health Promotion and Benefits Department. These reports summarized the outcomes for all clients seen at least 3 times during the quarter. The cost was less than $0.35 per member per month (less than the employer spent on advertising the program), and 0.5% of the population requested MNT during the first year of implementation (about what was expected for a new carveout benefit).
Garcia, Hong-Mei C.; Yun, David Y.
The rapid advancements in high performance global communication have accelerated cooperative image-based medical services to a new frontier. Traditional image-based medical services such as radiology and diagnostic consultation can now fully utilize multimedia technologies in order to provide novel services, including remote cooperative medical triage, distributed virtual simulation of operations, as well as cross-country collaborative medical research and training. Fast (efficient) and easy (flexible) retrieval of relevant images remains a critical requirement for the provision of remote medical services. This paper describes the database system requirements, identifies technological building blocks for meeting the requirements, and presents a system architecture for our target image database system, MISSION-DBS, which has been designed to fulfill the goals of Project MISSION (medical imaging support via satellite integrated optical network) -- an experimental high performance gigabit satellite communication network with access to remote supercomputing power, medical image databases, and 3D visualization capabilities in addition to medical expertise anywhere and anytime around the country. The MISSION-DBS design employs a synergistic fusion of techniques in distributed databases (DDB) and artificial intelligence (AI) for storing, migrating, accessing, and exploring images. The efficient storage and retrieval of voluminous image information is achieved by integrating DDB modeling and AI techniques for image processing while the flexible retrieval mechanisms are accomplished by combining attribute- based and content-based retrievals.
Continuous process of diabetic patient´s education is essential. Educator´s task is to select situationally and individually appropriate form of education and educational tools. Than he becomes capable to motivate patients to participate actively and cooperate. Use of practical and visual educational tools increases the memorability. Studies have shown positive effect on improvement of glycemic control for both individual and group education. When properly educated diabetic patient is able to make independent decisions and manage the disease. Achieving good long-term glycemic control with reduced risk of chronic complications in compliant diabetic patient is the expected target of treatment. Thus the medical care becomes cost-effective.Key words: conversation map tools - diabetes mellitus - educator - group education - individual education.
Gruppen, Larry D; Yoder, Ernie; Frye, Ann; Perkowski, Linda C; Mavis, Brian
The quality of the medical education research (MER) reported in the literature has been frequently criticized. Numerous reasons have been provided for these shortcomings, including the level of research training and experience of many medical school faculty. The faculty development required to improve MER can take various forms. This article describes the Medical Education Research Certificate (MERC) program, a national faculty development program that focuses exclusively on MER. Sponsored by the Association of American Medical Colleges and led by a committee of established medical education researchers from across the United States, the MERC program is built on a set of 11 interactive workshops offered at various times and places across the United States. MERC participants can customize the program by selecting six workshops from this set to fulfill requirements for certification. This article describes the history, operations, current organization, and evaluation of the program. Key elements of the program's success include alignment of program content and focus with needs identified by prospective users, flexibility in program organization and logistics to fit participant schedules, an emphasis on practical application of MER principles in the context of the participants' activities and interests, consistency in program content and format to ensure standards of quality, and a sustainable financial model. The relationship between the national MERC program and local faculty development initiatives is also described. The success of the MERC program suggests that it may be a possible model for nationally disseminated faculty development programs in other domains.
Gale, Rodney; Grant, Janet
This booklet presents guidelines for the management of change in medicine in Great Britain, particularly post-basic medical education. Following a forward and introduction, a description of the study from which the guidelines were developed is presented. That study was a major investigation of adapting business and industry change management…
... of Health Care Office Management American Health Information Management Association American College of Health Care Administrators For more information about academic programs in this field, visit Association of University ...
McCarthy, David; O'Gorman, Ciaran; Gormley, Gerry J
The landscape of medical education is changing as students embrace the accessibility and interactivity of e-learning. Virtual patients are e-learning resources that may be used to advance microbiology education. Although the development of virtual patients has been widely considered, here we aim to provide a coherent approach for clinical educators.
Cook, David A.; Beckman, Thomas J.
As medical education research advances, it is important that education researchers employ rigorous methods for conducting and reporting their investigations. In this article we discuss several important yet oft neglected issues in designing experimental research in education. First, randomization controls for only a subset of possible confounders.…
In the last few years, medical education policy makers have expressed concern about changes in the ethical attitude and behavior of medical trainees during the course of their education. They claim that newly graduated physicians (MDs) are entering residency years with inappropriate habits and attitudes earned during their education. This allegation has been supported by numerous research on the changes in the attitude and morality of medical trainees. The aim of this paper was to investigate ethical erosion among medical trainees as a serious universal problem, and to urge the authorities to take urgent preventive and corrective action. A comparison with the course of moral development in ordinary people from Kohlberg’s and Gilligan's points of view reveals that the growth of ethical attitudes and behaviors in medical students is stunted or even degraded in many medical schools. In the end, the article examines the feasibility of teaching ethics in medical schools and the best approach for this purpose. It concludes that there is considerable controversy among ethicists on whether teaching ethical virtues is plausible at all. Virtue-based ethics, principle-based ethics and ethics of care are approaches that have been considered as most applicable in this regard. PMID:28050246
In the last few years, medical education policy makers have expressed concern about changes in the ethical attitude and behavior of medical trainees during the course of their education. They claim that newly graduated physicians (MDs) are entering residency years with inappropriate habits and attitudes earned during their education. This allegation has been supported by numerous research on the changes in the attitude and morality of medical trainees. The aim of this paper was to investigate ethical erosion among medical trainees as a serious universal problem, and to urge the authorities to take urgent preventive and corrective action. A comparison with the course of moral development in ordinary people from Kohlberg's and Gilligan's points of view reveals that the growth of ethical attitudes and behaviors in medical students is stunted or even degraded in many medical schools. In the end, the article examines the feasibility of teaching ethics in medical schools and the best approach for this purpose. It concludes that there is considerable controversy among ethicists on whether teaching ethical virtues is plausible at all. Virtue-based ethics, principle-based ethics and ethics of care are approaches that have been considered as most applicable in this regard.
David, S P; Greer, D S
Medical education is often a frustrating endeavor, particularly when it attempts to change practice behavior. Traditional lecture-based educational methods are limited in their ability to sustain concentration and interest and to promote learner adherence to best-practice guidelines. Marketing techniques have been very effective in changing consumer behavior and physician behavior. However, the techniques of social marketing-goal identification, audience segmentation, and market research-have not been harnessed and applied to medical education. Social marketing can be applied to medical education in the effort to go beyond inoculation of learners with information and actually change behaviors. The tremendous potential of social marketing for medical education should be pilot-tested and systematically evaluated.
Cao, Shaoping; Yin, Chunguang; Zhao, Zhenying
Through the establishment of implantable medical device information management system, with the aid of the regional joint sharing of resources, we further enhance the implantable medical device traceability management level, strengthen quality management, control of medical risk.
Locke, Kenneth A.; Bates, Carol K.; Karani, Reena; Chheda, Shobhina G.
Background A rapidly evolving body of literature in medical education can impact the practice of clinical educators in graduate medical education. Objective To aggregate studies published in the medical education literature in 2011 to provide teachers in general internal medicine with an overview of the current, relevant medical education literature. Review We systematically searched major medical education journals and the general clinical literature for medical education studies with sound design and relevance to the educational practice of graduate medical education teachers. We chose 12 studies, grouped into themes, using a consensus method, and critiqued these studies. Results Four themes emerged. They encompass (1) learner assessment, (2) duty hour limits and teaching in the inpatient setting, (3) innovations in teaching, and (4) learner distress. With each article we also present recommendations for how readers may use them as resources to update their clinical teaching. While we sought to identify the studies with the highest quality and greatest relevance to educators, limitation of the studies selected include their single-site and small sample nature, and the frequent lack of objective measures of outcomes. These limitations are shared with the larger body of medical education literature. Conclusions The themes and the recommendations for how to incorporate this information into clinical teaching have the potential to inform the educational practice of general internist educators as well as that of teachers in other specialties. PMID:24404262
Malpas, Phillipa J; Corbett, Andrea
Medical and nursing student numbers are expected to increase significantly in NZ over the next few years. The ethical, and professional and clinical skills' training of trainee health practitioners is a central and crucial component in medical and nursing education and is underpinned by a strong commitment to improve patient health and well being. In this discussion we reflect on the virtue of empathy and the importance of role modelling in the education of nurses and doctors. We endorse the claim that as medical educators, how and what we teach matters.
Englebright, Jane D; Franklin, Michelle
The national focus on medication errors has stimulated rapid adoption of medication administration technologies with bar code verification. The effectiveness of these technologies in preventing errors is directly related to how consistently practitioners use the technology to verify both patient identity and drug identity with each administration. The authors discuss management strategies that have proven effective at increasing staff compliance with using bar code-enabled medication systems.
Henry, Robert G
Antiplatelet medications are drugs which decrease platelet aggregation and inhibit thrombus (clot) formation. They are widely used in primary and secondary prevention of thrombotic cerebrovascular or cardiovascular disease. The most common antiplatelet medications are the cyclooxygenase inhibitors (aspirin) and the adenosine disphosphate (ADP) receptor inhibitors clopidogrel (Plavix) and ticlopidine (Ticlid). The dental management of patients taking these drugs is reviewed here.
Margetts, J K
Ongoing serious breaches in medical professionalism might be avoided if UK doctors rethink their approach to law. UK medical education has a role in creating a climate of change by re-examining how law is taught to medical students. Adopting a more insightful approach in the UK to the impact of The Human Rights Act and learning to manipulate legal concepts, such as conflict of interest, need to be taught to medical students now if UK doctors are to manage complex decision-making in the NHS of the future. The literature is reviewed from a unique personal perspective of a doctor and lawyer, and practical proposals for developing medical education in law in the UK are suggested.
Electroconvulsive therapy (ECT) has demonstrated to be highly effective and safe, even life saving for many psychiatric disorders such as major depression, bipolar disorder and schizophrenia. Most patients who require ECT are also on concurrent pharmacotherapy. As such, the objective of this article is to provide a review of the most recent literature focusing on the medications used during an ECT procedure and on the effects of concurrent psychiatric and non-psychiatric medications on the effectiveness and safety of ECT. The review also attempts to summarize the recommendations derived from existing documents to guide pharmacotherapy decisions for patients undergoing ECT. For this purpose, using electronic databases, an extensive search of the current literature was made using ECT and medications or drug classes as keywords. PMID:27143894
Cianciolo, Anna T; Eva, Kevin W; Colliver, Jerry A
The role and status of theory is by no means a new topic in medical education. Yet summarizing where we have been and where we are going with respect to theory development and application is difficult because our community has not yet fully elucidated what constitutes medical education theory. In this article, we explore the idea of conceptualizing theory as an effect on scholarly dialogue among medical educators. We describe theory-enabled conversation as argumentation, which frames inquiry, permits the evaluation of evidence, and enables the acquisition of community understanding that has utility beyond investigators' local circumstances. We present ideas for assessing argumentation quality and suggest approaches to increasing the frequency and quality of argumentation in the exchange among diverse medical education scholars.
We need to ensure that we get value for money for our investments in medical education. Commissioning is one method of ensuring that we get value. However, like any other tool, it needs to be used properly.
Wanderer, Jonathan P; Charnin, Jonathan; Driscoll, William D; Bailin, Michael T; Baker, Keith
Our goal in this study was to develop decision support systems for resident operating room (OR) assignments using anesthesia information management system (AIMS) records and Accreditation Council for Graduate Medical Education (ACGME) case logs and evaluate the implementations. We developed 2 Web-based systems: an ACGME case-log visualization tool, and Residents Helping in Navigating OR Scheduling (Rhinos), an interactive system that solicits OR assignment requests from residents and creates resident profiles. Resident profiles are snapshots of the cases and procedures each resident has done and were derived from AIMS records and ACGME case logs. A Rhinos pilot was performed for 6 weeks on 2 clinical services. One hundred sixty-five requests were entered and used in OR assignment decisions by a single attending anesthesiologist. Each request consisted of a rank ordered list of up to 3 ORs. Residents had access to detailed information about these cases including surgeon and patient name, age, procedure type, and admission status. Success rates at matching resident requests were determined by comparing requests with AIMS records. Of the 165 requests, 87 first-choice matches (52.7%), 27 second-choice matches (16.4%), and 8 third-choice matches (4.8%) were made. Forty-three requests were unmatched (26.1%). Thirty-nine first-choice requests overlapped (23.6%). Full implementation followed on 8 clinical services for 8 weeks. Seven hundred fifty-four requests were reviewed by 15 attending anesthesiologists, with 339 first-choice matches (45.0%), 122 second-choice matches (16.2%), 55 third-choice matches (7.3%), and 238 unmatched (31.5%). There were 279 overlapping first-choice requests (37.0%). The overall combined match success rate was 69.4%. Separately, we developed an ACGME case-log visualization tool that allows individual resident experiences to be compared against case minimums as well as resident peer groups. We conclude that it is feasible to use ACGME case
McCurdy, Leyla Erk; Roberts, James; Rogers, Bonnie; Love, Rebecca; Etzel, Ruth; Paulson, Jerome; Witherspoon, Nsedu Obot; Dearry, Allen
Pediatric medical and nursing education currently lacks the environmental health content necessary to appropriately prepare pediatric health care professionals to prevent, recognize, manage, and treat environmental-exposure–related disease. Leading health institutions have recognized the need for improvements in health professionals’ environmental health education. Parents are seeking answers about the impact of environmental toxicants on their children. Given the biologic, psychological, and social differences between children and adults, there is a need for environmental health education specific to children. The National Environmental Education and Training Foundation, in partnership with the Children’s Environmental Health Network, created two working groups, one with expertise in medical education and one with expertise in nursing education. The working groups reviewed the transition from undergraduate student to professional to assess where in those processes pediatric environmental health could be emphasized. The medical education working group recommended increasing education about children’s environmental health in the medical school curricula, in residency training, and in continuing medical education. The group also recommended the expansion of fellowship training in children’s environmental health. Similarly, the nursing working group recommended increasing children’s environmental health content at the undergraduate, graduate, and continuing nursing education levels. Working groups also identified the key medical and nursing organizations that would be important in leveraging these changes. A concerted effort to prioritize pediatric environmental health by governmental organizations and foundations is essential in providing the resources and expertise to set policy and provide the tools for teaching pediatric environmental health to health care providers. PMID:15579423
The author documents a significant broadening of the interest of both state and federal government in influencing graduate medical education. He states that the unwillingness of the academic medical community to address the issues of manpower supply and specialty distribution, the limited effectiveness of minority enhancement programs, and an ambiguous position on foreign medical graduates have invited government intervention. The author maintains that such intervention was inevitable because academic medical centers have focused only on the educational process and the quality of graduates but have not dealt with the need to shape the output of their training programs to meet national health needs. He challenges the academic medical community to seize the initiative in seeking the difficult-to-find solutions to major issues of medical training or be prepared to yield to the decisions of lawmakers and regulators.
Dailey, Jason I.
As residents and medical students progress through their medical training, they are presented with multiple instances in which they feel they must manipulate the healthcare system and deceive others in order to efficiently treat their patients. This, however, creates a culture of manipulation resulting in untoward effects on trainees' ethical and…
Miller, George E., Ed.
Proceedings of a conference on Medical Education in the Contemporary World, organized by Dr. George E. Miller and sponsored by the University of Illinois in Chicago, September 13-14, 1976, are presented. American and foreign medical edu- cation experts considered the principal and recurrent problems confronting the field in a period of rapid…
Curran, Vernon R.; Bornstein, Stephen; Jong, Michael; Fleet, Lisa
(Purpose) This report summarizes a synthesis of the literature related to the evidence, initiatives and approaches to rural/northern medical education, particularly its role in strengthening the medical workforce in rural areas. (Methodology) A literature review was conducted involving the literature databases MEDLINE (January 1990-March 2003),…
Mayer, Heidi; Renouf, Tia
Despite a large number of yearly medical graduates, rural New Zealand is faced with a scarcity of practicing physicians. Opportunities to learn and practice in rural settings start at the undergraduate level and extend to practicing physicians. There are a number of different programs available to facilitate rural medical education for all students and physicians. These programs will be discussed in this article.
Chandy, Sujith John
Objective: A rising number of medicines and minimal emphasis on rational prescribing in the medical curriculum may compromise medication safety. There is no focused module in the curriculum dealing with factors affecting safety such as quality, medicines management, rational use, and approach to adverse effects. Creating awareness of these issues would hopefully plant a seed of safe prescribing and encourage pharmacovigilance. A study was therefore done to determine the need for such a module. Method: A quasi-experimental pre-post module study. Medical students (n = 88) completing pharmacology term were recruited after informed consent. A questionnaire containing 20 questions on various themes was administered and scored. Subsequently a module was developed and relevant safety themes taught to the students. After one month, the questionnaire was re-administered. Results: The pre module score was 9.52/20. Knowledge about the various themes, adverse effects, medication management, quality issues and rational use were similar though poor knowledge was evident in specific areas such as clinical trials, look alike-sound alike medicines (LASA) and medicine storage. The post module score was 12.24/20. The improvement of score was statistically significant suggesting the effectiveness of the module. Conclusion: The relatively poor knowledge and improvement with a specific educational module emphasizes the need of such a module within the medical curriculum to encourage safe use of medicines by Indian Medical Graduates (IMG). It is hoped that the policy makers in medical education will introduce such a module within the medical curriculum. PMID:28031610
Hoti, Kreshnik; Forman, Dawn; Hughes, Jeffery
There is lack of literature data reporting an incorporation of medication management reviews in students' interprofessional education (IPE) and practice programs in aged care settings. This pilot study reports how an interprofessional disease state and medication management review program (DSMMR) was established in a residential aged care facility in Perth, Western Australia. Students from the professions of nursing, pharmacy and physiotherapy focused on a wellness check in the areas of cognition, falls and continence while integrating a medication management review. Students' attitudes were explored using a pre- and post-placement questionnaire. Students indicated positive experience with the IPE DSMMR program which also resulted in their positive attitudinal shift towards IPE and practice. These findings indicated that aged care can be a suitable setting for student interprofessional programs focusing on DSMMR.
Reed, Suzanne; Shell, Richard; Kassis, Karyn; Tartaglia, Kimberly; Wallihan, Rebecca; Smith, Keely; Hurtubise, Larry; Martin, Bryan; Ledford, Cynthia; Bradbury, Scott; Bernstein, Henry Hank; Mahan, John D
The application of the best practices of teaching adults to the education of adults in medical education settings is important in the process of transforming learners to become and remain effective physicians. Medical education at all levels should be designed to equip physicians with the knowledge, clinical skills, and professionalism that are required to deliver quality patient care. The ultimate outcome is the health of the patient and the health status of the society. In the translational science of medical education, improved patient outcomes linked directly to educational events are the ultimate goal and are best defined by rigorous medical education research efforts. To best develop faculty, the same principles of adult education and teaching adults apply. In a systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education, the use of experiential learning, feedback, effective relationships with peers, and diverse educational methods were found to be most important in the success of these programs. In this article, we present 5 examples of applying the best practices in teaching adults and utilizing the emerging understanding of the neurobiology of learning in teaching students, trainees, and practitioners. These include (1) use of standardized patients to develop communication skills, (2) use of online quizzes to assess knowledge and aid self-directed learning, (3) use of practice sessions and video clips to enhance significant learning of teaching skills, (4) use of case-based discussions to develop professionalism concepts and skills, and (5) use of the American Academy of Pediatrics PediaLink as a model for individualized learner-directed online learning. These examples highlight how experiential leaning, providing valuable feedback, opportunities for practice, and stimulation of self-directed learning can be utilized as medical education continues its dynamic transformation in the years ahead.
Radoff, Kari; Nacht, Amy; Natch, Amy; McConaughey, Edie; Salstrom, Jan; Schelling, Karen; Seger, Suzanne
Midwives have been involved formally and informally in the training of medical students and residents for many years. Recent reductions in resident work hours, emphasis on collaborative practice, and a focus on midwives as key members of the maternity care model have increased the involvement of midwives in medical education. Midwives work in academic settings as educators to teach the midwifery model of care, collaboration, teamwork, and professionalism to medical students and residents. In 2009, members of the American College of Nurse-Midwives formed the Medical Education Caucus (MECA) to discuss the needs of midwives teaching medical students and residents; the group has held a workshop annually over the last 4 years. In 2014, MECA workshop facilitators developed a toolkit to support and formalize the role of midwives involved in medical student and resident education. The MECA toolkit provides a roadmap for midwives beginning involvement and continuing or expanding the role of midwives in medical education. This article describes the history of midwives in medical education, the development and growth of MECA, and the resulting toolkit created to support and formalize the role of midwives as educators in medical student and resident education, as well as common challenges for the midwife in academic medicine. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.
Ward, C D
The neuroscience curriculum should take account of the needs of patients and families and both undergraduate and postgraduate education should be guided by three criteria for quality of medical care--clinical competence, communication (and teamwork), and professional values. The assessment and management of neurological disability requires specific knowledge, skills and attitudes which can be supported by medical education. Suggestions are given on some of the elements which might be included in a curriculum relevant to neurological disability. The implementation of appropriate programmes is discussed. PMID:1564508
McGowan, Patrick T
With the changing health care environment, prevalence of chronic health conditions, and burgeoning challenges of health literacy, obesity, and homelessness, self-management support provides an opportunity for clinicians to enhance effectiveness and, at the same time, to engage patients to participate in managing their own personal care. This article reviews the differences between patient education and self-management and describes easy-to-use strategies that foster patient self-management and can be used by health care providers in the medical setting. It also highlights the importance of linking patients to nonmedical programs and services in the community.
Gruppen, Larry D
The Department of Medical Education (DME) at the University of Michigan Medical School has a strong and sustained history of contributing to medical education research. The author identifies several dimensions that contribute to this productivity: (1) the quality of department faculty and the complementary areas of expertise they possess; (2) a critical mass of educational scholars, both within and outside the DME; (3) extensive collaborations of DME faculty with colleagues in other departments on educational innovation; (4) the departmental status of the DME; (5) the separation of the DME from the administration of the curriculum; (6) the need to balance the missions of research and educational support of the medical school; (7) the research-intensive nature of the larger University of Michigan environment; (8) the complex challenge of funding the educational scholarship mission; and (9) the importance of maintaining visibility within the institution. Factors that will affect the health of future educational scholarship include (1) the response to the Accreditation Council for Graduate Medical Education's definition of resident competencies and similar initiatives; (2) the growth of opportunities for advanced training in educational scholarship and the corresponding expansion of medical school faculty with greater interest and skills in educational research; (3) an emerging emphasis on the importance of behavioral science in medical care; (4) demands on the clinical productivity of collaborating faculty; and (5) the paucity of funding for medical education research.
Dietze, Stefan; Taibi, Davide; Yu, Hong Qing; Dovrolis, Nikolas
Reusable educational resources became increasingly important for enhancing learning and teaching experiences, particularly in the medical domain where resources are particularly expensive to produce. While interoperability across educational resources metadata repositories is yet limited to the heterogeneity of metadata standards and interface…
The author addresses the fate and future of Graduate and Medical Education. The dominant concern lies with the identification of a reliable and continuous source of funding for the education, training and research experience of the students. The problems and the needs are discussed along with some potential remedies.
Masic, Izet; Pandza, Haris; Toromanovic, Selim; Masic, Fedja; Sivic, Suad; Zunic, Lejla; Masic, Zlatan
Advances in medicine in recent decades are in significant correlation with the advances in the information technology. Modern information technologies (IT) have enabled faster, more reliable and comprehensive data collection. These technologies have started to create a large number of irrelevant information, which represents a limiting factor and a real growing gap, between the medical knowledge on one hand, and the ability of doctors to follow its growth on the other. Furthermore, in our environment, the term technology is generally reserved for its technical component. Education means, learning, teaching, or the process of acquiring skills or behavior modification through various exercises. Traditionally, medical education meant the oral, practical and more passive transferring of knowledge and skills from the educators to students and health professionals. For the clinical disciplines, of special importance are the principles, such as, “learning at bedside,” aided by the medical literature. In doing so, these techniques enable students to contact with their teachers, and to refer to the appropriate literature. The disadvantage of these educational methods is in the fact, that teachers often do not have enough time. Additionally they are not very convenient to the horizontal and vertical integration of teaching, create weak or almost no self education, as well as, low skill levels and poor integration of education with a real social environment. In this paper authors describe application of modern IT in medical education – their advantages and disadvantages comparing with traditional ways of education. PMID:23408471
Bacal, Kira; Miller, Robert; Doerr, Harold
Differences in communication styles and languages between groups often lead to miscommunication, confusion, and/or frustration. Engineers, computer specialists, clinicians, and managers often utilize the English language in very different ways, with different groups using the same words to represent different concepts ("complaint" is a typical example). In addition, medical issues are often perceived as "off-nominal" and not "primary mission tasks" by managers, which can cause them to assign lower priorities to medical training time and resources. Knowledge bases differ due to variations in training and skill sets, and the goals (both immediate and long-term) of the communicators may also vary, with managers being primarily concerned with overall mission objectives, while clinicians focus on individual or group health issues. Furthermore, true communication is only possible when clinicians possess a deep understanding of mission requirements as well as the ability to communicate medical requirements on a priority basis using risk assessment, added value, and cost benefit analysis. These understandable differences may contribute to difficulties in expressing concerns and ideas in an efficient manner, particularly in projects, such as the space program or many military operations, where these varied groups must collaborate, and where the final decisions must be made by fully informed mission commanders. Methods: Three scenario-based approaches were developed utilizing decision trees and problem based learning, to help define and integrate these concepts. Results: Use of these techniques by NASA and military personnel will be presented. Discussion: To enhance communication, particularly of medical needs, one must identify the concerns and motivating factors for the other groups; for example, members of management may focus on financial concerns, a desire for risk mitigation, public perceptions, mission objectives, etc. Training clinicians to frame issues in these
Reutzel, Thomas; Watkins, Melissa
Objectives To identify whether and how pharmacy faculty members are addressing the issue of medication management in primary or secondary schools in their teaching, research, and service activities, and to ascertain the extent to which they think the issue is an important one. Methods Four hundred ninety-nine faculty members completed a questionnaire inquiring about the research, teaching, and service activities in which they participated that related to medication management in schools. Results Only 33 subjects (6.6%) addressed the topic of medication management in schools in their courses; only 13 (2.6%) conducted research on the topic; and only 30 (6%) were involved in service in this area. On the other hand, 432 respondents (86.6%) believed that the issue of medication management in schools was either somewhat or extremely important. Conclusions There is a large gap between the number of subjects that think medication management in schools is an important topic and the number who actually include the topic in teaching, research, and or service. PMID:17136150
Parsell, G. J.; Bligh, J.
It has long been recognised that intensive efforts are needed to reform medical education in order to meet the future needs of populations worldwide. Pressure for changes to the organisation, content and delivery of both undergraduate and postgraduate medical education has greatly increased in the last two decades. The experience of innovative medical schools, the emergence of learner-centred teaching methods and the implications of health-care reforms in North America and Britain are major factors influencing calls for change. The pace of change has accelerated to such an extent in recent years that progress towards widespread reform appears to be more attainable than ever before. This article provides an overview of the changing context of health-care, some patterns of existing medical education and some strategies for change. PMID:7567730
van Mook, Walther N K A; Gorter, Simone L; de Grave, Willem S; van Luijk, Scheltus J; O'Sullivan, Helen; Wass, Valerie; Zwaveling, Jan Harm; Schuwirth, Lambert W; van der Vleuten, Cees P M
Given the changes in society we are experiencing, the increasing focus on patient centred care and acknowledgment that medical education needs to continue not only in the residency programmes but throughout the doctors career, is not surprising. This article describes the attention currently paid to professionalism in the residency programmes, differences in perception of professionalism between patients, faculty, students and residents, differences in professionalism issues in the different educational phases, as well as their consequences for training and assessment regarding professionalism. Continuous medical education in professionalism is thereafter briefly discussed.
LaMantia, Joseph; Hamstra, Stanley J; Martin, Daniel R; Searle, Nancy; Love, Jeffrey; Castaneda, Jill; Aziz-Bose, Rahela; Smith, Michael; Griswold-Therodorson, Sharon; Leuck, JoAnna
This 2012 Academic Emergency Medicine consensus conference breakout session was devoted to the task of identifying the history and current state of faculty development in education research in emergency medicine (EM). The participants set a future agenda for successful faculty development in education research. A number of education research and content experts collaborated during the session. This article summarizes existing academic and medical literature, expert opinions, and audience consensus to report our agreement and findings related to the promotion of faculty development.
Army Regulation 40–25 BUMEDINST 10110.6 AFI 44-141 Medical Services Nutrition Standards and Education Headquarters Departments of the Army, Navy, and...YYYY) 15-06-2001 2. REPORT TYPE 3. DATES COVERED (FROM - TO) xx-xx-2001 to xx-xx-2001 4. TITLE AND SUBTITLE Nutrition Standards and Education...AFI 44–141 Nutrition Standards and Education This revision-- o Renames the recommended nutrient standards, changing the term from Military Recommended
Balasubramaniam, Sudharsanam Manni; Mohan, Yogesh; Roy, Gautam
A tsunami struck the coast of Tamilnadu and Pondicherry on 26 December 2004. Jawaharlal Institute of Postgraduate Medical Education & Research, (JIPMER) in Pondicherry played a vital role in providing medical relief. The experiences from the relief activities revealed areas of deficiency in medical education in regards to disaster preparedness. A qualitative study using focus group discussion was employed to find the lacunae in skills in managing medical relief measures. Many skills were identified; the most important of which was addressing the psychological impact of the tsunami on the victims. Limited coordination and leadership skills were also identified. It is recommended that activity-based learning can be included in the curriculum to improve these skills. PMID:26451183
Levy, Barry S; Wegman, David H
Because medical students and residents receive inadequate education and training in public health and preventive medicine, they will miss many opportunities, as they practice medicine, to improve the health of individual patients and populations. Although there is an ongoing need to expand the number and improve the specialist training of public health and preventive medicine residents, all medical students and residents should enter practice with substantive knowledge and practical skills in public health and preventive medicine. This knowledge and these skills will make them more effective in such areas as enabling patients to make lifestyle changes, identifying and reducing occupational and environmental risk factors, and empowering patients to manage their chronic health conditions. The authors propose a paradigm shift to establish public health and preventive medicine as the context for medical education and medical care.
Prepared in cooperation with the Defense Systems Management College; Headquarters, Department of the Ar Office of The Surqeon General: ’.S. Aim Trainind...of the MAMP is to enhance communica- tion and cooperation between the user and developer communities and to estab- lish a consolidated program review...the analytic plan; and (8) identify program constraints. Close cooperation is maintained with TIWG members to ensure that the intent of the
... HUMAN SERVICES Agency for Healthcare Research and Quality Scientific Information Request on Medication... scientific information submissions from the public on medication therapy management Scientific information is being solicited to inform our review of Medication Therapy Management, which is currently...
Whicker, Shari A.; Engle, Deborah L.; Chudgar, Saumil; DeMeo, Stephen; Bean, Sarah M.; Narayan, Aditee P.; Grochowski, Colleen O'Connor; Nagler, Alisa
Background Graduate medical education faculty bear the responsibility of demonstrating active research and scholarship; however, faculty who choose education-focused careers may face unique obstacles related to the lack of promotion tracks, funding, career options, and research opportunities. Our objective was to address education research and scholarship barriers by providing a collaborative peer-mentoring environment and improve the production of research and scholarly outputs. Methods We describe a Medical Education Scholarship Support (MESS) group created in 2013. MESS is an interprofessional, multidisciplinary peer-mentoring education research community that now spans multiple institutions. This group meets monthly to address education research and scholarship challenges. Through this process, we develop new knowledge, research, and scholarly products, in addition to meaningful collaborations. Results MESS originated with eight founding members, all of whom still actively participate. MESS has proven to be a sustainable unfunded local community of practice, encouraging faculty to pursue health professions education (HPE) careers and fostering scholarship. We have met our original objectives that involved maintaining 100% participant retention; developing increased knowledge in at least seven content areas; and contributing to the development of 13 peer-reviewed publications, eight professional presentations, one Masters of Education project, and one educational curriculum. Discussion The number of individuals engaged in HPE research continues to rise. The MESS model could be adapted for use at other institutions, thereby reducing barriers HPE researchers face, providing an effective framework for trainees interested in education-focused careers, and having a broader impact on the education research landscape. PMID:27476538
Gensini, Gian Franco; Conti, Andrea Alberto; Conti, Antonio
This paper presents an analysis of some innovative educational perspectives regarding the figure of the physician, on the basis of the awareness that the cultural formation of the medical class represents a major strategy in achieving a high quality medical standard and an effective evidence-based health care. Quality education, both during the graduate curriculum and in the post-graduate phase (today including Decision Making, Knowledge Management, Health Economics, General Practice Medicine, Evidence Based Medicine and Evidence Based History of Medicine, as in the Florence Medical School), is essential for the training of updated health professionals, as well as being geared to life-long learning. The classical medical education paradigm involved knowing, knowing how to do and knowing how to be; today this model should be enriched by other key competences for practicing medicine, among them knowing how to make other people do things and knowing how to continue with self-education. With specific reference to making others carry out tasks, the current need for team work renders it necessary for physicians to reconstruct their competences continuously in the light of the essential integration with the competence of non-medical colleagues with whom they work in an inter-disciplinary pattern. With regard to knowing how to continue with self-education, this is possibly the most relevant current and future challenge, not only for health systems but also for physicians.
Hatem, Charles J; Searle, Nancy S; Gunderman, Richard; Krane, N Kevin; Perkowski, Linda; Schutze, Gordon E; Steinert, Yvonne
Of the many roles that the academic-educator may fulfill, that of teacher is particularly challenging. Building on prior recommendations from the literature, this article identifies the skill set of teachers across the medical education continuum-characteristics of attitude and attributes, knowledge, and pedagogic skills that permit effective teaching to be linked with effective learning and understanding. This examination which characterizes teachers' attitudes, knowledge, and skills serves to reemphasize the centrality of teaching within medical education, provides direction for faculty and institutions alike in the discharge of academic responsibilities, and makes educational accountability clear. This listing of teacher attitudes and responsibilities was vetted in 2009 by medical education leaders from across North America during a national conference on faculty development.A set of recommendations concerning faculty development issues for medical teachers is offered. The recommendations are intended to establish an academic culture in medical education that values and rewards-academically and fiscally-those centrally committed to the role of teacher. The challenges of defining skills, developing and funding programs, and ongoing evaluation must be faced to achieve success in teaching throughout medical education, now and in the future. Faculty members, fellow learners, and patients deserve no less.
Yang, Eunbae B; Meng, Kwang Ho
This study is to investigate the historical characteristics of medical education and healthcare environment in Korea and to suggest the desirable direction for future medical education. We draw a consensus through the literature analysis and several debates from the eight experts of medical education. There are several historical characteristics of medical education: medical education as vocational education and training, as a higher education, rapid growth of new medical schools, change to the medical education system, curriculum development, reinforcement of medical humanities, improvement of teaching and evaluation methods, validation of the national health personnel licensing examination, accreditation system for quality assurance, and establishment of specialized medical education division. The changes of health care environment in medical education are development of medical technologies, changes in the structures of the population and diseases, growth of information and communication technology, consumer-centered society, and increased intervention by the third party stakeholder. We propose five suggestions to be made to improve future medical education. They are plan for outcome and competency-based medical education, connection between the undergraduate and graduate medical education, reinforcement of continuous quality improvement of medical education, reorganization of the medical education system and construction of leadership of "academic medicine."
Kadhiravan, Tamilarasu; Sharma, Surendra K
Antimycobacterial chemotherapy is the mainstay of treatment for the majority of patients with genitourinary tuberculosis (GUTB). A large body of evidence from clinical trials suggests that short-course chemotherapy regimens, employing four drugs including rifampicin and pyrazinamide, achieve cure in most of the patients with tuberculosis (TB) and are associated with the lowest rates of relapse. Standard six-month regimens are adequate for the treatment of GUTB. Directly observed treatment, short-course (DOTS) is the internationally recommended comprehensive strategy to control TB, and directly observed treatment is just one of its five elements. DOTS cures not only the individual with TB but also reduces the incidence of TB as well as the prevalence of primary drug-resistance in the community. Corticosteroids have no proven role in the management of patients with GUTB. Errors in prescribing anti-TB drugs are common in clinical practice. Standardized treatment regimens at correct doses and assured completion of treatment have made DOTS the present-day standard of care for the management of all forms of TB including GUTB.
The Bologna Process designates the ongoing activities whereby the Ministers responsible for Higher Education in Europe attempt to change and harmonize fundamental aspects of all higher education in the many countries involved. This grand scheme is gaining momentum. The number of participating countries is increasing, more aspects of higher education are included and the number of activities and projects is growing. Medical education has so far been neglected in the process and awareness of the development at medical schools has been limited. The purpose of this paper is to introduce the Bologna Process, its background, objectives and main activities and to draw attention to some of the challenges medical education will probably have to face in the near future such as a structure based on two main cycles, undergraduate and graduate, a system of easily readable and comparable degrees and European cooperation in quality assurance including a system of accreditation, certification or comparable procedures. The position of medical education towards the Bologna Process is essential.
Dean, Carolyn; Steinberg, Susan K.; Sylvester, William H.
Premenstrual syndrome (PMS) is characterized by a wide variety of symptoms occurring over several days before menstruation. In the differential diagnosis, family physicians should consider other conditions such as chronic yeast infection, allergy, stress, hypoglycemia and primary dysmenorrhea. Each patient should complete a daily menstrual diary for two to three monthly cycles. This diary may help the physician to determine the cyclical nature of PMS and specific symptoms. For most PMS sufferers, initial treatment involves the physician's acknowledgement of the problem and advice about lifestyle, dietary modification and vitamin supplements (e.g., pyridoxine). Seven steps are recommended to assist the family physician in the practical office management of most women with PMS. The potential role of progesterone and other agents in the treatment of PMS is described. Referral to a psychiatrist or psychologist, or the use of drugs such as lithium, danazol or bromocriptine may be required for women suffering from severe PMS. PMID:21267135
Holloway, K J
Resistance by physicians, medical researchers, medical educators, and medical students to pharmaceutical industry influence in medicine is often based on the notion that physicians (guided by the ethics of their profession) and the industry (guided by profit) are in conflict. This criticism has taken the form of a professional movement opposing conflict of interest (COI) in medicine and medical education and has resulted in policies and guidelines that frame COI as the problem and outline measures to address this problem. In this paper, I offer a critique of this focus on COI that is grounded in a broader critique of neo-liberalism, arguing it individualizes the relationship between physicians and industry, too neatly delineates between the two entities, and reduces the network of social, economic, and political relations to this one dilemma.
van Stiphout, F; Zwart-van Rijkom, J E F; Maggio, L A; Aarts, J E C M; Bates, D W; van Gelder, T; Jansen, P A F; Schraagen, J M C; Egberts, A C G; ter Braak, E W M T
Aims Educating physicians in the procedural as well as cognitive skills of information technology (IT)-mediated medication management could be one of the missing links for the improvement of patient safety. We aimed to compose a framework of tasks that need to be addressed to optimize medication management in outpatient care. Methods Formal task analysis: decomposition of a complex task into a set of subtasks. First, we obtained a general description of the medication management process from exploratory interviews. Secondly, we interviewed experts in-depth to further define tasks and subtasks. Setting: Outpatient care in different fields of medicine in six teaching and academic medical centres in the Netherlands and the United States. Participants: 20 experts. Tasks were divided up into procedural, cognitive and macrocognitive tasks and categorized into the three components of dynamic decision making. Results The medication management process consists of three components: (i) reviewing the medication situation; (ii) composing a treatment plan; and (iii) accomplishing and communicating a treatment and surveillance plan. Subtasks include multiple cognitive tasks such as composing a list of current medications and evaluating the reliability of sources, and procedural tasks such as documenting current medication. The identified macrocognitive tasks were: planning, integration of IT in workflow, managing uncertainties and responsibilities, and problem detection. Conclusions All identified procedural, cognitive and macrocognitive skills should be included when designing education for IT-mediated medication management. The resulting framework supports the design of educational interventions to improve IT-mediated medication management in outpatient care. PMID:25753467
Despite a large number of yearly medical graduates, rural New Zealand is faced with a scarcity of practicing physicians. Opportunities to learn and practice in rural settings start at the undergraduate level and extend to practicing physicians. There are a number of different programs available to facilitate rural medical education for all students and physicians. These programs will be discussed in this article. PMID:27882273
David, Y; Jahnke, E
Appropriate deployment of technological innovation contributes to improvement in the quality of healthcare delivered, the containment of cost, and access to the healthcare system. Hospitals have been allocating a significant portion of their resources to procuring and managing capital assets; they are continuously faced with demands for new medical equipment and are asked to manage existing inventory for which they are not well prepared. To objectively manage their investment, hospitals are developing medical technology management programs that need pertinent information and planning methodology for integrating new equipment into existing operations as well as for optimizing costs of ownership of all equipment. Clinical engineers can identify technological solutions based on the matching of new medical equipment with hospital's objectives. They can review their institution's overall technological position, determine strengths and weaknesses, develop equipment-selection criteria, supervise installations, train users and monitor post procurement performance to assure meeting of goals. This program, together with cost accounting analysis, will objectively guide the capital assets decision-making process. Cost accounting analysis is a multivariate function that includes determining the amount, based upon a strategic plan and financial resources, of funding to be allocated annually for medical equipment acquisition and replacement. Often this function works closely with clinical engineering to establish equipment useful life and prioritization of acquisition, upgrade, and replacement of inventory within budget confines and without conducting time consuming, individual financial capital project evaluations.
Decentralized medication management systems (DMMSs) are used in hospitals, long-term care facilities, prisons, outpatient clinics, surgery centers, and other places to manage the distribution of drugs. DMMSs consist of storage compartments for medications, with an internal computer that controls and records the administration of drugs. Some DMMSs are stationary cabinets and others are mobile carts. There have been important advances in DMMS technology since we evaluated these products in 1996, including enhanced computer memory and processing power, wider adoption of wireless networking, better user interfaces, and greater integration with other hospital information systems. To get the most out of a DMMS purchase or upgrade, facilities will need careful planning that involves assessing their own needs, selecting hardware and software configurations that meet those needs, and then choosing the right vendor and model. A properly selected DMMS can help to enforce medication distribution policies, prevent errors, and streamline processes.
Marion-Veyron, Régis; Bourquin, Céline; Saraga, Michael; Stiefel, Friedrich
For many years, a major focus of interest has been the patient, in the context of a constantly changing society and increasingly complex medical practices. We propose to shift this focus on the physician, who is entangled in a similar, but less evident way. In these three articles, we explore, in succession, the lived experience of the contemporary physician, the ethos which brings together the medical community, and the education of the future physician, using research projects currently under way within the Service of Liaison Psychiatry at Lausanne University Hospital. The article hereunder is dedicated to the education and will examine the multiple and paradoxical expectations that punctuate it.
Barnum, Trevor J; Thome, Lindsay; Even, Elizabeth
Medical students are expected to learn certain procedural skills in addition to clinical skills, such as assessment and decision making. There is much literature that shows proficiency in procedural skills translated to improved outcomes and cost-saving. Given the time constraints placed by increasing clinical demands, physicians have less time to work with students in teaching technical skills. There is a unique opportunity to utilize nurses in clinical clerkships to teach procedural skills. A dedicated nurse educator can provide a consistent curriculum, work with learners to achieve proficiency, and provide measurable outcomes. Future research should explore the role played by nurses in medical education and the comparison of instructional effectiveness.
Otero, Hansel J; Ondategui-Parra, Silvia; Erturk, Sukru Mehmet; Ros, Pablo R
Radiology graduate medical education (GME) is exposed to huge financial challenges. First, there is a continuous increase in demand for imaging services by referring doctors and the general population, aggravating the staff shortage. Second, there has been an important decline in reimbursements. Third and probably most important is the progressive reduction of federal funds subsidizing GME. Medicare is the largest single contributor to GME. The Balanced Budget Act (BBA) of 1997 introduced reductions in Medicare payments to the major teaching hospitals calculated at $5.6 billion over the first 5 years after implementation. The BBA also brought other changes directly affecting GME. Financial changes in health care over the past decade have increased the pressure on academic institutions, which must preserve or improve the quality of training and the quality of care and manage an increased workload with fewer funds available and a narrow margin for errors. Yet the use of new technology promises to help simplify processes, decreasing workloads for residents and faculty members and increasing overall productivity, and new sources of funding have been suggested. By reviewing the financial challenges of radiologic training in today's academic centers, the authors reach the conclusion that there is still space for improving academic quality and the quality of care within current financial boundaries. But more reliable data about the specific benefits and drawbacks of having a residency program in a clinical radiology department are required.
Williams, Ruth; Evans, Lowri; Alshareef, Nora Talal
Medical dramas are an incredibly popular TV genre especially amongst medical learners, and they have become an increasingly accepted resource in learning experiences. Educators have recognised their pedagogical value, as they allow a host of complex medical and psychosocial issues to be presented to learners in an engaging format. Care has to be taken however to appreciate and overcome their limitations including recognising 'unexpected learning outcomes'. What is vital to their successful incorporation into teaching programme is the reflection component; which facilitates discussion and allows for a deeper learning experience.
Mandal, Jharna; Dinoop, KP; Parija, Subhash Chandra
“Microethics” is an avant-garde in the field of ethics. When the term “ethics” is brought into discussion in medical education or clinical practice, it customarily points to the traditional ethics, that is, biomedical ethics that deals with the ethical issues faced during unaccustomed or rare clinical circumstances. In contrast, microethics is a continuous ethical science existing in the physician-patient interaction that happens each day in every physician's clinical liaison. These ethical issues of everyday importance need to be introduced in the ethics training programs of medical institutions to provide insight and thereby promoting improvement in medical care and outcome. PMID:26629449
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Remote Medication Management System. 880.6315... Miscellaneous Devices § 880.6315 Remote Medication Management System. (a) Identification. A remote medication management system is a device composed of clinical and communications software, a medication delivery...
... Miscellaneous Devices § 880.6315 Remote Medication Management System. (a) Identification. A remote medication management system is a device composed of clinical and communications software, a medication delivery unit... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Remote Medication Management System....
Roemer, M. I.
The physician, said Henry Sigerist in 1940, has been acquiring an increasingly social role. For centuries, however, codes of medical ethics have concentrated on proper behavior toward individual patients and almost ignored the doctor's responsibilities to society. Major health service reforms have come principally from motivated lay leadership and citizen groups. Private physicians have been largely hostile toward movements to equalize the economic access for people to medical care and improve the supply and distribution of doctors. Medical practice in America and throughout the world has become seriously commercialized. In response, governments have applied various strategies to constrain physicians and induce more socially responsible behavior. But such external pressures should not be necessary if a broad socially oriented code of medical ethics were followed. Health care system changes would be most effective, but medical education could be thoroughly recast to clarify community health problems and policies required to meet them. Sigerist proposed such a new medical curriculum in 1941; if it had been introduced, a social code of medical ethics would not now seem utopian. An international conference might well be convened to consider how physicians should be educated to reach the inspiring goals of the World Health Organization. PMID:7405276
The widespread adoption of ultrasound technologies in medicine has necessitated the development of educational programs to address the growing demand for trained expertise in both academia and industry. The demand has been especially great in the field of therapeutic ultrasound that has experienced a significant level of research and development activities in the past decade. The applications cover a wide range including cancer treatment, hemorrhage control, cardiac ablation, gene therapy, and cosmetic surgery. A comprehensive educational program in ultrasound is well suited for bioengineering departments at colleges and universities. Our educational program for students in Bioengineering at the University of Washington includes a year-long coursework covering theory and practice of ultrasound, conducting research projects, attending and presenting at weekly seminars on literature survey, presentations at scientific meetings, and attending specialized workshops offered by various institutions for specific topics. An important aspect of this training is its multi-disciplinary approach, encompassing science, engineering, and medicine. The students are required to build teams with expertise in these disciplines. Our experience shows that these students are well prepared for careers in academia, conducting cutting edge research, as well as industry, being involved in the transformation of research end-products to commercially viable technology.
Goss, A N
There is an increasing population of apparently well, but in fact medically compromised people in the community. Most will require dental treatment at some stage and will usually seek it away from a hospital environment. In a recent survey of a general dental practice in Australia it was found that up to 55 per cent of some age groups had concurrent medical problems. Thus there is a real risk that adverse interactions between medical conditions and dental treatment may occur--on some occasions, even fatal ones. It is not possible for any one individual to know the details of all medical conditions, their treatment and the possible interactions with dental treatment. However, by the application of some sound general principles the risks of any potential interactions can be evaluated. The essential steps are: knowledge of the medical history of all patients; knowledge of the potential interactions; and knowledge of the management of medical emergencies. These principles will be discussed and illustrated by examples of medically compromised patients who may experience common or potentially serious sequelae as a result of dental treatment.
Some aspects of the educative system at the Mexican Institute of Social Security are described. It is based on the perception of a problematic situation that constitutes a challenge. An educational process to enhance the quality of medical education is proposed, with the adoption of a participative model of self-constructive learning. This proposal is based on theoretical references in a both philosophical and sociological knowledge perspective of an individual related to institutional behavior, to end with a psychological view from which some learning theories are explored. An educational model is built with the inclusion of institutional elements, like the new evaluation system for residents; centers for educational investigation and a teacher training process. Three axes of the educational process are proposed: tutorial teaching, development of complex abilities of thought and critical reading. The evaluation system includes guides for measuring the operational process established and the professional responsibilities of the different participants.
Christiaanse, Mary E.; Russell, Eleanor L.; Crandall, Sonia J.; Lambros, Ann; Manuel, Janeen C.; Kirk, Julienne K.
Introduction: Medical education research is gaining recognition as scholarship within academic medical centers. This survey was conducted at a medium-sized academic medical center in the United States. The purpose of the study was to learn faculty interest in research in medical education, so assets could be used to develop educational scholarship…
An international PEB seminar on "Information and Communications Technology and Educational Property Management" was held in Montreal, Canada, from 31 October to 3 November 2004. The aim of this seminar was to examine how information and communications technology (ICT) can be incorporated into educational property management by…
Levacic, Rosalind, Ed.; Glatter, Ron, Ed.
This book offers an opportunity to look in depth at the nature of changes in further education (FE) in Britain and how change has been managed: the drivers, the challenges, the constraints, the costs, and the meaning for all those involved in FE. "Introduction: Themes in the Management of Change in Further Education" (Rosalind Levacic)…
KHABAZ MAFINEJAD, MAHBOOBEH; AHMADY, SOLEIMAN; SOLTANI ARABSHAHI, SEYYED KAMRAN; BIGDELI, SHOALEH
Introduction The current literature supports the inclusion of inter-professional education in healthcare education. Changes in the structure and nature of the integrated medical education and healthcare system provide some opportunities for interprofessional education among various professions. This study is an attempt to determine the perceptions of students and faculty members about interprofessional education in the context of the medical education and healthcare system. Methods This qualitative content analysis study was conducted using purposeful sampling in 2012. Thirteen semi-structured interviews were conducted with 6 faculty members and 7 students at Tehran and Iran Universities of Medical Sciences. Data collection and analysis were concurrent. Results Data analysis revealed four categories and nine subcategories. The categories emerging from individual interviews were “educational structure”, “mediating factors”, “conceptual understanding”, and “professional identity”. These categories are explained using quotes derived from the data. Conclusion Matching the existing educational context and structure with IPE through removing barriers and planning to prepare the required resources and facilities can solve numerous problems associated with implementation and design of inter-professional training programs in Iran. In this way, promoting the development of a cooperative rather than a competitive learning and working atmosphere should be taken into account. The present findings will assist the managers and policy makers to consider IPE as a useful strategy in the integrated medical education and healthcare system. PMID:27382577
Millett, John D.; And Others
This document on personnel management in higher education contains three papers that are designed to be used as guidelines for educational administrators. The first two papers, by John D. Millett, discuss the scope and problems of higher education administration and the problems associated with collective bargaining and tenure on college campuses.…
Summary Objectives This paper aims to present an overview of the medical informatics landscape in Greece, to describe the Greek ehealth background and to highlight the main education and research axes in medical informatics, along with activities, achievements and pitfalls. Methods With respect to research and education, formal and informal sources were investigated and information was collected and presented in a qualitative manner, including also quantitative indicators when possible. Results Greece has adopted and applied medical informatics education in various ways, including undergraduate courses in health sciences schools as well as multidisciplinary postgraduate courses. There is a continuous research effort, and large participation in EU-wide initiatives, in all the spectrum of medical informatics research, with notable scientific contributions, although technology maturation is not without barriers. Wide-scale deployment of eHealth is anticipated in the healthcare system in the near future. While ePrescription deployment has been an important step, ICT for integrated care and telehealth have a lot of room for further deployment. Conclusions Greece is a valuable contributor in the European medical informatics arena, and has the potential to offer more as long as the barriers of research and innovation fragmentation are addressed and alleviated. PMID:26123910
Blatt, Benjamin; Plack, Margaret; Suzuki, Mari; Arepalli, Sruthi; Schroth, Scott; Stagnaro-Green, Alex
Few avenues exist to familiarize medical students with careers as clinician-educators, and the clinician-educator career pathway has not been well defined. In this article, the authors describe how they integrated a career-oriented student track into the 2011 Northeast Group on Educational Affairs (NEGEA) annual retreat to introduce students to careers in medical education. Annual education conferences are principal sources of educational scholarship, networking, collaboration, and information sharing; as such, they represent attractive venues for early exposure to the culture of medical education. The authors' goal in creating the NEGEA conference student track was to excite students about careers in medical education by providing them with an array of opportunities for active involvement in both student-specific and general conference activities.The authors draw from their experience to provide a guide for recruiting student participants to career-building student tracks. They also offer a guide for developing future student tracks, based on their experience and grounded in social cognitive career theory. Although their focus is on medical education, they believe these guides will be useful for educators planning a conference-based student track in any field.
Luanrattana, Rattiporn; Win, Khin Than; Fulcher, John; Iverson, Don
This study was undertaken to determine the PDA functionalities for a problem-based learning (PBL) medical curriculum at the Graduate School of Medicine (GSM), the University of Wollongong (UOW). The study determines the factors/aspects of incorporating PDAs, and the attitudes of stakeholders regarding the use of PDAs in such a PBL-based medical curriculum. In-depth interviews were designed and conducted with medical faculty, the medical education technology team and honorary medical academics. Four major PDA functionalities were identified, these being: clinical-log, reference, communication, and general functions. Two major aspects for the incorporation of PDAs into the PBL-medical curriculum at the UOW were determined from the interviews, these being technical and practical aspects. There is a potential for PDAs to be incorporated into the PBL-medical curricula at the UOW. However, a clear strategy needs to be defined as to how best to incorporate PDAs into PBL-medical curricula with minimal impact on students, as well as financial and resource implications for the GSM.
Ferris, Helena A.; Collins, Mary E.
The landscape of medical education is continuously evolving, as are the needs of the learner. The appropriate use of research and evaluation is key when assessing the need for change and instituting one's innovative endeavours. This paper demonstrates how research seeks to generate new knowledge, whereas evaluation uses information acquired from…
Burn, Barbara B., Ed.
As part of a study of access and admission to higher education in Germany and the United States, a group of papers on medical admissions in various countries was commissioned. The papers presented in this book reveal wide differences in admissions policies and procedures. Barbara Burn examines some of the major issues in a foreword: representation…
Irby, David M.; Edwards, Janine C. Ed.
Medical educators debate which models of scientific research should be applied to problems in academic medicine. The reigning model was derived from the first scientific revolution of Newtonian physics. The emerging model is grounded in the second scientific revolution of Einstein's quantum physics. (Author/MSE)
Fox, Ellen; And Others
This article reviews the 25-year history of undergraduate medical ethics education. Alternatives to the traditional model that focus more directly on students' personal values, attitudes, and behavior, are discussed. Three incipient trends are identified: everyday ethics, student ethics, and macro-ethics. Specific course and curricula are used as…
Fleming, Kenneth; Pugh, Christopher; Best, Denise
Postgraduate medical education in the UK has gone through a maelstrom of change in the last 20 years; many components have disadvantaged clinical academic training in particular. In this article we summarise some of the changes and describe the advantages of the creation of a dedicated clinical academic graduate school as a response to these changes.
Lewis, Natalie J.; Rees, Charlotte E.; Hudson, J. Nicky; Bleakley, Alan
The construct of emotional intelligence (EI) has gained increasing popularity over the last 10 years and now has a relatively large academic and popular associated literature. EI is beginning to be discussed within the medical education literature, where, however, it is treated uncritically. This reflections paper aims to stimulate thought about…
Coulehan, Jack; Williams, Peter C.
Asserts that North American medical education favors an explicit commitment to traditional values of doctoring--empathy, compassion, and altruism--but a tacit commitment to behaviors grounded in an ethic of detachment, self-interest, and objectivity. Explores differing ways (conflation, deflation, and maintaining of values) that students respond…
Alwadie, Adnan D.
As the largest country in the Middle East, Saudi Arabia and its health care system are well positioned to embark on an online learning intervention so that health care providers in all areas of the country have the resources for updating their professional knowledge and skills. After a brief introduction, online continuing medical education is…
Network-based training can provide continuing medical education with methods, whose implementation by means of traditional training is difficult or practically impossible. By virtue of its chronological and geographical flexibility, educational application of the network may provide extra advantage for the trainee and the trainer. Implementation of network-based training is, however, demanding and laborious both technically and pedagogically, whereby organizations should strive for collaboration in organizing the training. In addition, the status of network-based continuing education in relation to the physician's working time should be clearly defined.
Bhattarai, M D
The learners have to take active parts in the teaching learning activities. To make them aware and to help them develop the skills required, the need of the study skills course in medical education early in the part of their training has been realized for the postgraduate residents. The important areas of the study skills course focusing in the requirement of clinical components of the postgraduate residents are 1) Interpersonal and communications skills, 2) Teaching, learning and presentation skills, 3) Language, reading and computer use, 4) Evidence based medicine and diagnosis and management, 5) Assessment principles and strategies, 6) Time management strategies to get the best out of the training, 7) Reflection, portfolio and self-directed lifelong learning, and 8) Follow-up presentation. The methodologies that could be used in such study skills course are interactive lectures, brainstorming, presentations by the trainees, demonstration to and by the trainees, small group discussion, group work and presentation, group and individual feedback, practice sessions, role play, short relevant video movies, video recording of the trainees and viewing with feedback. With their already tight training schedule and posting and other similar other mandatory courses required for the postgraduate residents, much time cannot be allocated for the study skills course in medical education alone. Similar study skills course in medical education may need to be arranged for the undergraduate medical students as well.
Lyon, Deborah S
The 20th century model of medical education has focused on a network of urban medical centers serving primarily indigent patients in an unspoken contract of medical services in exchange for student and resident education. The improvement in federal and state reimbursement for indigent care services, along with the decline in reimbursement rates from the private sector, has led to competition for these patients from nonacademic providers. As numbers of patients seeking care at urban teaching centers have steadily declined, concerns about adequate teaching volume and revenue generation have led to very creative problem-solving. Bringing marketing concerns into the indigent care environment is not a straightforward undertaking, but the rewards might far exceed the simple goal of "getting our numbers back up."
Park, H W; Park, Y J; Yeo, I S; Kim, I S
Medical education in Je Joong Won was proposed and initiated by Dr. HN Allen. In his proposal of building a new hospital, submitted to the king in 1885, he expressed his wish to teach Western medicine to young Koreans at the hospital. The king welcomed his proposal and the plan was soon realized. Je Joon Won, the first modern hospital in Korea, opened on April 10th, 1885. The following year, on March 29th, Dr. Allen began medical school attached to the hospital. Many applicants were recruited by the government and 16 students were selected through the entrance examination. At first, they were taught English and finally 12 students out of them were selected after three months of teaching. The selected students were taught arithmetic, physics, chemistry, anatomy and physiology. The medical education at this period cannot be evaluated entirely successful since none of the 12 students was presumed to have worked as a practitioner.
Ai, Zhuming; Dech, Fred; Silverstein, Jonathan; Rasmussen, Mary
By combining teleconferencing, tele-presence, and Virtual Reality, the Tele-Immersive environment enables master surgeons to teach residents in remote locations. The design and implementation of a Tele-Immersive medical educational environment, Teledu, is presented in this paper. Teledu defines a set of Tele-Immersive user interfaces for medical education. In addition, an Application Programming Interface (API) is provided so that developers can easily develop different applications with different requirements in this environment. With the help of this API, programmers only need to design a plug-in to load their application specific data set. The plug-in is an object-oriented data set loader. Methods for rendering, handling, and interacting with the data set for each application can be programmed in the plug-in. The environment has a teacher mode and a student mode. The teacher and the students can interact with the same medical models, point, gesture, converse, and see each other.
Steeves, Lea C.
Continuing medical education is an essential feature of the practice of modern medicine since it furnishes the means to maintain the doctor's ability to provide quality patient care. To ensure that continuing medical education is provided efficiently and in the best quality, and utilized fully, it is necessary that: (1) the medical faculty inculcate in the student the concept of lifelong learning; (2) the practitioner adopt less time-consuming patterns of practice, to free more of his time for learning; (3) community hospital-based clinical teaching be provided universally; and (4) research be conducted to determine the best of current teaching methods and develop better ones. Conflicting efforts to meet these needs by practitioners (whose primary responsibility it is) and by organized medicine, specialty societies, voluntary health agencies and others have led to inefficient use of medical faculty teachers. The key parties in continuing medical education—practitioner and teacher—can learn best in medical school-administered programs, which need be supported by all other interested organizations. PMID:14278031
Linville, Mark David; Bates, J Edward
Graduate medical education (GME) is a critical link in the educational chain for physicians. Graduating from a strict apprenticeship model, GME has become a highly structured educational system whose peer-review organization provides an intentional and direct approach to ensuring that GME not only addresses the public's expectations of the profession but also positions itself to be a foundational structure in the outcomes-focused healthcare environment of the nation. GME is currently in a state of accelerated change-grounded in both educational and patient outcomes. This article provides an update on the significant changes that have occurred in GME over the past 10 years, a review of current initiatives and the perspectives related to educating physicians-in-training. Additionally, an analysis is provided on the future of GME, including areas of continued focus and uncertainty.
Garcia, Richard Staggers
Race is important in medicine. In order to correct the inequality in healthcare racial minority people can expect to receive, a new rhetorical stance is needed so that we can place our discourse in a productive arena. Most recommended solutions argue for increased education on "cultural competence" for physicians. Who will educate the educators? What rhetorical stance will work? A requirement for physicians to learn about cultural and linguistic competence will not get us to fairness in medical care, independent of race. That's because race is not the problem. There's nothing wrong with our race. Other disciplines within academe must contribute to students' understanding and treatment of race in America if we are to seriously address disparities in medical care. PMID:16749662
Peletskaya, E.; Griko, Y. V.
, technologies capable of predicting and managing medication side effects, interactions, and toxicity of drugs during spaceflight are needed. We propose to develop and customize for NASAs applications available on the market Personalized Prescribing System (PPS) that would provide a comprehensive, non-invasive solution for safer, targeted medication management for every crew member resulting in safer and more effective treatment and, consequently, better performance. PPS will function as both decision support and record-keeping tool for flight surgeons and astronauts in applying the recommended medications for situations arising in flight. The information on individual drug sensitivity will translate into personalized risk assessment for adverse drug reactions and treatment failures for each drug from the medication kit as well as predefined outcome of any combination of them. Dosage recommendations will also be made individually. The mobile app will facilitate ease of use by crew and medical professionals during training and flight missions.
Texas Education Agency, Austin. Dept. of Occupational Education and Technology.
Developed by an instructional materials center, this teaching guide was prepared to present home management and consumer education in the perspective of family living. Arranged in four major sections the section on Homemaking I introduces the student to management in everyday living, while Homemaking II emphasizes the management of household…
Komenda, Martin; Víta, Martin; Vaitsis, Christos; Schwarz, Daniel; Pokorná, Andrea; Zary, Nabil; Dušek, Ladislav
Background No universal solution, based on an approved pedagogical approach, exists to parametrically describe, effectively manage, and clearly visualize a higher education institution’s curriculum, including tools for unveiling relationships inside curricular datasets. Objective We aim to solve the issue of medical curriculum mapping to improve understanding of the complex structure and content of medical education programs. Our effort is based on the long-term development and implementation of an original web-based platform, which supports an outcomes-based approach to medical and healthcare education and is suitable for repeated updates and adoption to curriculum innovations. Methods We adopted data exploration and visualization approaches in the context of medical curriculum innovations in higher education institutions domain. We have developed a robust platform, covering detailed formal metadata specifications down to the level of learning units, interconnections, and learning outcomes, in accordance with Bloom’s taxonomy and direct links to a particular biomedical nomenclature. Furthermore, we used selected modeling techniques and data mining methods to generate academic analytics reports from medical curriculum mapping datasets. Results We present a solution that allows users to effectively optimize a curriculum structure that is described with appropriate metadata, such as course attributes, learning units and outcomes, a standardized vocabulary nomenclature, and a tree structure of essential terms. We present a case study implementation that includes effective support for curriculum reengineering efforts of academics through a comprehensive overview of the General Medicine study program. Moreover, we introduce deep content analysis of a dataset that was captured with the use of the curriculum mapping platform; this may assist in detecting any potentially problematic areas, and hence it may help to construct a comprehensive overview for the subsequent
Jones, Daryl; Duke, Graeme; Green, John; Briedis, Juris; Bellomo, Rinaldo; Casamento, Andrew; Kattula, Andrea; Way, Margaret
Introduction Most literature on the medical emergency team (MET) relates to its effects on patient outcome. Less information exists on the most common causes of MET calls or on possible approaches to their management. Methods We reviewed the calling criteria and clinical causes of 400 MET calls in a teaching hospital. We propose a set of minimum standards for managing a MET review and developed an approach for managing common problems encountered during MET calls. Results The underlying reasons for initiating MET calls were hypoxia (41%), hypotension (28%), altered conscious state (23%), tachycardia (19%), increased respiratory rate (14%) and oliguria (8%). Infection, pulmonary oedema, and arrhythmias featured as prominent causes of all triggers for MET calls. The proposed minimum requirements for managing a MET review included determining the cause of the deterioration, documenting the events surrounding the MET, establishing a medical plan and ongoing medical follow-up, and discussing the case with the intensivist if certain criteria were fulfilled. A systematic approach to managing episodes of MET review was developed based on the acronym 'A to G': ask and assess; begin basic investigations and resuscitation, call for help if needed, discuss, decide, and document, explain aetiology and management, follow-up, and graciously thank staff. This approach was then adapted to provide a management plan for episodes of tachycardia, hypotension, hypoxia and dyspnoea, reduced urinary output, and altered conscious state. Conclusion A suggested approach permits audit and standardization of the management of MET calls and provides an educational framework for the management of acutely unwell ward patients. Further evaluation and validation of the approach are required. PMID:16507153
Lisasi, Esther; Kulanga, Ahaz; Muiruri, Charles; Killewo, Lucy; Fadhili, Ndimangwa; Mimano, Lucy; Kapanda, Gibson; Tibyampansha, Dativa; Ibrahim, Glory; Nyindo, Mramba; Mteta, Kien; Kessi, Egbert; Ntabaye, Moshi; Bartlett, John
The Kilimanjaro Christian Medical University (KCMU) College and the Medical Education Partnership Initiative (MEPI) are addressing the crisis in Tanzanian health care manpower by modernizing the college’s medical education with new tools and techniques. With a $10 million MEPI grant and the participation of its partner, Duke University, KCMU is harnessing the power of information technology (IT) to upgrade tools for students and faculty. Initiatives in eLearning have included bringing fiber-optic connectivity to the campus, offering campus-wide wireless access, opening student and faculty computer laboratories, and providing computer tablets to all incoming medical students. Beyond IT, the college is also offering wet laboratory instruction for hands-on diagnostic skills, team-based learning, and clinical skills workshops. In addition, modern teaching tools and techniques address the challenges posed by increasing numbers of students. To provide incentives for instructors, a performance-based compensation plan and teaching awards have been established. Also for faculty, IT tools and training have been made available, and a medical education course management system is now being widely employed. Student and faculty responses have been favorable, and the rapid uptake of these interventions by students, faculty, and the college’s administration suggests that the KCMU College MEPI approach has addressed unmet needs. This enabling environment has transformed the culture of learning and teaching at KCMU College, where a path to sustainability is now being pursued. PMID:25072581
Lisasi, Esther; Kulanga, Ahaz; Muiruri, Charles; Killewo, Lucy; Fadhili, Ndimangwa; Mimano, Lucy; Kapanda, Gibson; Tibyampansha, Dativa; Ibrahim, Glory; Nyindo, Mramba; Mteta, Kien; Kessi, Egbert; Ntabaye, Moshi; Bartlett, John
The Kilimanjaro Christian Medical University (KCMU) College and the Medical Education Partnership Initiative (MEPI) are addressing the crisis in Tanzanian health care manpower by modernizing the college's medical education with new tools and techniques. With a $10 million MEPI grant and the participation of its partner, Duke University, KCMU is harnessing the power of information technology (IT) to upgrade tools for students and faculty. Initiatives in eLearning have included bringing fiber-optic connectivity to the campus, offering campus-wide wireless access, opening student and faculty computer laboratories, and providing computer tablets to all incoming medical students. Beyond IT, the college is also offering wet laboratory instruction for hands-on diagnostic skills, team-based learning, and clinical skills workshops. In addition, modern teaching tools and techniques address the challenges posed by increasing numbers of students. To provide incentives for instructors, a performance-based compensation plan and teaching awards have been established. Also for faculty, IT tools and training have been made available, and a medical education course management system is now being widely employed. Student and faculty responses have been favorable, and the rapid uptake of these interventions by students, faculty, and the college's administration suggests that the KCMU College MEPI approach has addressed unmet needs. This enabling environment has transformed the culture of learning and teaching at KCMU College, where a path to sustainability is now being pursued.
Cleland, Jennifer; Scott, Neil; Harrild, Kirsten; Moffat, Mandy
This AMEE Guide offers an introduction to the use of databases in medical education research. It is intended for those who are contemplating conducting research in medical education but are new to the field. The Guide is structured around the process of planning your research so that data collection, management and analysis are appropriate for the research question. Throughout we consider contextual possibilities and constraints to educational research using databases, such as the resources available, and provide concrete examples of medical education research to illustrate many points. The first section of the Guide explains the difference between different types of data and classifying data, and addresses the rationale for research using databases in medical education. We explain the difference between qualitative research and qualitative data, the difference between categorical and quantitative data, and the difference types of data which fall into these categories. The Guide reviews the strengths and weaknesses of qualitative and quantitative research. The next section is structured around how to work with quantitative and qualitative databases and provides guidance on the many practicalities of setting up a database. This includes how to organise your database, including anonymising data and coding, as well as preparing and describing your data so it is ready for analysis. The critical matter of the ethics of using databases in medical educational research, including using routinely collected data versus data collected for research purposes, and issues of confidentiality, is discussed. Core to the Guide is drawing out the similarities and differences in working with different types of data and different types of databases. Future AMEE Guides in the research series will address statistical analysis of data in more detail.
Medical physics, an applied field of physics, is the applications of physics in medicine. Medical physicists are essential professionals in contemporary healthcare, contributing primarily to the diagnosis and treatment of diseases through numerous inventions, advances, and improvements in medical imaging and cancer treatment. Clinical service, research, and teaching by medical physicists benefits thousands of patients and other individuals every day. This talk will cover three main topics. First, exciting current research and development areas in the medical physics sub-specialty of radiation oncology physics will be described, including advanced oncology imaging for treatment simulation, image-guided radiation therapy, and biologically-optimized radiation treatment. Challenges in patient safety in high-technology radiation treatments will be briefly reviewed. Second, the educational path to becoming a medical physicist will be reviewed, including undergraduate foundations, graduate training, residency, board certification, and career opportunities. Third, I will introduce the American Association of Physicists in Medicine (AAPM), which is the professional society that represents, advocates, and advances the field of medical physics (www.aapm.org).
Brigley, S.; Young, Y.; Littlejohns, P.; McEwen, J.
The Royal Colleges and their Faculties have moved continuing professional development up the agenda of doctors in the UK. The low educational value and failure to change professional practice of much continuing medical education has led to criticism of its emphasis on formal, didactic teaching and academic knowledge. The ubiquitous scientific or technical bias in medical education makes questionable assumptions about the nature of professional knowledge, how professionals learn, and the linkage of theory and practice in professional work. Given its narrow conception of professional knowledge, it is hardly surprising that the effectiveness of continuing medical education has proven difficult to evaluate. These points of criticism suggest that a more systematic and coherent approach to continuing education is required. The adoption of the concept of continuing professional development, which draws on learning by reflective practice, marks an important step in this direction. Continuing professional development emphasises self-directed learning, professional self-awareness, learning developed in context, multidisciplinary and multilevel collaboration, the learning needs of individuals and their organisations, and an inquiry-based concept of professionalism. It also involves a widening of accountability to patients, the community, managers and policymakers, and a form of evaluation which is internal, participatory and collaborative rather than external and scientific in character. PMID:9039405
This is part I of a two-part annotated bibliography of selected references on medical education in the People's Republic of China. The references date from 1925 to 1983. Most of the references are from the 1970's. (RH)
Lewis, Kadriye O; Cidon, Michal J; Seto, Teresa L; Chen, Haiqin; Mahan, John D
e-Learning has become a popular medium for delivering instruction in medical education. This innovative method of teaching offers unique learning opportunities for medical trainees. The purpose of this article is to define the present state of e-learning in pediatrics and how to best leverage e-learning for educational effectiveness and change in medical education. Through addressing under-examined and neglected areas in implementation strategies for e-learning, its usefulness in medical education can be expanded. This study used a systematic database review of published studies in the field of e-learning in pediatric training between 2003 and 2013. The search was conducted using educational and health databases: Scopus, ERIC, PubMed, and search engines Google and Hakia. A total of 72 reference articles were suitable for analysis. This review is supplemented by the use of "e-Learning Design Screening Questions" to define e-learning design and development in 10 randomly selected articles. Data analysis used template-based coding themes and counting of the categories using descriptive statistics.Our search for pediatric e-learning (using Google and Hakia) resulted in six well-defined resources designed to support the professional development of doctors, residents, and medical students. The majority of studies focused on instructional effectiveness and satisfaction. There were few studies about e-learning development, implementation, and needs assessments used to identify the institutional and learners' needs. Reviewed studies used various study designs, measurement tools, instructional time, and materials for e-learning interventions. e-Learning is a viable solution for medical educators faced with many challenges, including (1) promoting self-directed learning, (2) providing flexible learning opportunities that would offer continuous (24h/day/7 days a week) availability for learners, and (3) engaging learners through collaborative learning communities to gain
Rich, Eugene C; Liebow, Mark; Srinivasan, Malathi; Parish, David; Wolliscroft, James O; Fein, Oliver; Blaser, Robert
The past decade has seen ongoing debate regarding federal support of graduate medical education, with numerous proposals for reform. Several critical problems with the current mechanism are evident on reviewing graduate medical education (GME) funding issues from the perspectives of key stakeholders. These problems include the following: substantial interinstitutional and interspecialty variations in per-resident payment amounts; teaching costs that have not been recalibrated since 1983; no consistent control by physician educators over direct medical education (DME) funds; and institutional DME payments unrelated to actual expenditures for resident education or to program outcomes. None of the current GME reform proposals adequately address all of these issues. Accordingly, we recommend several fundamental changes in Medicare GME support. We propose a re-analysis of the true direct costs of resident training (with appropriate adjustment for local market factors) to rectify the myriad problems with per-resident payments. We propose that Medicare DME funds go to the physician organization providing resident instruction, keeping DME payments separate from the operating revenues of teaching hospitals. To ensure financial accountability, we propose that institutions must maintain budgets and report expenditures for each GME program. To establish educational accountability, Residency Review Committees should establish objective, annually measurable standards for GME program performance; programs that consistently fail to meet these minimum standards should lose discretion over GME funds. These reforms will solve several long-standing, vexing problems in Medicare GME funding, but will also uncover the extent of undersupport of GME by most other health care payers. Ultimately, successful reform of GME financing will require “all-payer” support. PMID:11972725
Rich, Eugene C; Liebow, Mark; Srinivasan, Malathi; Parish, David; Wolliscroft, James O; Fein, Oliver; Blaser, Robert
The past decade has seen ongoing debate regarding federal support of graduate medical education, with numerous proposals for reform. Several critical problems with the current mechanism are evident on reviewing graduate medical education (GME) funding issues from the perspectives of key stakeholders. These problems include the following: substantial interinstitutional and interspecialty variations in per-resident payment amounts; teaching costs that have not been recalibrated since 1983; no consistent control by physician educators over direct medical education (DME) funds; and institutional DME payments unrelated to actual expenditures for resident education or to program outcomes. None of the current GME reform proposals adequately address all of these issues. Accordingly, we recommend several fundamental changes in Medicare GME support. We propose a re-analysis of the true direct costs of resident training (with appropriate adjustment for local market factors) to rectify the myriad problems with per-resident payments. We propose that Medicare DME funds go to the physician organization providing resident instruction, keeping DME payments separate from the operating revenues of teaching hospitals. To ensure financial accountability, we propose that institutions must maintain budgets and report expenditures for each GME program. To establish educational accountability, Residency Review Committees should establish objective, annually measurable standards for GME program performance; programs that consistently fail to meet these minimum standards should lose discretion over GME funds. These reforms will solve several long-standing, vexing problems in Medicare GME funding, but will also uncover the extent of undersupport of GME by most other health care payers. Ultimately, successful reform of GME financing will require "all-payer" support.
Hang, Jianjin; Zhang, Chaoqun; Wu, Xiang-Yang
Based on the practice of workflow, information management system about medical equipment was developed and its functions such as gathering, browsing, inquiring and counting were introduced. With dynamic and complete case management of medical equipment, the system improved the management of medical equipment.
Goosby, Eric P; von Zinkernagel, Deborah
The Medical Education Partnership Initiative (MEPI) and Nursing Education Partnership Initiative (NEPI) are innovative approaches to strengthening the academic and clinical training of physicians and nurses in Sub-Saharan African countries, which are heavily burdened by HIV/AIDS. Begun in 2010 by the U.S. President's Emergency Plan for AIDS Relief with the National Institutes of Health, investments in curricula, innovative learning technologies, clinical mentoring, and research opportunities are providing a strong base to advance high-quality education for growing numbers of urgently needed new physicians and nurses in these countries. The MEPI and NEPI focus on strengthening learning institutions is central to the vision for expanding the pool of health professionals to meet the full range of a country's health needs. A robust network of exchange between education institutions and training facilities, both within and across countries, is transforming the quality of medical education and augmenting a platform for research opportunities for faculty and clinicians, which also serves as an incentive to retain professionals in the country. Excellence in patient care and a spirit of professionalism, core to MEPI and NEPI, provide a strong foundation for the planning and delivery of health services in participating countries.
Fetterolf, Donald; Olson, Marty
Historically, health plans and disease management companies have employed "opt-out" strategies for evaluating medical management outcomes across larger populations, targeting the entire population of eligible individuals and allowing those not interested to opt out. Recent observations that the predominant effort of these programs is on high-risk patients has lead some managers to suggest that the focus be on only those individuals with an anticipated higher effectiveness and lower cost to the payers of such services. They believe such "opt-in" models, in which only higher risk participants are targeted and enrolled, will deliver higher value. The use of common opt-in models, however, is not only methodologically unsound, but experience in the field suggests there may be less overall effect as well. Calculation methods for developing impact remain extremely sensitive to methodology
Carlson, Peggy, Ed.
The technology explosion in medical education has led to the use of computer models, videotapes, interactive videos, and state-of-the-art simulators in medical training. This booklet describes alternatives to using animals in medical education. Although it is mainly intended to describe products applicable to medical school courses, high-quality,…
Beckers, Stefan K; Timmermann, Arnd; Müller, Michael P; Angstwurm, Matthias; Walcher, Felix
Background Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Methods Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Results Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6). Conclusion Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education
Koh, Gerald Ch; Lee, Jeremy Ne; Agrawal, Neelima; Tam, John Kc; Samarasekera, Dujeepa; Koh, Dow Rhoon; Wong, John El; Tan, Chay Hoon
This study assessed the effectiveness of education reforms on student-reported learning outcomes at the end of the 5-year medical school (M5) and 1-year internship (HO) in 2006, 2007 and 2008. A self-administered anonymous survey with 17 learning outcomes assessed, derived from Harden's Three-Circle Outcomes Model for outcomes-based education, was administered to 683 students at the end of medical school (M5) and internship (HO) from 2006, 2007 and 2008. We identified learning outcomes which changed significantly for internship (Cohorts A, B and C) and medical school (Cohorts B, C and D) between cohorts from 2006 to 2008, and compared learning outcomes between medical school and internship within cohorts (i.e. Cohort B which was M5 in 2006 and HO in 2007; Cohort C which was M5 in 2007 and HO in 2008). The proportion of students who agreed that medical school helped them achieve learning outcomes increased significantly from 2006 to 2008 for 15 out of 17 learning outcomes assessed. The proportion of students who agreed that internship helped them achieve learning outcomes increased significantly from 2006 to 2008 for 6 learning outcomes assessed. For Cohorts B and C, internship was more effective than medical school in achieving 8 learning outcomes. Cohort C reported that internship was more effective than medical school in 3 additional learning outcomes than Cohort B: patient management, humility and dedication. We conclude that a successful journey of education reform is an ongoing process that needs to comprehensively address multifaceted components such as faculty, administration and curriculum.
Curtis, Michael T.; DiazGranados, Deborah; Feldman, Moshe
Use of simulation-based training is fast becoming a vital source of experiential learning in medical education. Although simulation is a common tool for undergraduate and graduate medical education curricula, the utilization of simulation in continuing medical education (CME) is still an area of growth. As more CME programs turn to simulation to…
Balkanci, Z. Dicle; Pehlivanoglu, Bilge
Physiology education, which occupies an important place in undergraduate medical education, exhibits diversities across the world. Since there was no specific source of information about physiology education in Turkish medical faculties, the authors aimed to evaluate the general status of undergraduate physiology teaching of medical students in…
Colwell, N. P.
This bulletin documents: (1) a quarter century's progress in medical education, including inadequate governmental control over medical education, action by a voluntary agency, legal power v. publicity, greatly enlarged teaching plants, hospitals as related to medical education, hospital internships, and the hospital as an important educational…
Pinchera, A; Jannini, E A; Lenzi, A
Advances in sexual pharmacology have stimulated the development of new analytical instruments in the management of sexual dysfunction, with increasing research in the area of basic mechanisms of human sexual response. However, the public is greatly interested and eager for new discoveries and pharmacological treatments to enhance sexual performance and relationships, and cure common sexual dysfunctions and symptoms. The need for sexology--in this case, a new "medical" sexology--to utilize scientific tools and be taught in medical schools is therefore evident.
Affirmative action programs of all types are under attack legally and politically. Although medical schools have not been specifically targeted, their affirmative action programs, like others in higher education, are potentially in danger. This article examines the current legal status of affirmative action in medical education and concludes that a refurbished defense of such programs is essential if they are to survive impending judicial and political scrutiny. An analysis of existing case law and available evidence suggests that a carefully reinvigorated diversity argument is the tactic most likely to pass constitutional muster, as well as the justification most likely to blunt growing public and political opposition to admissions policies that take race and ethnicity into consideration. PMID:10432920
Rosiek, Anna; Leksowski, Krzysztof
The leadership organization focuses on education, teamwork, customer relationship and developing strategy which help in building added value, in managing activities, time and quality. Everyday orthopedic experience shows that medical education is a mixture of: specific knowledge, skills and attitudes of people working together, and that creates effective teamwork in a hospital environment. Apart from the main reason of medical education, teaching about disease treatment and health problem solving, medical education should also concentrate on human factors and behavioral aspects of patient treatment in hospital.Assessment of an organization and medical education process by cultural and teamwork criteria, offers a powerful new way to think about performance at the frontlines of healthcare and in the future it could be gold standard for assessing the success of an organization, and standards in medical education, not only in orthopedics.
Ellaway, Rachel H; Albright, Susan; Smothers, Valerie; Cameron, Terri; Willett, Timothy
Abstract descriptions of how curricula are structured and run. The American National Standards Institute (ANSI) MedBiquitous Curriculum Inventory Standard provides a technical syntax through which a wide range of different curricula can be expressed and subsequently compared and analyzed. This standard has the potential to shift curriculum mapping and reporting from a somewhat disjointed and institution-specific undertaking to something that is shared among multiple medical schools and across whole medical education systems. Given the current explosion of different models of curricula (time-free, competency-based, socially accountable, distributed, accelerated, etc.), the ability to consider this diversity using a common model has particular value in medical education management and scholarship. This article describes the development and structure of the Curriculum Inventory Standard as a way of standardizing the modeling of different curricula for audit, evaluation and research purposes. It also considers the strengths and limitations of the current standard and the implications for a medical education world in which this level of commonality, precision, and accountability for curricular practice is the norm rather than the exception.
Medical education is now suffused with concepts that have their source outside the traditional scientific and medical disciplines: concepts such as holism, connectedness and reflective practice. Teaching of these, and other problematic concepts such as medical uncertainty and error, has been defined more by the challenge they pose to the standard model rather than being informed by a strong positive understanding. This challenge typically involves a critical engagement with the idea of objectivity, which is rarely acknowledged as an inherently metaphysical critique. Consequently, these ideas prove to be difficult to teach well. I suggest that the lack of an integrating, positive narrative is the reason for teaching difficulty, and propose that what is needed is an explicit commitment to teach the metaphysics of medicine, with the concept of holism being the fulcrum on which the remaining concepts turn. An acknowledged metaphysical narrative will encompass the scientific realism that medical students typically bring to their tertiary education, and at the same time enable a bigger picture to be drawn that puts the newer and more problematic concepts into context.
Logan, Judith R; Price, Susan L
The core curriculum in the education of medical informaticians remains a topic of concern and discussion. This paper reports on a survey of medical informaticians with Master's level credentials that asked about computer science (CS) topics or skills that they need in their employment. All subjects were graduates or "near-graduates" of a single medical informatics Master's program that they entered with widely varying educational backgrounds. The survey instrument was validated for face and content validity prior to use. All survey items were rated as having some degree of importance in the work of these professionals, with retrieval and analysis of data from databases, database design and web technologies deemed most important. Least important were networking skills and object-oriented design and concepts. These results are consistent with other work done in the field and suggest that strong emphasis on technical skills, particularly databases, data analysis, web technologies, computer programming and general computer science are part of the core curriculum for medical informatics.
Ruiz, Jorge G; Mintzer, Michael J; Leipzig, Rosanne M
The authors provide an introduction to e-learning and its role in medical education by outlining key terms, the components of e-learning, the evidence for its effectiveness, faculty development needs for implementation, evaluation strategies for e-learning and its technology, and how e-learning might be considered evidence of academic scholarship. E-learning is the use of Internet technologies to enhance knowledge and performance. E-learning technologies offer learners control over content, learning sequence, pace of learning, time, and often media, allowing them to tailor their experiences to meet their personal learning objectives. In diverse medical education contexts, e-learning appears to be at least as effective as traditional instructor-led methods such as lectures. Students do not see e-learning as replacing traditional instructor-led training but as a complement to it, forming part of a blended-learning strategy. A developing infrastructure to support e-learning within medical education includes repositories, or digital libraries, to manage access to e-learning materials, consensus on technical standardization, and methods for peer review of these resources. E-learning presents numerous research opportunities for faculty, along with continuing challenges for documenting scholarship. Innovations in e-learning technologies point toward a revolution in education, allowing learning to be individualized (adaptive learning), enhancing learners' interactions with others (collaborative learning), and transforming the role of the teacher. The integration of e-learning into medical education can catalyze the shift toward applying adult learning theory, where educators will no longer serve mainly as the distributors of content, but will become more involved as facilitators of learning and assessors of competency.
Coates, Wendy C; Love, Jeffrey N; Santen, Sally A; Hobgood, Cherri D; Mavis, Brian E; Maggio, Lauren A; Farrell, Susan E
As the definition of scholarship is clarified, each specialty should develop a cadre of medical education researchers who can design, test, and optimize educational interventions. In 2004, the Association for American Medical Colleges' Group on Educational Affairs developed the Medical Education Research Certificate (MERC) program to provide a curriculum to help medical educators acquire or enhance skills in medical education research, to promote effective collaboration with seasoned researchers, and to create better consumers of medical education scholarship. MERC courses are offered to individuals during educational meetings. Educational leaders in emergency medicine (EM) identified a disparity between the "scholarship of teaching" and medical education research skills, and they collaborated with the MERC steering committee to develop a mentored faculty development program in medical education research. A planning committee comprising experienced medical education researchers who are also board-certified, full-time EM faculty members designed a novel approach to the MERC curriculum: a mentored team approach to learning, grounded in collaborative medical education research projects. The planning committee identified areas of research interest among participants and formed working groups to collaborate on research projects during standard MERC workshops. Rather than focusing on individual questions during the course, each mentored group identified a single study hypothesis. After completing the first three workshops, group members worked under their mentors' guidance on their multiinstitutional research projects. The expected benefits of this approach to MERC include establishing a research community network, creating projects whose enrollments offer a multiinstitutional dimension, and developing a cadre of trained education researchers in EM.
Hanson, Janice L; Balmer, Dorene F; Giardino, Angelo P
This paper provides a primer for qualitative research in medical education. Our aim is to equip readers with a basic understanding of qualitative research and prepare them to judge the goodness of fit between qualitative research and their own research questions. We provide an overview of the reasons for choosing a qualitative research approach and potential benefits of using these methods for systematic investigation. We discuss developing qualitative research questions, grounding research in a philosophical framework, and applying rigorous methods of data collection, sampling, and analysis. We also address methods to establish the trustworthiness of a qualitative study and introduce the reader to ethical concerns that warrant special attention when planning qualitative research. We conclude with a worksheet that readers may use for designing a qualitative study. Medical educators ask many questions that carefully designed qualitative research would address effectively. Careful attention to the design of qualitative studies will help to ensure credible answers that will illuminate many of the issues, challenges, and quandaries that arise while doing the work of medical education.
Al-Eraky, Mohamed Mostafa
Review of studies published in medical education journals over the last decade reveals that teaching medical professionalism is essential, yet challenging. According to a recent Best Evidence in Medical Education (BEME) guide, there is no consensus on a theoretical or practical model to integrate the teaching of professionalism into medical education. The aim of this article is to outline a practical manual for teaching professionalism at all levels of medical education. Drawing from research literature and author's experience, Twelve Tips are listed and organised in four clusters with relevance to (1) the context, (2) the teachers, (3) the curriculum, and (4) the networking. With a better understanding of the guiding educational principles for teaching medical professionalism, medical educators will be able to teach one of the most challenging constructs in medical education.
Texas Tech Univ., Lubbock. Home Economics Curriculum Center.
Designed for use in consumer and homemaking education in Texas, this curriculum guide is on the subject of home management and consumer education. An introduction to the guide, covering its use and program and curriculum planning, provides a list of suggested reading. Information on teaching handicapped and disadvantaged students follows. The…
Yaghoubi, Maryam; Raeisi, Ahmad Reza; Afshar, Mina; Yarmohammadian, Mohammad Hossein; Hasanzadeh, Akbar; Javadi, Marzi; Ansary, Maryam
BACKGROUND: Old methods of administrating can’t cover the rapid changes of today. These changes redounded new organizations like learning organizations to be formed. The purpose of this research was to study the relationship between learning organization and organizational commitment among nursing managers. METHODS: This was a descriptive analytic survey. The population of study included 90 nursing managers of 9 educational hospitals. Data gathering was done via learning organizational (LO) and organizational commitment (OC) questionnaires. Data analysis was done using SPSS software. RESULTS: The mean score of LO was 56.9 ± 18.1 among nursing mangers, and the mean score of OC was 62.3 ± 10.1. In general, there was a significant relationship between LO and OC and there was a significant relationship between LO and job experience based on ANOVA test. CONCLUSIONS: In today’s changing environment of very rapid changes which have been seen in different areas of science and technology and the increasing complexity and dynamics of environmental factors, only organizations with active adaptation (dynamic equilibrium) can survive and remain capable of growth. This aim can be fulfilled just in learning organizations. PMID:21589785
Ohba, Hisateru; Ogasawara, Katsuhiko; Hoshino, Shuhei; Hosoba, Minoru; Okuda, Yasuo; Konishi, Yasuhiko; Ikeda, Ryuji
The purpose of this study was to clarify actual conditions and problems in medical information education and to propose the educational concept to be adopted in medical information. A questionnaire survey was carried out by the anonymous method in June 2008. The survey was intended for 40 radiological technology schools. The questionnaire items were as follows: (1) educational environment in medical information education, (2) content of a lecture in medical information, (3) problems in medical information education. The response rate was 55.0% (22 schools). Half of the responding schools had a laboratory on medical information. Seventeen schools had a medical information education facility, and out of them, approximately 50% had an educational medical information system. The main problems of the medical information education were as follows: (a) motivation of the students is low, (b) the educational coverage and level for medical information are uncertain, (c) there are not an appropriate textbook and educational guidance. In conclusion, these findings suggest that it is necessary to have a vision of medical information education in the education of radiological technologists.
Alpert, Shannon Atkinson
This study identified factors that influenced the use of project management in higher education research projects. Using a qualitative grounded theory approach that included in-depth interviews with assistant professors, the researcher examined how these individuals were using project management processes and tools and factors that enabled,…
Commonwealth Secretariat, London (England).
This volume contains 11 papers on the under-representation of women in higher education management in Bahrain, Finland, France, India, Indonesia, Malaysia, Nigeria, Peru, the United States and Canada, the South Pacific and the West Indies. All papers were written by women vice-chancellors, presidents and senior managers of universities in those…
Terrana, Maryann; Grills, Caroline
Discusses an expert roundtable's list of desirable qualities for higher education managers: strong leadership, ability to teach others, ability to develop a cadre of people who can carry out the mission, partnering well with outsiders, managing well, adaptability, being a change agent, understanding the competition, and having an entrepreneurial…
Sprague, Laurie A.; Bell, Brad; Sullivan, Tim; Voss, Mark; Payer, Andrew F.; Goza, Stewart Michael
The NASA Johnson Space Center (JSC)/LinCom Corporation, the University of Texas Medical Branch at Galveston (UTMB), and the Galveston Independent School District (GISD) have teamed up to develop a virtual visual environment display (VIVED) that provides a unique educational experience using virtual reality (VR) technologies. The VIVED end product will be a self-contained educational experience allowing students a new method of learning as they interact with the subject matter through VR. This type of interface is intuitive and utilizes spatial and psychomotor abilities which are now constrained or reduced by the current two dimensional terminals and keyboards. The perpetual challenge to educators remains the identification and development of methodologies which conform the learners abilities and preferences. The unique aspects of VR provide an opportunity to explore a new educational experience. Endowing medical students with an understanding of the human body poses some difficulty challenges. One of the most difficult is to convey the three dimensional nature of anatomical structures. The ideal environment for addressing this problem would be one that allows students to become small enough to enter the body and travel through it - much like a person walks through a building. By using VR technology, this effect can be achieved; when VR is combined with multimedia technologies, the effect can be spectacular.
Lopreiato, Joseph O; Sawyer, Taylor
The use of simulation-based medical education (SBME) in pediatrics has grown rapidly over the past 2 decades and is expected to continue to grow. Similar to other instructional formats used in medical education, SBME is an instructional methodology that facilitates learning. Successful use of SBME in pediatrics requires attention to basic educational principles, including the incorporation of clear learning objectives. To facilitate learning during simulation the psychological safety of the participants must be ensured, and when done correctly, SBME is a powerful tool to enhance patient safety in pediatrics. Here we provide an overview of SBME in pediatrics and review key topics in the field. We first review the tools of the trade and examine various types of simulators used in pediatric SBME, including human patient simulators, task trainers, standardized patients, and virtual reality simulation. Then we explore several uses of simulation that have been shown to lead to effective learning, including curriculum integration, feedback and debriefing, deliberate practice, mastery learning, and range of difficulty and clinical variation. Examples of how these practices have been successfully used in pediatrics are provided. Finally, we discuss the future of pediatric SBME. As a community, pediatric simulation educators and researchers have been a leading force in the advancement of simulation in medicine. As the use of SBME in pediatrics expands, we hope this perspective will serve as a guide for those interested in improving the state of pediatric SBME.
Ekmekçi, Perihan Elif
Medical ethics can be traced back to Hippocratic Oath in antiquity. Last decade witnessed improvements in science and technology which attracted attention to the ethical impacts of the innovations in medicine. The need to combine medical innovations with a preservation of human values and to cultivate ethical competencies required by professionalism conceived medical ethics education in various levels in medical schools. Despite the diversities regarding teaching hours, methodology and content of the courses, medical ethics became a fundamental part of medical education around the world. In Turkey medical ethics education is given both in undergraduate and postgraduate levels. The high increase in the number of medical schools and shortfall of instructors who have medical ethics as their primary academic focus creates a big challenge in medical ethics education in both levels. Currently there are 89 medical schools in Turkey and only six medical schools are giving postgraduate medical ethics education. In 2010 only 33 of all medical schools could establish a separate department dedicated to medical ethics. There are no medical ethics courses embedded in residency programs. The quality and standardization of undergraduate medical ethics education has started but there are no initiatives to do so in postgraduate level.
Ekmekçi, Perihan Elif
Medical ethics can be traced back to Hippocratic Oath in antiquity. Last decade witnessed improvements in science and technology which attracted attention to the ethical impacts of the innovations in medicine. The need to combine medical innovations with a preservation of human values and to cultivate ethical competencies required by professionalism conceived medical ethics education in various levels in medical schools. Despite the diversities regarding teaching hours, methodology and content of the courses, medical ethics became a fundamental part of medical education around the world. In Turkey medical ethics education is given both in undergraduate and postgraduate levels. The high increase in the number of medical schools and shortfall of instructors who have medical ethics as their primary academic focus creates a big challenge in medical ethics education in both levels. Currently there are 89 medical schools in Turkey and only six medical schools are giving postgraduate medical ethics education. In 2010 only 33 of all medical schools could establish a separate department dedicated to medical ethics. There are no medical ethics courses embedded in residency programs. The quality and standardization of undergraduate medical ethics education has started but there are no initiatives to do so in postgraduate level. PMID:27213100
Lukas, Rimas V; Blood, Angela; Park, Yoon Soo; Brorson, James R
In neurology education there is evidence that trainees may have greater ability in general localization and diagnosis than they do in treatment decisions, particularly with considering longer term care and supportive care. We hypothesized that medical students completing a neurology clerkship would exhibit greater skill at considering the acute diagnostic and therapeutic management than at considering supportive management measures. Data from 720 standardized patient encounters by 360 medical students completing a neurology clerkship being evaluated via an objective structured clinical examination were analyzed for skill in three components of clinical decision making: diagnostic evaluation, therapeutic intervention, and supportive intervention. Scores for all standardized patient encounters over the 2008-2012 interval revealed a significantly higher percentage of correct responses in both the diagnostic (mean [M]=62.6%, standard deviation [SD]=20.3%) and therapeutic (M=63.0%, SD=28.8%) categories in comparison to the supportive (M=31.8%, SD=45.2%) category. However, only scores in therapeutic and supportive treatment plans were found to be significant predictors of the USA National Board of Medical Examiners (NBME) clinical neurology subject examination scores; on average, a percent increase in therapeutic and support scores led to 5 and 2 point increases in NBME scores, respectively. We demonstrate empirical evidence of deficits in a specific component of clinical reasoning in medical students at the completion of a neurology clerkship.
Bennett, Elisabeth E.; Higgens, Thomas L.
Physician education has followed relatively rigid guidelines since the Flexner report of 1910. Medical education has been largely didactic with time-based progression and certifying exams, and with variable degrees of autonomy and supervision in graduate (post MD/DO degree) medical education programs. Innovative educational approaches now…
Sundberg, Kristina; Josephson, Anna; Reeves, Scott; Nordquist, Jonas
A key role for educational leaders within undergraduate medical education is to continually improve the quality of education; global quality health care is the goal. This paper reports the findings from a study employing a power model to highlight how educational leaders influence the development of undergraduate medical curricula and the…
Colwell, N. P.
This bulletin reports on the status of medical education in the United States for the years 1926-1928. During the past two years the number of medical schools recognized by the American Medical Association has been reduced from 80 to 74. Reports to the American Medical Association show that the enrollment of medical students has increased from…
In a healthcare environment of strained resources and scarce profits, hospital administrators must seek revenue from all available sources. Some potential revenue sources are capital intensive, however, requiring large initial investments for new construction and modern equipment. Other potential revenue sources may require starting new programs and recruiting additional staff. Few potentially income-producing alternatives can be funded from existing assets, require little additional investment, and yield significant revenue. But hospitals that own and lease medical office buildings, will find that with proper management these existing assets can become sources of additional revenue.
Mohan, Arun; Riley, Brian; Boyington, Dane; Kripalani, Sunil
Although illustrated medication instructions may improve medication management among vulnerable populations, little prior research has evaluated their use among Latinos. We conducted focus groups and interviews with Latino patients with diabetes at two safety net clinics in Tennessee to understand medication taking practices and perceptions of illustrated medication instructions. Patients reported confidence in being able to take medications, but demonstrated a lack of understanding of medication instructions. On further probing, they described several barriers to effective medication management rooted in poor communication. Patients expressed preference for illustrated medication instructions which could address several of the challenges raised by patients. PMID:22453163
Drug-resistant tuberculosis (TB) is still a major threat worldwide. However, recent scientific advances in diagnostic and therapeutic tools have improved the management of drug-resistant TB. The development of rapid molecular testing methods allows for the early detection of drug resistance and prompt initiation of an appropriate treatment. In addition, there has been growing supportive evidence for shorter treatment regimens in multidrug-resistant TB; and for the first time in over 50 years, new anti-TB drugs have been developed. The World Health Organization has recently revised their guidelines, primarily based on evidence from a meta-analysis of individual patient data (n=9,153) derived from 32 observational studies, and outlined the recommended combination and correct use of available anti-TB drugs. This review summarizes the updated guidelines with a focus on the medical management of drug-resistant TB.
Woodbridge, Mark; Fagiolo, Gianlorenzo; O'Regan, Declan P
Clinical picture archiving and communications systems provide convenient, efficient access to digital medical images from multiple modalities but can prove challenging to deploy, configure and use. MRIdb is a self-contained image database, particularly suited to the storage and management of magnetic resonance imaging data sets for population phenotyping. It integrates a mature image archival system with an intuitive web-based user interface that provides visualisation and export functionality. In addition, utilities for auditing, data migration and system monitoring are included in a virtual machine image that is easily deployed with minimal configuration. The result is a freely available turnkey solution, designed to support epidemiological and imaging genetics research. It allows the management of patient data sets in a secure, scalable manner without requiring the installation of any bespoke software on end users' workstations. MRIdb is an open-source software, available for download at http://www3.imperial.ac.uk/bioinfsupport/resources/software/mridb .
Dauphinee, W Dale; Wood-Dauphinee, Sharon
The development of the Best Evidence Medical Education (BEME) Collaboration is introduced in the context of other systematic review initiatives, specifically the Cochrane and Campbell collaborations. The commentary addresses two goals: to describe the current status of BEME and to situate BEME in the broader context of the medical education community's need to be accountable, to conduct research to understand educational processes and results, and the key role that medical educational research must play within the quality-improvement agenda. Lessons drawn from the evidence-based practice movement of the last ten years and the current experience with BEME suggest that, although BEME will inform some educational policies and practices, its initial success may be limited because of the paucity of studies that meet current standards for evidence and the great difficulty in conducting methodologically rigorous studies in the complex social interaction called education. Nonetheless, the need exists for medical education research to continue to address key issues in medical education using experimental designs, while at the same time anticipating the need for more situation-specific data to permit educators to monitor and benchmark their existing programs within a quality-improvement and accountability framework. The authors conclude that the very nature of being professional in today's social and fiscal context demands that medical educators provide evidence of effectiveness and efficiency of their programs while at the same time BEME and medical education research continue to grow and mature.
Aschenbrener, Carol A; Ast, Cori; Kirch, Darrell G
Nearly half a century ago, Lowell T. Coggeshall recommended, through what has come to be known as the Coggeshall Report, that physician education-medical school (or undergraduate medical education [UME]), residency training (or graduate medical education [GME]), and continuing medical education (CME)-be "planned and provided as a continuum." While the dream of a true continuum remains unfulfilled, recent innovations focused on defining and assessing meaningful outcomes at last offer the anchor for the creation of a seamless, flexible, and ongoing pathway for the preparation of physicians. Recent innovations, including a widely accepted competency framework and entrustable professional activities (EPAs), provide key tools for creating a continuum. The competency framework is being leveraged in UME, GME, and CME and is serving as the foundation for the continuum. Learners and those who assess them are increasingly relying on observable behaviors (e.g., EPAs) to determine progress. The GME community in the United States and Canada has played-and continues to play-a leading role in the creation of these tools and a true medical education continuum. Despite some systemic challenges to implementation (e.g., premedical learner formation, time-in-step requirements), the GME community is already operationalizing these tools as a basis for other innovations that are improving transitions across the continuum (e.g., competency-based progression of residents). The medical education community's greatest responsibility in the years ahead will be to build on these efforts in GME-joining together to learn from one another and develop a continuum that serves the public and the profession.
Alexander, C B
Comprehensive data show trends in graduate medical education in pathology with regard to the numbers of accredited programs, persons certified from those programs, and demographics of the population of first year-trainees in pathology. Experience with US seniors and foreign-trained physicians in the PGY match process for pathology from 1991 through 2000 is presented, along with data on the types of medical schools generating pathology trainees for the PGY-1 year and the top medical schools of origin of US medical graduates who completed the program and became certified in pathology between 1995 and 1999. The impact of reimbursement of the credentialing year is also addressed through data collected from the PRODS Survey 2000, and those results are reviewed. Finally, turnover rates among pathology program directors of combined AP/CP programs and subspecialty programs since 1994 are presented. An analysis of these trends is provided, along with suggestions to improve both the perception of careers in pathology and the actual choice of a career in pathology.
Nara, Nobuo; Suzuki, Toshiya; Tohda, Shuji
To contribute to the innovation of the medical education system in Japan, we visited 35 medical schools and 5 institutes in 12 countries of North America, Europe, Australia and Asia in 2008-2010 and observed the education system. We met the deans, medical education committee and administration affairs and discussed about the desirable education system. We also observed the facilities of medical schools.Medical education system shows marked diversity in the world. There are three types of education course; non-graduate-entry program(non-GEP), graduate-entry program(GEP) and mixed program of non-GEP and GEP. Even in the same country, several types of medical schools coexist. Although the education methods are also various among medical schools, most of the medical schools have introduced tutorial system based on PBL or TBL and simulation-based learning to create excellent medical physicians. The medical education system is variable among countries depending on the social environment. Although the change in education program may not be necessary in Japan, we have to innovate education methods; clinical training by clinical clerkship must be made more developed to foster the training of the excellent clinical physicians, and tutorial education by PBL or TBL and simulation-based learning should be introduced more actively.
Spellman, Douglas F.; Griffith, Annette K.; Huefner, Jonathan C.; Wise, Neil, III; McElderry, Ellen; Leslie, Laurel K.
This article presents a psychotropic medication management approach that is used within a residential care program. The approach is used to assess medications at youths' times of entry and to facilitate decision making during care. Data from a typical case study have indicated that by making medication management decisions slowly, systematically,…
Transformative learning is a most important issue in medical education. Ethnographic edutainment is a concept that consists of reward, competition, and motivation strategies, which are more effective in engaging with learners. First-year medical students (N = 321) were included in this study during the Doctor and Society course at Chulalongkorn University in 2011. Four preset learning objectives were set and participants assigned a term group project with clouding technologies. The deliverables and the attitude toward this method were evaluated. Nineteen of 20 (95%) groups achieved all objectives. Females rated higher scores for this activity than males (P < 0.001). Statistically significant differences were found between lecture-based sessions and field visit sessions as well as ethnographic edutainment activity sessions and other types (P < 0.01). The results were consistent in both male and female groups. Ethnographic edutainment can be well-accepted with higher satisfaction than some other types of teaching.
Tidmarsh, Patrica J; Cummings, Joseph; Hersh, William R; Freidman, Charles P
The curricula of most medical informatics training programs are incomplete. We used Internet2-based videoconferencing to expand the educational opportunities of medical informatics students at Oregon Health & Science University and the University of Pittsburgh. Students and faculty in both programs shared extra-curricular research conferences and journal club meetings. A course in Information Retrieval was made available to students in both programs. The conferences, meetings and class were well accepted by participants. A few problems were experienced with the technology, some of which were resolved, and some non-technical challenges to distributing academic conferences, meetings and coursework were also uncovered. We plan to continue our efforts with expanded course and extra-curricular offerings and a more comprehensive evaluation strategy.
Tidmarsh, Patrica J.; Cummings, Joseph; Hersh, William R.; Freidman, Charles P.
The curricula of most medical informatics training programs are incomplete. We used Internet2-based videoconferencing to expand the educational opportunities of medical informatics students at Oregon Health & Science University and the University of Pittsburgh. Students and faculty in both programs shared extra-curricular research conferences and journal club meetings. A course in Information Retrieval was made available to students in both programs. The conferences, meetings and class were well accepted by participants. A few problems were experienced with the technology, some of which were resolved, and some non-technical challenges to distributing academic conferences, meetings and coursework were also uncovered. We plan to continue our efforts with expanded course and extra-curricular offerings and a more comprehensive evaluation strategy. PMID:12463932
The introduction of new didactic guidelines, for the graduate degrees in medicine and allied disciplines, is secondary to the new needs of the National Health Care System, and in part to the significant developments of science. It is not easy to meet this challenge. It is likewise not easy to channel coherently the required changes, with respect to the scientific, clinical and didactic goals. Paradoxically the same institutions that are in such great need of transformation, are also a significant part of the existing problem. In many countries, schools of medicine have developed centers for medical education that are geared toward the development and growth of students, teachers-tutors, and patients alike. Medical education has become more global, in an attempt to meet much needed communication needs, from both ends, teachers and students, as well as the recipients of care, patients. One major goal of such centers is the introduction of innovative didactic activities. There is indeed a new tendency toward the development of methodological tracks aiming at the acquisition and consolidation of a deeper and broader cultural knowledge. Amongst these initiatives there is the introduction of an evaluation of the teaching delivered, as well as the development of a multidisciplinary approach to didactics. The latter, is a prerequisite of an effective training directed toward the development of the concept of "team approach", whose ultimate goal is patient care. In Italy, at the Università Campus Biomedico, in Rome, one of the first of such centers of medical education has been developed. Its goal is to be both a learning organization, as well as a center for both research and clinical services.
McBane, Sarah E; Dopp, Anna L; Abe, Andrew; Benavides, Sandra; Chester, Elizabeth A; Dixon, Dave L; Dunn, Michaelia; Johnson, Melissa D; Nigro, Sarah J; Rothrock-Christian, Tracie; Schwartz, Amy H; Thrasher, Kim; Walker, Scot
The American College of Clinical Pharmacy (ACCP) previously published position statements on collaborative drug therapy management (CDTM) in 1997 and 2003. Since 2003, significant federal and state legislation addressing CDTM has evolved and expanded throughout the United States. CDTM is well suited to facilitate the delivery of comprehensive medication management (CMM) by clinical pharmacists. CMM, defined by ACCP as a core component of the standards of practice for clinical pharmacists, is designed to optimize medication-related outcomes in collaborative practice environments. New models of care delivery emphasize patient-centered, team-based care and increasingly link payment to the achievement of positive economic, clinical, and humanistic outcomes. Hence clinical pharmacists practicing under CDTM agreements or through other privileging processes are well positioned to provide CMM. The economic value of clinical pharmacists in team-based settings is well documented. However, patient access to CMM remains limited due to lack of payer recognition of the value of clinical pharmacists in collaborative care settings and current health care payment policy. Therefore, the clinical pharmacy discipline must continue to establish and expand its use of CDTM agreements and other collaborative privileging mechanisms to provide CMM. Continued growth in the provision of CMM by appropriately qualified clinical pharmacists in collaborative practice settings will enhance recognition of their positive impact on medication-related outcomes.
Gallagher, Stephen; Wallace, Sarah; Nathan, Yoga; McGrath, Deirdre
Psychology is viewed by medical students in a negative light. In order to understand this phenomenon, we interviewed 19 medical students about their experiences of psychology in medical education. Interviews were transcribed verbatim and analysed using thematic analysis. Four main themes were generated: attitudes, teaching culture, curriculum factors and future career path; negative attitudes were transmitted by teachers to students and psychology was associated with students opting for a career in general practice. In summary, appreciation of psychology in medical education will only happen if all educators involved in medical education value and respect each other's speciality and expertise.
Winseman, Jeffrey; Malik, Abid; Morison, Julie; Balkoski, Victoria
Objective: Empathy is a prominent goal of medical education that is too often underachieved. Using concept mapping, the authors constructed a student-generated conceptual model of factors viewed as affecting empathy during medical education. Methods: During the 2005-2006 academic year, 293 medical students and interns answered a brainstorming…
Quinn, Robert; Price, Jamie
Examines investment and consumption features of the demand for medical education, using medical application data over the 1948 to 1994 time period. Examines a variant of a pure human capital (investment) model and a model augmented by consumption and demographic variables, using medical education data. A static human capital model best forecasts…
Jolly, Paul, Ed.; Hudley, Dorothea M., Ed.
This 1994 version of an annual data book on United States medical education offers extensive data on 12 topics which are fundamental or most frequently requested. Data sources include the Association of American Medical Colleges, the Educational Commission for Foreign Medical Graduates, the National Institutes of Health, Health Care Financing…
Das, Mandira; And Others
This study sought to evaluate faculty opinion of existing medical curricula in two medical schools in different countries in terms of six educational strategies using the "SPICES continuum." Significant differences between existing educational plans of the two medical schools were identified. (LZ)
Ghias, Kulsoom; Khan, Kausar S; Ali, Rukhsana; Azfar, Shireen; Ahmed, Rashida
Objective: Aga Khan University, a private medical college, had a vision of producing physicians who are not only scientifically competent, but also socially sensitive, the latter by exposure of medical students to a broad-based curriculum. The objective of this study was to identify the genesis of broad-based education and its integration into the undergraduate medical education program as the Humanities and Social Sciences (HASS) course. Methods: A qualitative methodology was used for this study. Sources of data included document review and in-depth key informant interviews. Nvivo software was utilized to extract themes. Results: The study revealed the process of operationalization of the institutional vision to produce competent and culturally sensitive physicians. The delay in the establishment of the Faculty of Arts and Sciences, which was expected to take a lead role in the delivery of a broad-based education, led to the development of an innovative HASS course in the medical curriculum. The study also identified availability of faculty and resistance from students as challenges faced in the implementation and evolution of HASS. Conclusions: The description of the journey and viability of integration of HASS into the medical curriculum offers a model to medical colleges seeking ways to produce socially sensitive physicians. PMID:27648038
This special issue of "Journal for Learning through the Arts" focuses on the uses of literature and arts in medical education. The introductory article addresses current debate in the field of medical humanities (MH), namely the existential question of what is the purpose of integrating humanities/arts in medical education; and then examines how…
Neufeld, Karin J.; Schuckit, Marc A.; Hernandez-Avila, Carlos A.
The Alcohol Medical Scholars Program (AMSP) is designed to improve medical education related to substance use disorders (SUDs) through mentorship of junior, full-time academic faculty from medical schools across the United States. Scholarship focuses on literature review and synthesis, lecture development and delivery, increasing SUD education in…
Peluso, Michael J; Hafler, Janet P
All physicians, at some point in their career, are responsible for the education of their peers and junior colleagues. Although medical students are expected to develop clinical and research skills in preparation for residency, it is becoming clear that a student should also be expected to develop abilities as a teacher. A handful of institutions have student-as-teacher programs to train medical students in education, but most students graduate from medical school without formal training in this area. When such a program does not exist, medical students can gain experience in education through participation in peer teaching, course design, educational committees, and medical education scholarship. In doing so, they attain important skills in the development, implementation, and evaluation of educational programs. These skills will serve them in their capacity as medical educators as they advance in their careers and gain increasing teaching responsibility as residents, fellows, and attending physicians.
Ethics has an established place within the medical curriculum. However notable differences exist in the programme characteristics of different schools of medicine. This paper addresses the main differences in the curricula of medical schools in South East Europe regarding education in medical ethics and bioethics, with a special emphasis on research ethics, and proposes a model curriculum which incorporates significant topics in all three fields. Teaching curricula of Medical Schools in Bulgaria, Bosnia and Herzegovina, Croatia, Serbia, Macedonia and Montenegro were acquired and a total of 14 were analyzed. Teaching hours for medical ethics and/or bioethics and year of study in which the course is taught were also analyzed. The average number of teaching hours in medical ethics and bioethics is 27.1 h per year. The highest national average number of teaching hours was in Croatia (47.5 h per year), and the lowest was in Serbia (14.8). In the countries of the European Union the mean number of hours given to ethics teaching throughout the complete curriculum was 44. In South East Europe, the maximum number of teaching hours is 60, while the minimum number is 10 teaching hours. Research ethics topics also show a considerable variance within the regional medical schools. Approaches to teaching research ethics vary, even within the same country. The proposed model for education in this area is based on the United Nations Educational, Scientific and Cultural Organization Bioethics Core Curriculum. The model curriculum consists of topics in medical ethics, bioethics and research ethics, as a single course, over 30 teaching hours.
Weil, Thomas P
The past several decades have witnessed a significant increase in the number of graduate programs in health management, either on campus or online. The alternative for a health professional to attending a graduate program on campus is to receive an MBA or MHA degree online. The current cost ranges from $13,600 to $78,000, with the more expensive online programs tied to graduate programs that are accredited by the Commission on the Accreditation of Healthcare Management Education and provide the names and qualifications of their faculty. The for-profit online programs have not been forthcoming to this author concerning their health management faculty or their curriculum. For the individual desiring more health management education who is unable to enroll, for family or financial reasons, in an on-campus program, the top-tier online programs seem like a worthwhile but is a relatively expensive option.
Burden, Paul R.
Time management principles can help teachers become more aware of ways in which time can be used to the greatest advantage. An exploration of personal time perspectives is a step toward establishing effective patterns of behavior. Productivity may be high in the morning and low in the late afternoon, for example, and organizing some activities to…
The first full paper that is dedicated to cost in medical education appears in the "BMJ" in 1893. This paper "The cost of a medical education" outlines the likely costs associated with undergraduate education at the end of the nineteenth century, and offers guidance to the student on how to make financial planning. Many lessons…
As an external review mechanism, accreditation has played a positive global role in quality assurance and promotion of educational reform. Accreditation systems for medical education have been developed in more than 100 countries including China. In the past decade, Chinese standards for basic medical education have been issued together with…
In this paper I argue that medical education must remain attuned to the interests that physicians have in their own self-development despite ongoing calls for ethics education aimed at ensuring physicians maintain focus on the interests of the patient and society. In particular, I argue that medical education should advance (and abide by) criteria…
In the past several years, mobile learning made rapid inroads into the provision of medical education. There are significant advantages associated with mobile learning. These include high access, low cost, more situated and contextual learning, convenience for the learner, continuous communication and interaction between learner and tutor and between learner and other learners, and the ability to self-assess themselves while learning. Like any other form of medical pedagogy, mobile learning has its downsides. Disadvantages of mobile learning include: inadequate technology, a risk of distraction from learning by using a device that can be used for multiple purposes, and the potential for breakdown in barriers between personal usage of the mobile device and professional or educational use. Despite these caveats, there is no question but that mobile learning offers much potential. In the future, it is likely that the strategy of mobile first, whereby providers of e-learning think of the user experience on a mobile first, will result in learners who increasingly expect that all e-learning provision will work seamlessly on a mobile device.
Lippincott, L L; Brown, K R
Pediatric sinusitis can be a challenging disease to treat, whether by a primary care physician or an otolaryngologist. When initial appropriate therapy fails to resolve the disorder, frustration may develop on the part of the patient, the family, and the physician. In addition to treatment with appropriate antibiotics for a sufficient length of time, other associated conditions that can exacerbate the condition must be considered and addressed as necessary. These may include viral upper respiratory infections, allergic rhinitis, immune deficiencies, asthma, and gastroesophageal reflux disease. Unless all associated conditions have been optimized, treatment of chronic sinusitis will often be unsuccessful. Recognition that there may be another factor contributing to the patient's continuing illness should prompt appropriate evaluation and occasionally referral to appropriate specialists. Except for the unusual pediatric patient with a truly anatomic disorder or an underlying chronic illness such as cystic fibrosis, proper medical management will almost always resolve chronic sinusitis.
Tosteson, Daniel C., Ed.; And Others
This book details how Harvard Medical School (Massachusetts) overcame prevailing educational inertia and developed a curriculum and educational program consistent with preparing students to practice medicine in the 21st century. The New Pathway in General Medical Education program emphasizes both acquiring current knowledge and developing learning…
Barnes, N P; Hull, J; Thomson, A H
Considerable heterogeneity exists in the management of parapneumonic pleural disease. A randomized controlled trial (RCT) demonstrated the effectiveness of small-catheter drainage with fibrinolysis, but surgical devotees suggest this may only be applicable to "early" cases. We examined evidence-based medical management in "all-comers." We performed a retrospective database analysis of the management of all children with complex pleural effusion admitted to the John Radcliffe Hospital over the 7-year period 1996-2003. One hundred and ten children were admitted. Ten were excluded as they were part of a multicenter RCT and had received intrapleural saline instead of urokinase. Of the remaining 100, 51 were female and 49 male. Median age on admission was 5.8 years (range, 0.3-16.5). Symptoms preadmission averaged 11 days, with December the most common month for presentation. Ninety-six underwent chest ultrasound, confirming an effusion in all, described as loculated/septated (68) or echogenic (11). In 17 cases, no specific comment was made regarding the nature of the fluid seen on ultrasound. Ninety-five had subsequent chest tube drainage and then received intrapleural fibrinolysis with urokinase. An etiological organism was identified in 21 cases (21%) (Streptococcus pneumoniae in 10, group A Streptococcus in 5, Staphylococcus aureus in 4, Haemophilus influenzae in 1, and coliform in 1). In a further 9 cases (9%), Gram-positive organisms were seen on pleural fluid microscopy, but did not grow on culture. Two (2%) required surgery due to the persistence of symptoms and an inadequate response to medical management. Median duration of admission was 7 days (range, 2-21 days); median duration of stay from intervention was 5 days (range, 2-19 days). At median follow-up of 8 weeks (range, 3-20 weeks), all children were symptom-free, with minimal pleural thickening on chest X-ray. In conclusion, antibiotic therapy with chest drain insertion and intrapleural urokinase is
Ryan, Greg; Woulfe, Jim; Bartimote-Aufflick, Kathryn
Objectives To investigate whether pharmacy students' anonymous peer assessment of a medication management review (MMR) was constructive, consistent with the feedback provided by an expert tutor, and enhanced the students' learning experience. Design Fourth-year undergraduate pharmacy students were randomly and anonymously assigned to a partner and participated in an online peer assessment of their partner's MMR. Assessment An independent expert graded a randomly selected sample of the MMR's using a schedule developed for the study. A second expert evaluated the quality of the peer and expert feedback. Students also completed a questionnaire and participated in a focus group interview. Student peers gave significantly higher marks than an expert for the same MMR; however, no significant difference between the quality of written feedback between the students and expert was detected. The majority of students agreed that this activity was a useful learning experience. Conclusions Anonymous peer assessment is an effective means of providing additional constructive feedback on student performance on the medication review process. Exposure to other students' work and the giving and receiving of peer feedback were perceived as valuable by students. PMID:20798808
The author recounts an incident of cheating by two first-year medical students, and how it was handled. One of the students, George, had waited until the last minute to write what he called a "stupid" paper that was required as the final examination in a health policy course. His classmate Ellen offered to write the paper for him, and other students also offered to help; no one pointed out that this would be unethical. After some hesitation, George was persuaded to accept Ellen's offer, and he turned in the paper as his own. The course director deduced the deception, and when the students were confronted, they immediately admitted what they had done, blamed only themselves, and said they had been "foolish." Subsequent events showed that the faculty saw the incident as a clear-cut case of cheating, whereas many students felt that George and Ellen's transgression was trivial when compared with plagiarizing a research paper or falsifying lab results on a patient's chart. Also, the faculty chose a more severe and long-lasting punishment, one that many students did not agree with. The author believes that the faculty's refusal to give George and Ellen a clean slate after a reasonable time reflected a lack of forgiveness that is antithetical to the compassionate, forgiving role of physician-healer that medical education promotes. She concludes by explaining how this incident illustrates complex generational and cultural differences in moral reasoning and the selection of punishment, and the great emphasis that medical education places on knowing the facts rather than working creatively with ideas.
Korszun, Ania; Dinos, Sokratis; Ahmed, Kamran; Bhui, Kamaldeep
Background: Reducing stigma associated with mental illness is an important aim of medical education, yet evidence indicates that medical students' attitudes toward patients with mental health problems deteriorate as they progress through medical school. Objectives: Authors examined medical students' attitudes to mental illness, as compared with…
Masters, Ken; Ellaway, Rachel H; Topps, David; Archibald, Douglas; Hogue, Rebecca J
Mobile technologies (including handheld and wearable devices) have the potential to enhance learning activities from basic medical undergraduate education through residency and beyond. In order to use these technologies successfully, medical educators need to be aware of the underpinning socio-theoretical concepts that influence their usage, the pre-clinical and clinical educational environment in which the educational activities occur, and the practical possibilities and limitations of their usage. This Guide builds upon the previous AMEE Guide to e-Learning in medical education by providing medical teachers with conceptual frameworks and practical examples of using mobile technologies in medical education. The goal is to help medical teachers to use these concepts and technologies at all levels of medical education to improve the education of medical and healthcare personnel, and ultimately contribute to improved patient healthcare. This Guide begins by reviewing some of the technological changes that have occurred in recent years, and then examines the theoretical basis (both social and educational) for understanding mobile technology usage. From there, the Guide progresses through a hierarchy of institutional, teacher and learner needs, identifying issues, problems and solutions for the effective use of mobile technology in medical education. This Guide ends with a brief look to the future.
There is a lot of problems related to undergraduate medical education (UME) at Slovak medical schools, e.g. low level co-ordination and integration of curriculum, isolation of teaching subjects, amateurish teaching methods, low level of management, which result in low level of effectivity, late and insufficient reactions to the needs of medical practice. There is urgent need for complex reform of UME if we like to be able to complete with high quality medical schools in Europe. The reform should be focused to the content of curriculum--to integrate preventive and acute medicine into the UME, to improve training of medical students for service in primary health care, to start with renaissance of humanistic education of medical students, to improve research training and teaching of medical informatics. For improving organisation of UME it is necessary to prepare modern profile of graduates from medical school, and from the profile to derive co-ordinated and integrated system of UME. The teachers at medical school should be professionals not only in medical specialization, but in pedagogy, psychology and management, too. Passive forms of education (e.g. lectures) should be partly substituted by active methods, e.g. problem--based learning. More attention should be devoted to elaboration of criteria for evaluation quality of teaching process. The reform of UME have to be done if we like to have a chance to be as good as the best medical schools in Europe. I believe, we want it all! (Ref. 31.)
Majumder, M A A
This article addresses the roles, issues, approaches, rationale, pitfalls, priorities and balance of research in medical education, particularly its "disarray" status in Asia. Research in medical education has influenced education in many ways. Most importantly, it provides legitimate evidences to stakeholders on which to make educational decisions. It also has a wider social impact on teaching practice and subsequent clinical practice. However, in Asia, medical educational research has not substantially influenced educational policy and medical practices. Moreover, it fails to receive comparable attention as in developed countries. A number of constraints that have hampered the development of educational research in Asia are identified: low socio-economic condition of the region; cultural and religious values and beliefs of the people; lack of congruence between the mission and vision of medical schools; leadership crisis; lack of financial resources; inadequate exposure to medical educational research in undergraduate training; lack of collaboration and commitment; and unforeseeable short-term outcome of medical education. The article concludes with some specific recommendations to strengthen research and to create a research culture in the region, including active leadership and commitment of the institutes/organisations, careful assessment and strategic settings of the priorities of medical educational research, establishment of a regional centre for medical education research, availability of financial resources, wider dissemination of research findings, collaboration with the developed countries and initiative to publish regional-based medical education journals, including electronic journals. Appropriate research environment and culture will enable stakeholders to obtain evidence-based information from educational research to increase the relevance, quality, cost-effectiveness and equity of medical education and practice in Asia.
Curry, Raymond H; Burgener, Alan J; Dooley, Sharon L; Christopher, Robert P
The governance of graduate medical education (GME) and management of its interface with clinical care is a shared responsibility of teaching hospitals and medical educators. Significant changes in the structure and financing of medical care over the last few decades, along with a recent shift in the educational paradigm for GME, have made this collaboration all the more challenging. Calls for increased institutional accountability for GME from the Association of American Medical Colleges and the Accreditation Council on Graduate Medical Education have highlighted the need for more effective models of GME governance. With these challenges in mind, this article examines the recent experiences of The McGaw Medical Center of Northwestern University, a multiinstitutional, not-for-profitcorporation that serves as the vehicle for educational collaboration between Northwestern University Feinberg School of Medicine and the teaching hospitals/health systems that provide the clinical homes for McGaw-sponsored GME programs. The authors explore the rationale for pursuing a new model of GME governance at McGaw, and various factors important to its success. These "critical success factors" may be of use in other, similarly complex GME settings.
Okuda, Yasuharu; Bryson, Ethan O; DeMaria, Samuel; Jacobson, Lisa; Quinones, Joshua; Shen, Bing; Levine, Adam I
Medical schools and residencies are currently facing a shift in their teaching paradigm. The increasing amount of medical information and research makes it difficult for medical education to stay current in its curriculum. As patients become increasingly concerned that students and residents are "practicing" on them, clinical medicine is becoming focused more on patient safety and quality than on bedside teaching and education. Educators have faced these challenges by restructuring curricula, developing small-group sessions, and increasing self-directed learning and independent research. Nevertheless, a disconnect still exists between the classroom and the clinical environment. Many students feel that they are inadequately trained in history taking, physical examination, diagnosis, and management. Medical simulation has been proposed as a technique to bridge this educational gap. This article reviews the evidence for the utility of simulation in medical education. We conducted a MEDLINE search of original articles and review articles related to simulation in education with key words such as simulation, mannequin simulator, partial task simulator, graduate medical education, undergraduate medical education, and continuing medical education. Articles, related to undergraduate medical education, graduate medical education, and continuing medical education were used in the review. One hundred thirteen articles were included in this review. Simulation-based training was demonstrated to lead to clinical improvement in 2 areas of simulation research. Residents trained on laparoscopic surgery simulators showed improvement in procedural performance in the operating room. The other study showed that residents trained on simulators were more likely to adhere to the advanced cardiac life support protocol than those who received standard training for cardiac arrest patients. In other areas of medical training, simulation has been demonstrated to lead to improvements in medical
and Surgery CAC Common Access Card CRS Centralized Receivables Service DoD FMR DoD Financial Management Regulation MSA Medical Service Account MTF...H 4 , 2 0 1 5 Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight Report No. DODIG-2015...04 MAR 2015 2. REPORT TYPE 3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Delinquent Medical Service Accounts at Naval
Okumbe, J. A.
This book provides the reader with principal theories and practices of management in educational organizations. It attempts to widen both the breadth and depth of the body of knowledge in this area of specialization. The work provides useful reference material for students and scholars at the undergraduate and postgraduate levels in universities…
Organisation for Economic Cooperation and Development, Paris (France). Centre for Educational Research and Innovation.
This is the report of a conference sponsored by the Centre for Educational Research and Innovation. The conference discussed the findings of the Centre's 2-year program which attempted to demonstrate how the resource management of universities may be improved through better decisionmaking in the realms of finance, information, human flows, the use…
Visscher, Adrie J., Ed.
The eight chapters of this theme issue deal with the design, implementation, and evaluation of computer-assisted information systems for educational organizations. Points of commonality and difference across seven countries are explored with regard to the processes and uses of computing in school administration and management. (SLD)
Howe, W. Stewart; Martin, Graeme
A literature review and case study of a British business school examined these areas: (1) competing rationales for internationalizing management education; (2) transfer of best practice from the west; and (3) problems that parent and host countries face in joint ventures. (SK)
Ring, Johannes; Rakoski, Jürgen
Quality control in education and training in allergology comprises activities at the different levels of the curriculum of medical schools, residency programs and postgraduate education. Unfortunately, until now allergology in Germany has not yet been regularly embedded in the medical curriculum of all medical schools. Therefore, the German Society for Allergology and Clinical Immunology (DGAI) has demanded for years that chairs and departments of allergology be introduced at every Medical Faculty in Germany. The new Medical Licensure Rules (Approbationsordnung) offer the possibility to select allergology, amongst others, as an obligatory subject in the medical state examination. Furthermore, allergological topics can now be introduced into the newly established interdisciplinary fields (Querschnittsbereiche). At the level of residency training, doctors who want to become allergists have to undergo a special curriculum in the field of allergology, formerly called additional specialisation in allergology (Zusatzbezeichnung) after having finished their board examination in an organ-related specialty subject. Following a decision of the German "Arztetag" in May 2003, this 24-months curriculum has unfortunately been reduced to 18 months. 12 months of this 18 months requirement may be fulfilled during a residency programme in either dermatovenerology, otolaryngology, internal medicine, pulmology and/or paediatrics. Compared to previous years, this results in a drastic deterioration of allergy training in Germany. The DGAI has decided to take up the fight for its improvement in both a quantitative and qualitative respect. The crucial issue is to develop quality criteria for persons as well as institutions eligible as training centres in allergology. As regards post-graduate education, the German Academy of Allergology and Environmental Medicine (Deutsche Akademie für Allergie und Umweltmedizin, DAAU) has introduced a system of certified continuing medical education (CME
Hirshfield, Laura E; Underman, Kelly
In this brief review, we build upon suggestions in Pedersen's  excellent critical review of empathy research in medical education and make the case for an increase in social constructivist scholarship related to emotions and empathy within medical education contexts. In the process, we define social construction, as well as provide several key opportunities in which these types of theories could provide insights for medical educators.
This is Part II of a two-part annotated bibliography of selected references on medical education in the People's Republic of China. The references date from 1913 to 1982. Most of the references are from the 1960's and 1970's. (RH)
The unprecedented progress in biomedical sciences and technology during the last few decades has resulted in great transformations in the concepts of health and disease, health systems and healthcare organization and practices. Those changes have been accompanied by the emergence of a broad range of ethical dilemmas that confront the health professionals more frequently in an increasing range of problems and situations. Health care that has been practiced for centuries on the basis of a direct doctor-patient relationship has been increasingly transformed to a more complex process integrating the health-team, the patient (healthcare seeker) and the community. Systematic review of the specialized literature revealed that Healthcare Ethics Education became a basic requirement for any training program for health professionals, and should cover the different stages of undergraduate, postgraduate and continuing education. Both theoretical foundations and practical skills are required for the appropriate ethical reasoning, ethical attitude and decision-making. There is growing evidence that physicians' professional and moral development is not determined by the formal curriculum of ethics, rather more, it is determined by the moral environment of the professional practice, the "hidden curriculum" which deserves serious consideration by medical educators.
Koppelman-White, Elysa; Mi, Misa; Wasserman, Jason Adam; Krug III, Ernest F.; Joyce, Barbara
Objective To review the research literature on epistemic cognition in medical education. Methods We conducted database searches using keywords related to epistemic cognition and medical education or practice. In duplicate, authors selected and reviewed empirical studies with a central focus on epistemic cognition and participant samples including medical students or physicians. Independent thematic analysis and consensus procedures were used to identify major findings about epistemic cognition and implications for research and medical education. Results Twenty-seven articles were selected. Themes from the findings of selected studies included developmental frameworks of epistemic cognition revealing simple epistemological positions of medical learners, increasing epistemological sophistication with experience, relationships between epistemic cognition and context, patterns in epistemic orientations to clinical practice, and reactions to ambiguity and uncertainty. Many studies identified the need for new instruments and methodologies to study epistemic cognition in medical education settings and its relationship to clinical outcomes. Relationships between epistemological beliefs and humanistic patient care and influences of medical education practices were commonly cited implications for medical education. Conclusions Epistemic cognition is conceptualized and operationalized in a variety of ways in the medical research literature. Advancing theoretical frameworks and developing new methodological approaches to examine epistemic cognition are important areas for future research. Also, examination of the relationship between the contexts of medical learning and practice and epistemic cognition has potential for improving medical education. This work also establishes a need for further investigation into the implications of epistemic cognition for humanistic orientations and ultimately for patient care. PMID:28064257
Albanese, Mark; Mejicano, George; Gruppen, Larry
Medical education is facing a convergence of challenges that the authors characterize as the four horsemen of the medical education apocalypse: teaching patient shortages, teacher shortages, conflicting systems, and financial problems. Rapidly expanding class sizes and new medical schools are coming online as medical student access to teaching patients is becoming increasingly difficult because of the decreasing length and increasing intensity of hospital stays, concerns about patient safety, patients who are stressed for time, teaching physician shortages and needs for increasing productivity from those who remain, and increasing emphasis on translational research. Further, medical education is facing reductions in funding from all sources, just as it is mounting its first major expansion in 40 years. The authors contend that medical education is on the verge of crisis and that little outside assistance is forthcoming. If medical education is to avoid a catastrophic decline, it will need to take steps to reinvent itself and make optimum use of all available resources. Curriculum materials developed nationally, increased reliance on simulation and standardized patient experiences, and adoption of quality-control methods such as competency-based education are suggested as ways to keep medical education vital in an environment that is increasingly preoccupied with fending off the four horsemen. The authors conclude with a call for a national dialogue about how the medical education community can address the problems represented by the four horsemen, and they offer some potential ways to maintain the vitality of medical education in the face of such overwhelming problems.
Keil, Andreas; Gegier, Konstantin; Pobiruchin, Monika; Wiesner, Martin
Medication adherence is an important factor for the outcome of medical therapies. To support high adherence levels, smartwatches can be used to assist the patient. However, a successful integration of such devices into clinicians' or general practitioners' information systems requires the use of standards. In this paper, a medication management system supplied with smartwatch generated feedback events is presented. It allows physicians to manage their patients' medications and track their adherence in real time. Moreover, it fosters interoperability via a ISO/IEC 16022 data matrix which encodes related medication data in compliance with the German Medication Plan specification.
Coleman, Eli; Elders, Joycelyn; Satcher, David; Shindel, Alan; Parish, Sharon; Kenagy, Gretchen; Bayer, Carey Roth; Knudson, Gail; Kingsberg, Sheryl; Clayton, Anita; Lunn, Mitchell R; Goldsmith, Elizabeth; Tsai, Perry; Light, Alexis
INTRODUCTION.: Medical education in sexual health in the United States and Canada is lacking. Medical students and practicing physicians report being underprepared to adequately address their patients' sexual health needs. Recent studies have shown little instruction on sexual health in medical schools and little consensus around the type of material medical students should learn. To address and manage sexual health issues, medical students need improved education and training. AIM.: This meeting report aims to present findings from a summit on the current state of medical school education in sexual health and provides recommended strategies to better train physicians to address sexual health. METHODS.: To catalyze improvements in sexual health education in medical schools, the summit brought together key U.S. and Canadian medical school educators, sexual health educators, and other experts. Attendees reviewed and discussed relevant data and potential recommendations in plenary sessions and then developed key recommendations in smaller breakout groups. RESULTS.: Findings presented at the summit demonstrate that the United States and Canada have high rates of poor sexual health outcomes and that sexual health education in medical schools is variable and in some settings diminished. To address these issues, government, professional, and student organizations are working on efforts to promote sexual health. Several universities already have sexual health curricula in place. Evaluation mechanisms will be essential for developing and refining sexual health education. CONCLUSIONS.: To be effective, sexual health curricula need to be integrated longitudinally throughout medical training. Identifying faculty champions and supporting student efforts are strategies to increase sexual health education. Sexual health requires a multidisciplinary approach, and cross-sector interaction between various public and private entities can help facilitate change. Areas important to
Naidu, Thirusha; Kumagai, Arno K
The idea of exporting the concept of reflective practice for a global medical education audience is growing. However, the uncritical export and adoption of Western concepts of reflection may be inappropriate in non-Western societies. The emphasis in Western medical education on the use of reflection for a specific end--that is, the improvement of individual clinical practice--tends to ignore the range of reflective practice, concentrating on reflection alone while overlooking critical reflection and reflexivity. This Perspective places the concept of reflective practice under a critical lens to explore a broader view for its application in medical education outside the West. The authors suggest that ideas about reflection in medicine and medical education may not be as easily transferable from Western to non-Western contexts as concepts from biomedical science are. The authors pose the question, When "exporting" Western medical education strategies and principles, how often do Western-trained educators authentically open up to the possibility that there are alternative ways of seeing and knowing that may be valuable in educating Western physicians? One answer lies in the assertion that educators should aspire to turn exportation of educational theory into a truly bidirectional, collaborative exchange in which culturally conscious views of reflective practice contribute to humanistic, equitable patient care. This discussion engages in troubling the already-muddy waters of reflective practice by exploring the global applicability of reflective practice as it is currently applied in medical education. The globalization of medical education demands critical reflection on reflection itself.
Background Despite an increasing concern about a future shortage of medical educators, little published research exists on career choices in medical education nor the impact of specific training posts in medical education (e.g. academic registrar/resident positions). Medical educators at all levels, from both medical and non-medical backgrounds, are crucial for the training of medical students, junior doctors and in continuing professional development. We explored the motivations and experiences of junior doctors considering an education career and undertaking a medical education registrar (MER) post. Methods Data were collected through semi-structured interviews with junior doctors and clinicians across Queensland Health. Framework analysis was used to identify themes in the data, based on our defined research questions and the medical education workforce issues prompting the study. We applied socio-cognitive career theory to guide our analysis and to explore the experience of junior doctors in medical education registrar posts as they enter, navigate and fulfil the role. Results We identified six key themes in the data: motivation for career choice and wanting to provide better education; personal goals, expectations and the need for self-direction; the influence of role models; defining one’s identity; support networks and the need for research as a potential barrier to pursuing a career in/with education. We also identified the similarities and differences between the MERs’ experiences to develop a composite of an MER’s journey through career choice, experience in role and outcomes. Conclusions There is growing interest from junior doctors in pursuing education pathways in a clinical environment. They want to enhance clinical teaching in the hospitals and become specialists with an interest in education, and have no particular interest in research or academia. This has implications for the recruitment and training of the next generation of clinical
Anderson, M. Brownell, Ed.
Provides summary reports of 81 innovative approaches to medical education in the areas of program management and assessment, admission and student-support programs, computer applications, preclinical and clinical course integration, development of professional skills and values, introduction to clinical medicine, community-based experiences,…
1. Origins 9 2. Why Network-Based Instruction? ; 9 3. Educational Uses of the Internet 11 4. Learning Styles 13 5. Cost Effectiveness 15 H...for organizations to train and educate their personnel anytime and anywhere. [Ref. 6] 4. Learning Styles Distance learning may extend access...the conventional classroom will not benefit students. To create options that enhance learning, we must consider different learning styles in the
Hochleitner, Margarethe; Nachtschatt, Ulrike; Siller, Heidi
Gender medicine, which takes a differentiated look at human beings as individuals and aims to provide targeted, gender-specific medical care, is slowly gaining recognition and acceptance. Nevertheless, this medical science that cuts across all medical disciplines has been only marginally incorporated into medical education curricula. The authors will look at the incorporation of gender medicine into the curriculum of Innsbruck Medical University to discuss the factors and the strategy that helped to establish it.
Background Chronic fatigue syndrome (CFS) affects at least 4 million people in the United States, yet only 16% of people with CFS have received a diagnosis or medical care for their illness. Educating health care professionals about the diagnosis and management of CFS may help to reduce population morbidity associated with CFS. Methods This report presents findings over a 5-year period from May 2000 to June 2006 during which we developed and implemented a health care professional educational program. The objective of the program was to distribute CFS continuing education materials to providers at professional conferences, offer online continuing education credits in different formats (e.g., print, video, and online), and evaluate the number of accreditation certificates awarded. Results We found that smaller conference size (OR = 80.17; 95% CI 8.80, 730.25), CFS illness related target audiences (OR = 36.0; 95% CI 2.94, 436.34), and conferences in which CFS research was highlighted (OR = 4.15; 95% CI 1.16, 14.83) significantly contributed to higher dissemination levels, as measured by visit rates to the education booth. While print and online courses were equally requested for continuing education credit opportunities, the online course resulted in 84% of the overall award certificates, compared to 14% for the print course. This remained consistent across all provider occupations: physicians, nurses, physician assistants, and allied health professionals. Conclusion These findings suggest that educational programs promoting materials at conferences may increase dissemination efforts by targeting audiences, examining conference characteristics, and promoting online continuing education forums. PMID:19954535
HOSSEINI, SEYYED NASROLLAH; MOHSENI BAND PEY, ANOSHIRAVAN; HOSSEINI, SEYYED ALI; KARAMI MATIN, BEHZAD; MIRZAEI ALAVIJEH, MEHDI; JALILIAN, FARZAD
Introduction Shahid Motahari Annual Educational Festival aims to improve the quality of medical education in the Islamic Republic of Iran, and has held since 2008. The present study was performed to determine the satisfaction level of Iranian medical universities’ faculty members about holding Shahid Motahari Annual Educational Festival during the past six years, from 2008 to 2014. Methods This cross-sectional study was conducted on 473 faculty members (FMs) including deputies and educational administrators, managers, and faculty members of medical education development centers, members of scientific committees, and faculty members who participated in Shahid Motahari Festival from 42 medical sciences universities in Iran. Data collection instruments were two reliable and valid questionnaires on the background and also participants’ satisfaction towards Shahid Motahari Educational Festival. Data were analyzed using SPSS Software, version 14. Results Among all participants, 30 FMs (6.3%) were educational deputies, 36 FMs (7.6%) managers of medical education development centers, 226 FMs (56.2%) members of scientific committees, 29 FMs (6.1%) members of the national committees, 343 FMs (27.5%) attendees, and 264 FMs (55.8%) had participated for retraining. The total satisfaction level of the participants was 73.3% which shows a good satisfaction level. Conclusion The results identified the main important strength points such as “proposals’ review process at the country level” and weakness points such as “organizing the festival”. PMID:26457313
Gousseau, Michael; Sommerfeld, Connor; Gooi, Adrian
Background With growing evidence on the benefits of active learning, audience response systems (ARSs) have been increasingly used in conferences, business, and education. With the introduction of mobile ARS as an alternative to physical clickers, there are increasing opportunities to use this tool to improve interactivity in medical education. Aim The aim of this study is to provide strategies on using mobile ARS in medical education by discussing steps for implementation and pitfalls to avoid. Method The tips presented reflect our commentary of the literature and our experiences using mobile ARS in medical education. Results This article offers specific strategies for the preparation, implementation, and assessment of medical education teaching sessions using mobile ARS. Conclusion We hope these tips will help instructors use mobile ARS as a tool to improve student interaction, teaching effectiveness, and participant enjoyment in medical education. PMID:27942242
Miroshnichenko, Iu V; Goriachev, A B; Bunin, S A
The usage of basic regulations of logistics in practical activity for providing joints and military units with medical asset is theoretically justified. The role of logistics in organizing, building and functioning of military (armed forces) medical supply system is found out. The methods of solving urgent problems of improvement the resources management of medical asset on the basis of logistics are presented.
Daigneau, William A.; Valenti, Mark S.; Ricciarini, Sylvana; Bender, Stephen O.; Alleyne, Nicole; Di Grappa, Michael; Duart, Josep M.; Lupianez, Francisco; Sanchez, Miguel Angel Ehrenzweig
The OECD Programme on Educational Building, together with the Association of Higher Education Facilities Officers (APPA) and the OECD Programme on Institutional Management in Higher Education, organised an international conference on the planning, design and management of facilities for higher education institutions on April 24-27, 2005. The…
toxicities will occur and significantly complicate management . Consequent to the radiation exposure, lymphopenia, bone marrow atrophy, pancytopenia...Skeletal and renal deposition of uranium occurs from implanted DU fragments. The toxic level for long-term chronic exposure to internal uranium metal is...MEDICAL MANAGEMENT OF RADIOLOGICAL CASUALTIES Online Third Edition June 2010 Military Medical Operations
... MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.63 Initial medical evaluation and management. (a... hunger strike: (1) Measure and record height and weight; (2) Take and record vital signs; (3) Urinalysis... weight and vital signs at least once every 24 hours while the inmate is on a hunger strike....
... MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.63 Initial medical evaluation and management. (a... hunger strike: (1) Measure and record height and weight; (2) Take and record vital signs; (3) Urinalysis... weight and vital signs at least once every 24 hours while the inmate is on a hunger strike....
Califano, Joseph A., Jr.
Issues addressed in this speech to the Association of American Medical Colleges include: oversupply of doctors, geographic maldistribution, demographic changes needed by medical schools, federal strategies, medical ethics, preventive medicine, and the economics of health care.
The medical care system is undergoing widespread and significant changes. Individual hospitals may be disappearing as mergers, acquisitions, and a variety of multi-institutional arrangements become the dominant form and as a host of free-standing medical enterprises spread out into the community. (MLW)
Kosik, Russell Oliver; Huang, Lei; Cai, Qiaoling; Xu, Guo-Tong; Zhao, Xudong; Guo, Li; Tang, Wen; Chen, Qi; Fan, Angela Pei-Chen
Today's doctor is as much a humanist as a scientist. Medical schools have responded to this change by introducing a variety of courses, most notably those concerning the humanities and ethics. Thus far, no one has examined the extent of use of these subjects in Chinese medical schools. The goal of this study is to determine how many and in what…
Maxwell, Jessica E.; Sherman, Scott K.; O’Dorisio, Thomas M.; Howe, James R.
Medullary thyroid cancer (MTC) is an aggressive form of thyroid cancer, which occurs in both heritable and sporadic forms. Discovery that mutations in the RET protooncogene predispose to familial cases of this disease has allowed for presymptomatic identification of gene carriers and prophylactic surgery to improve the prognosis of these patients. A significant number of patients with the sporadic type of MTC and even with familial disease, still present with nodal or distant metastases, making surgical cure difficult. Over the past several decades, many different types of therapy for metastatic disease have been attempted, with limited success. Improved understanding of the molecular defects and pathways involved in both familial and sporadic MTC has resulted in new hope for these patients with the development of drugs targeting the specific alterations responsible. This new era of targeted therapy with kinase inhibitors represents a significant step forward from previous trials of chemotherapy, radiotherapy, and hormonal therapy. Although much progress has been made, additional agents and strategies are needed to achieve durable, long-term responses in patients with metastatic MTC. This article reviews the history and results of medical management for metastatic MTC from the early 1970s up until the present day. PMID:24942936
Ellis, Wendy; Kaasalainen, Sharon; Baxter, Pamela; Ploeg, Jenny
In long-term care (LTC), the complexity of residents' conditions and their treatment requirements present challenges for nurses managing medications. The purpose of this qualitative descriptive study was to explore medication management as described by licensed nurses working in LTC. A total of 22 licensed nurses from 2 LTC facilities located in the Canadian province of Ontario participated in 4 focus groups. Thematic content analysis was used to organize data into themes and a conceptual model was developed. The overarching theme was that nurses are "racing against time" to manage medications and 3 subthemes described how they coped with this important care process: preparing to race, running the race, and finishing the race. Barriers to safe medication management included time restraints, knowledge limitations, interruptions and distractions, and poor communication. The findings can be used to better inform health-care providers and to guide future research. They also have the potential to directly impact outcomes related to safe medication management in LTC.
Bleakley, Alan; Bligh, John
Medical students must be prepared for working in inter-professional and multi-disciplinary clinical teams centred on a patient's care pathway. While there has been a good deal of rhetoric surrounding patient-centred medical education, there has been little attempt to conceptualise such a practice beyond the level of describing education of…
Ross, Brian M.; Daynard, Kim; Greenwood, David
Until recently medical education has been largely silent on those aspects of the physician's life, both professional and unprofessional, that differ from place to place. This has contributed to health inequity through an undersupply of health care workers to many communities. A growing movement for social accountability in medical education has…
Canadian Medical Association, Ottawa (Ontario).
Designed as a guide to accreditation for educational programs in the allied medical disciplines in Canada, this report provides educators with guidelines, general requirements and requirements for specific programs. Following information on the organization, structure, goals and terminology of accreditation of allied medical programs in Canada,…
Vovides, Yianna; Inman, Sarah
Using discourse analysis, the goal of this exploratory project was to determine what practitioners of medical education in Sub-Saharan Africa considered key achievements, within the scope of their Medical Education Partnership Initiative (MEPI) activities, after their initial two-year implementation efforts. To do so, a series of 58 video stories…
Al Mosawi, Aamir Jalal
The lack of resources in a country experiencing decades of successive wars, blockade, administrative corruption, and poor governance led to deteriorated standards throughout medical education. Although professional certification programs exist, continuing medical education accreditation and credit systems are required to monitor and certify the…
Kitts, Robert Li; Christodoulou, Joanna; Goldman, Stuart
Objective: Professional siloing within medical institutions has been identified as a problem in medical education, including resident training. The authors discuss how trainees from different disciplines can collaborate to address this problem. Method: A group of trainees from psychiatry, developmental medicine, neurology, and education came…
Mattick, Karen; Barnes, Rebecca; Dieppe, Paul
Previous debate has explored whether medical education research should become more like health services research in terms of frameworks, collaborations and methodologies. Notable recent changes in health services research include an increasing emphasis on complex interventions, defined as interventions that involve more than one component. The purpose of this study was to explore the extent of thinking about medical education as a complex intervention and to analyse medical education research to determine whether its collaborations and methodologies are becoming more like health services research. Research articles published in three journals over 2 years were analysed to determine the purpose of the research in relation to a framework for evaluating complex interventions, the degree of collaboration, and the methodology. Most studies aimed to develop theory or assess effectiveness and many categories of the complex interventions framework were not represented in the medical education research literature. Studies usually involved only one research site and were predominantly quantitative but not experimental or quasi-experimental. Whilst medical education research has not moved significantly in the direction of health services research over recent years, the complex interventions lens provided insights into why this might be so (namely the significant challenges associated with researching medical education). We recommend that medical education researchers work within a complex interventions framework and look to research fields with similar challenges (e.g. the study of chronic illness in a changing context) for ideas about theories, frameworks, methodologies and collaborations that can illuminate the field of medical education research.
Kiguli-Malwadde, Elsie; Olapade-Olaopa, E Oluwabunmi; Kiguli, Sarah; Chen, Candice; Sewankambo, Nelson K; Ogunniyi, Adesola O; Mukwaya, Solome; Omaswa, Francis
Background Relatively little has been written on Medical Education in Sub-Saharan Africa, although there are over 170 medical schools in the region. A number of initiatives have been started to support medical education in the region to improve quality and quantity of medical graduates. These initiatives have led to curricular changes in the region, one of which is the introduction of Competency-Based Medical Education (CBME). Institutional reviews This paper presents two medical schools, Makerere University College of Health Sciences and College of Medicine, University of Ibadan, which successfully implemented CBME. The processes of curriculum revision are described and common themes are highlighted. Both schools used similar processes in developing their CBME curricula, with early and significant stakeholder involvement. Competencies were determined taking into consideration each country’s health and education systems. Final competency domains were similar between the two schools. Both schools established medical education departments to support their new curricula. New teaching methodologies and assessment methods were needed to support CBME, requiring investments in faculty training. Both schools received external funding to support CBME development and implementation. Conclusion CBME has emerged as an important change in medical education in Sub-Saharan Africa with schools adopting it as an approach to transformative medical education. Makerere University and the University of Ibadan have successfully adopted CBME and show that CBME can be implemented even for the low-resourced countries in Africa, supported by external investments to address the human resources gap. PMID:25525404
Head, Barbara A; Schapmire, Tara J; Earnshaw, Lori; Chenault, John; Pfeifer, Mark; Sawning, Susan; Shaw, Monica A
The needs of an aging population and advancements in the treatment of both chronic and life-threatening diseases have resulted in increased demand for quality palliative care. The doctors of the future will need to be well prepared to provide expert symptom management and address the holistic needs (physical, psychosocial, and spiritual) of patients dealing with serious illness and the end of life. Such preparation begins with general medical education. It has been recommended that teaching and clinical experiences in palliative care be integrated throughout the medical school curriculum, yet such education has not become the norm in medical schools across the world. This article explores the current status of undergraduate medical education in palliative care as published in the English literature and makes recommendations for educational improvements which will prepare doctors to address the needs of seriously ill and dying patients. PMID:26955298
Head, Barbara A; Schapmire, Tara J; Earnshaw, Lori; Chenault, John; Pfeifer, Mark; Sawning, Susan; Shaw, Monica A
The needs of an aging population and advancements in the treatment of both chronic and life-threatening diseases have resulted in increased demand for quality palliative care. The doctors of the future will need to be well prepared to provide expert symptom management and address the holistic needs (physical, psychosocial, and spiritual) of patients dealing with serious illness and the end of life. Such preparation begins with general medical education. It has been recommended that teaching and clinical experiences in palliative care be integrated throughout the medical school curriculum, yet such education has not become the norm in medical schools across the world. This article explores the current status of undergraduate medical education in palliative care as published in the English literature and makes recommendations for educational improvements which will prepare doctors to address the needs of seriously ill and dying patients.
Newman-Casey, Paula Anne; Weizer, Jennifer S.; Heisler, Michele; Lee, Paul P.; Stein, Joshua D.
Adherence to prescribed glaucoma medications is often poor, and proper adherence can be challenging for patients. We systematically reviewed the literature and identified eight studies using educational interventions to improve glaucoma medication adherence. Overall, five of the eight studies found that educational interventions lead to a significant improvement in medication adherence, and the remaining studies found a trend towards improvement. Using information from this systematic review and Health Behavior Theory, we constructed a conceptual framework to illustrate how counseling and education can improve glaucoma medication adherence. More rigorous studies grounded in Health Behavior Theory with adequately powered samples and longer follow-up are needed. PMID:23697623
Benbassat, Jochanan; Baumal, Reuben
Undergraduate medical education is too long; it does not meet the needs for physicians' workforce; and its content is inconsistent with the job characteristics of some of its graduates. In this paper we attempt to respond to these problems by streamlining medical education along the following three reforms. First, high school graduates would be…
Petrova, N G; Balokhina, S A
The contemporary social economic conditions dictate the necessity to change tactics and strategy of functioning of medical institutions of different property forms. Marketing, alongside with management is to become a leading concept of administration of medical institutions. It should be a framework for systematic collection, registration and analysis of data relevant to the medical services market. The issues of the implementation of marketing concept in the practical everyday activities of commercial medical organization providing cosmetology services to population of metropolis.
Hyoguchi, Naomi; Kobayashi, Daisuke; Kubota, Toshio; Shimazoe, Takao
Deaf people often experience difficulty in understanding medication information provided by pharmacists due to communication barriers. We held medication education lectures for deaf and hard of hearing (HH) individuals and examined the extent to which deaf participants understood medication-related information as well as their attitude about…
London Univ. (England). Inst. of Education.
This 1967 summary of closed circuit television (CCTV) activities in medical education presents descriptive information on 35 different medical institutions in Great Britain. Specific data on CCTV are offered by institution, equipment, and uses under each medical field: anatomy, anaesthetics, geriatrics, medicine, obstretrics and gynaecology,…
Haubert, Lisa M.; Way, David; DePhilip, Robert; Tam, Marty; Bishop, Julie; Jones, Kenneth; Moffatt-Bruce, Susan D.
Despite extensive experience teaching residents, surgeons are an untapped resource for educating medical students. We hypothesized that by involving surgeons as teachers earlier in the medical school curriculum, medical students' interest in surgery will increase and their opinions of surgeons will improve. Five programs designed to involve…
Tomaszewski, Brian; Dusabejambo, Vincent; Ndayiragije, Vincent; Gonsalves, Snedden; Sawant, Aishwarya; Mumararungu, Angeline; Gasana, George; Amendezo, Etienne; Haake, Anne; Mutesa, Leon
locally adapted mobile education app that utilizes specific Rwandan medical education resources. Based on our results, we propose a mobile medical education app that could provide many benefits such as rapid decision making with lower error rates, increasing the quality of data management and accessibility, and improving practice efficiency and knowledge. In areas where Internet access is limited, the proposed mobile medical education app would need to run on a mobile device without Internet access. Conclusions A user-centered design approach was adopted, starting with a needs assessment with representative end users, which provided recommendations for the development of a mobile medical education app specific to Rwanda. Specific app features were identified through the needs assessment and it was evident that there will be future benefits to ongoing incorporation of user-centered design methods to better inform the software development and improve its usability. Results of the user-centered design reported here can inform other medical education technology developments in LMIC to ensure that technologies developed are usable by all stakeholders. PMID:27731861
Medical education is expensive. There is a growing interest in the subject of cost and value in medical education. However, in the medical education literature, terms are sometimes used loosely - and so there is a need for basic grounding in the meaning of commonly used and important terms in medical education economics. The purpose of this article is to define some terms that are frequently used in economic analysis in medical education. In this article, terms are described, and the descriptions are followed by a worked example of how the terms might be used in practice. The following terms are described: opportunity cost, total cost of ownership, sensitivity analysis, viewpoint, activity-based costing, efficiency, technical efficiency, allocative efficiency, price and transaction costs.
Schull, Amy P.
This guide describes a course designed to prepare students for employment as medical records clerks capable of handling all types of medical forms and reports, and using and spelling medical terminology correctly. The need for medical typists is critical. The guide contains enrollment guidelines, performance objectives (i.e., type medical…
Keenan, Craig R.; Nguyen, Hien H.; Srinivasan, Malathi
Objective: Electronic medical records (EMRs) are becoming prevalent and integral tools for residents and medical students. EMRs can integrate point-of-service information delivery within the context of patient care. Though it may be an educational tool, little is known about how EMR technology is currently used for medical learners. Method: The…
Washburn, Susan C; Hornberger, Cynthia A
Heart failure is a chronic illness that poses a significant societal burden in the United States. Health care facilities are challenged to provide the most current treatment options available for patients with heart failure. Patient education focusing on self-management is recognized as essential. Nurses play a key role in the delivery of patient education. This article reviews the limited available evidence regarding nurses' knowledge of heart failure self-management principles. The key topics of symptom and weight management, dietary recommendations, medications, and activity are discussed.
DasGupta, Sayantani; Fornari, Alice; Geer, Kamini; Hahn, Louisa; Kumar, Vanita; Lee, Hyun Joon; Rubin, Susan; Gold, Marji
Although social justice is an integral component of medical professionalism, there is little discussion in medical education about how to teach it to future physicians. Using adult learning theory and the work of Brazilian educator Paulo Freire, medical educators can teach a socially-conscious professionalism through educational content and teaching strategies. Such teaching can model non-hierarchical relationships to learners, which can translate to their clinical interactions with patients. Freirian teaching can additionally foster professionalism in both teachers and learners by ensuring that they are involved citizens in their local, national and international communities.
The Relationship Between the Educational Background and Managerial Experience of Senior Navy Medical Service Corps Executives (Health Care Administrators) and their Perceived Current and Required Management Capabilities.
alternatives 20 Develop a Comunicate vision 34 writing effectively 53 Providing feedback 4 Oral prsentatim. 55 Listenng tfeatively 56 Suilding vomk...describes a future of health care delivery in which the present pressures affecting health care administrators will intensify due to "changing demographics...corresponding survey questions are presented in Appendix B. The "Preliminary Analysis of Educational Needs for Navy Health Care Executives" [Ref. 21 provided
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION National Committee on Foreign Medical Education and Accreditation AGENCY: Office of Postsecondary Education, U.S. Department of Education, National Committee on Foreign Medical Education and...
Amini, M; Kojuri, J; Lotfi, F; Karimian, Z; Abadi, A S H
Ways are needed to effect quality improvement in medical education research in the Eastern Mediterranean Region (EMR). This study aimed to determine the principle themes and to draw up a list of priorities in medical education research in EMR. Using the nominal group technique with a group of 30 experts, a list of major themes in medical education research was prepared. In a 2-round Delphi survey the list was sent to another 47 experts in the Region with a questionnaire that included open questions about change and reform in medical education. In the final list of 20, the 5 highest priorities identified were: training physicians to be effective teachers; community-driven models for curriculum development; clinical teaching models; education about professionalism and ethics; and education for evidence-based medicine. Themes determined by this survey can help researchers in EMR to focus on priority areas in research.
Huo, Yong; Thompson, Peter; Buddhari, Wacin; Ge, Junbo; Harding, Scott; Ramanathan, Letchuman; Reyes, Eugenio; Santoso, Anwar; Tam, Li-Wah; Vijayaraghavan, Govindan; Yeh, Hung-I
Acute coronary syndromes (ACS) remain a leading cause of mortality and morbidity in the Asia-Pacific (APAC) region. International guidelines advocate invasive procedures in all but low-risk ACS patients; however, a high proportion of ACS patients in the APAC region receive solely medical management due to a combination of unique geographical, socioeconomic, and population-specific barriers. The APAC ACS Medical Management Working Group recently convened to discuss the ACS medical management landscape in the APAC region. Local and international ACS guidelines and the global and APAC clinical evidence-base for medical management of ACS were reviewed. Challenges in the provision of optimal care for these patients were identified and broadly categorized into issues related to (1) accessibility/systems of care, (2) risk stratification, (3) education, (4) optimization of pharmacotherapy, and (5) cost/affordability. While ACS guidelines clearly represent a valuable standard of care, the group concluded that these challenges can be best met by establishing cardiac networks and individual hospital models/clinical pathways taking into account local risk factors (including socioeconomic status), affordability and availability of pharmacotherapies/invasive facilities, and the nature of local healthcare systems. Potential solutions central to the optimization of ACS medical management in the APAC region are outlined with specific recommendations.
Simforoosh, Nasser; Ziaee, Seyed Amir Mohsen; Tabatabai, Shima H
Over the past 35 years Iran had significant quantitative progress in postgraduate medical education; and growth in specialist's physician workforce supply. Health and medical education policy makers have struggled with many issues related to physician supply, such as determining the sufficient number of physicians workforce and the appropriate number to train; establishing new medical schools; the diversity of specialty programs; efforts to increase the supply of physicians in specialty level in remote and rural areas; and the growing number of female physicians and its impact on health services. After establishment of Ministry of Health and Medical Education (MoHME) in Iran, expansion of medical specialty education was a priority. Since then, great advances have been made in training of new specialty programs. Despite of these brilliant advances during the last decades in Iran, there has been no integrated and comprehensive documentation of previous and current growth trend, yet. To understand where Iranian physician supply and specialty training is headed, we examined the Iranian medical specialist's trends from 1979 to 2013 in a national study by support of Iranian academy of medicine. This paper documents the growth trend of medical specialist's workforce over the past 35 years. Examining the health manpower growth trends allow health and medical education policy makers to plan innovative strategies for the purposeful development of postgraduate medical education to ensure that in future there would be sufficient physicians supply, with the right skills, in the right places in response to population demands.
Jackson Allen, Patricia; Simenson, Steven
The common cold, an acute upper respiratory tract infection of viral origin, is among the most widespread ailments in the world. Although the general public usually relies on over-the-counter (OTC) medication(s) to treat cough/cold symptoms, reliable guidance is needed to help select the appropriate OTC medication for each individual. Consumers may be confused by the wide variety of products available, containing ≥ 1 active pharmaceutical ingredient. Health care professionals are in a position to help people identify the most bothersome symptom(s), evaluate underlying medical conditions and medications, and recommend the most appropriate OTC active ingredient(s) for treatment. Patients should be educated about available OTC medications to manage cough/cold symptoms and the importance of learning to read the package labeling for appropriate dosing and administration. In addition, potentially serious causes of cough/cold symptoms (eg, influenza, asthma, bronchitis) or underlying medical conditions that put the individual at increased risk for complications should be ruled out when symptoms do not resolve within a typical cold timeline. This review article discusses the active ingredients found in OTC medications and the clinical evidence supporting their use. The need to educate health care professionals and patients on the safe and effective use of OTC medications is addressed, and we offer a guide for the management of symptoms that appear during the timeline of a typical common cold.
Examines differences between library management and information resource management (IRM). Highlights include a historical perspective of library management education and IRM; the organizational perspective of library management and the emphasis of information as a resource in IRM; library management and advances in information technology; and…
Mazzuoccolo, Luis D; Marciano, Sebastián; Echeverría, Cristina M
The ECHO® (Extension for Community Healthcare Outcomes) project is a model of distance medical education. Its mission is to expand knowledge and evaluate the results of this action, both in the training of human resources in healthcare and in the accomplishment of the best medical practices in the community target. It is developed through case presentation videoconferencing, between experts in chronic and complex diseases and physicians, with the aim of reducing the healthcare asymmetries between large urban centers and peripherals areas. We have implemented this telementoring for dermatologists and residents who treat patients with psoriasis. After 10 sessions, a survey was conducted to evaluate the educational attainment of the participants. A significant improvement was found in their abilities to determine the severity of psoriasis, screening for arthritis, assessment of the patient before beginning systemic treatment and appropriate follow-up under different systemic therapies. ECHO replication model helped improve the skills of the participants in the management of this disease, and reduced professional isolation.
Evidence-based management of medical disposable materials pays attention to collect evidence comprehensively and systematically, accumulate and create evidence through its own work and also evaluate evidence strictly. This can be used as a function to guide out job. Medical disposable materials evidence system contains product register qualification, product quality certification, supplier's behavior, internal and external communication evidence. Managers can find different ways in creating and using evidence referring to specific inside and outside condition. Evidence-based management can help accelerating the development of management of medical disposable materials from traditional experience pattern to a systematic and scientific pattern. It also has the very important meaning to improve medical quality, control the unreasonable growth of medical expense and make purchase and supply chain be more efficient.
Khatun, M; Ali, M I; Pathan, F H
Medical education in Bangladesh is poorly assessed and there is a general lack of documented knowledge about the challenges facing this field and the needs for its development. It was Cross-sectional descriptive type of study carried out among the teachers of two public (Sir Salimullah Medical College, Dhaka and Sher-E-Bangla Medical College, Barisal) and two non-government Medical Colleges (Northern Medical College, Dhaka and IBN Sina Medical College, Dhaka) during the period of July 1, 2011 to June 30, 2012 to explore their views regarding the training or course in medical education. The sample size was 204 who were selected purposively. The data were collected by a semi-structured and self-administered questionnaire. From the study it was revealed that majority 201(98.5%) of respondents showed their interest for training or course on medical education. Among them 123(61.2%) preferred a regular course, 58(28.8%) desired for training program and 20(9.9%) for refresher training on medical education. Most 83(67.4%) of the respondents agreed that there are barriers to participate in a training or course on medical education. Thirty four (43.6%) expressed their opinion that the duration of the training should be at least three months.
Patrick, Heather; Williams, Geoffrey C.
Historically, medical education has focused largely on medical students' intellectual development, mostly ignoring the broader psychological milieu of medical practice. This chasm can result in practitioners who are less likely to process their emotions and/or support their patient's needs, and more likely to experience burnout. Self-determination…
collection. This is the first in a series of reports concerning medical service accounts ( MSAs ). This report provides the results of our review...performed at U.S. Army Brooke Army Medical Center (BAMC). We reviewed the 25 highest dollar delinquent MSAs valued at $11.0 million. Finding BAMC...Uniform Business Office (UBO) management did not effectively manage delinquent MSAs . As of May 29, 2013, BAMC UBO management had 15,106 outstanding
Manning, Kevin J; Clarke, Christina; Lorry, Alan; Weintraub, Daniel; Wilkinson, Jayne R; Duda, John E; Moberg, Paul J
Medication non-adherence is associated with chronic disease and complex medication schedules, and Parkinson's disease (PD) patients also frequently have cognitive impairments that may interfere with effective medication management. The current study quantitatively assessed the medication management skills of PD patients and probed the neurocognitive underpinnings and clinical correlates of this skill. A total of 26 men with PD completed a neuropsychological battery and a modified version of the Hopkins Medication Schedule (HMS), a standard test of a person's ability to understand and implement a routine prescription medication. Estimated adherence rates from performance on the HMS were low. Memory, executive functioning, and processing speed were strongly related to different components of the HMS. A range of neuropsychological abilities is associated with the ability to understand and implement a medication schedule and pillbox in individuals with PD.
Kochevar, Deborah T
The Association of American Veterinary Medical College's (AAVMC's) role in the progression of academic veterinary medical education has been about building successful partnerships in the US and internationally. Membership in the association has evolved over the past 50 years, as have traditions of collaboration that strengthen veterinary medical education and the association. The AAVMC has become a source of information and a place for debate on educational trends, innovative pedagogy, and the value of a diverse learning environment. The AAVMC's relationship with the American Veterinary Medical Association Council on Education (AVMA COE), the accreditor of veterinary medical education recognized by the United Sates Department of Education (DOE), is highlighted here because of the key role that AAVMC members have played in the evolution of veterinary accreditation. The AAVMC has also been a partner in the expansion of veterinary medical education to include global health and One Health and in the engagement of international partners around shared educational opportunities and challenges. Recently, the association has reinforced its desire to be a truly international organization rather than an American organization with international members. To that end, strategic AAVMC initiatives aim to expand and connect the global community of veterinary educators to the benefit of students and the profession around the world. Tables in this article are intended to provide historical context, chronology, and an accessible way to view highlights.
Medical school professors and lecturers are often called to be practicing clinicians, researchers in their own field, in addition to executing their education and curricular responsibilities. Some further accumulate healthcare management responsibilities. These areas pose conflicting demands on time and intellectual activity, but despite their apparent differences, knowledge and skills from management, leadership and informatics may prove useful in helping to smooth these conflicts and hence increase personal effectiveness in these areas. This article tries to clarify some concepts and advance why training in management, leadership and health informatics would seem particularly useful for the medical academic. As opposed to the idea of educational dispersion/specialization, the concept of an integrative tetrahedronal education framework is advanced as a way to plan workshops and other faculty development activities which could be implemented transnationally as well as locally.
Boyers, Lindsay N; Schultz, Amanda; Baceviciene, Rasa; Blaney, Susan; Marvi, Natasha; Dellavalle, Robert P; Dunnick, Cory A
Although teledermatology (TD) is regarded as a tool to improve patient access to specialty healthcare, little has been done to evaluate its role in medical education. We describe the TD program at the Denver (CO) Department of Veterans Affairs Medical Center and evaluate its use as an educational tool for teaching dermatology to dermatology residents and medical students. Dermatology residents manage TD consultations and review all cases with a faculty preceptor; medical students participate as observers when possible. This study assessed dermatology resident (n=14) and medical student (n=16) perceptions of TD and its usefulness in teaching six core clinical competencies. Both residents (79%) and medical students (88%) "strongly agree" or "agree" that TD is an important educational tool. In general, medical students were slightly more satisfied than residents across all of the core competencies assessed except for patient care. Medical students and residents were most satisfied with the competencies of practice-based learning and improvement and medical knowledge, whereas they were least satisfied with those of interpersonal and communication skills and professionalism. Overall, TD is valued as a teaching tool for dermatology in the areas of patient care, medical knowledge, practice-based learning and improvement, and systems-based practice.
Management Information System (TAMMIS) and the division level version of the system, TAMMIS-D. TAMMIS/ TAMMIS-D are automated, on-line, interactive, microcomputer systems designed to manage combat medical information but capable of performing peacetime functions as well. The systems were developed to meet the needs of medical commanders by providing timely, accurate, and relevant information on the status of patients, medical units, and medical supplies on the battlefield. The IOT&E was conducted at Fort Lewis, WA in tents erected between two-story barracks
Kusec, Sanja; Jaksić, Zelimir; Vuletić, Gorka; Kovacić, Luka; Pavleković, Gordana
The recent technological developments have found its place in medical education as well. Hypermedia has become very popular through the widespread use of the Internet. In its research project, the Department of Educational Technology of the Andrija Stampar School of Public Health studied and applied the educational methods in continuing training of health professionals using hypermedia and taking into account the specificities of medical and health practices. Potentials of hypermedia in medical education are presented within the topic on quality of health care. The result of this project is an interactive educational disk designed for physicians and other health professionals in primary health care faced with the issue of quality. This paper gives an overview of the experience gained during the work on the project and describes the created educational disk with all its specificities observed in the development of the educational hypermedia materials.
Solarsh, Geoff; Lindley, Jennifer; Whyte, Gordon; Fahey, Michael; Walker, Amanda
The learning objectives, curriculum content, and assessment standards for distributed medical education programs must be aligned across the health care systems and community contexts in which their students train. In this article, the authors describe their experiences at Monash University implementing a distributed medical education program at metropolitan, regional, and rural Australian sites and an offshore Malaysian site, using four different implementation models. Standardizing learning objectives, curriculum content, and assessment standards across all sites while allowing for site-specific implementation models created challenges for educational alignment. At the same time, this diversity created opportunities to customize the curriculum to fit a variety of settings and for innovations that have enriched the educational system as a whole.Developing these distributed medical education programs required a detailed review of Monash's learning objectives and curriculum content and their relevance to the four different sites. It also required a review of assessment methods to ensure an identical and equitable system of assessment for students at all sites. It additionally demanded changes to the systems of governance and the management of the educational program away from a centrally constructed and mandated curriculum to more collaborative approaches to curriculum design and implementation involving discipline leaders at multiple sites.Distributed medical education programs, like that at Monash, in which cohorts of students undertake the same curriculum in different contexts, provide potentially powerful research platforms to compare different pedagogical approaches to medical education and the impact of context on learning outcomes.
Jolly, Freddy; Whiteman, Gail; Atkinson, Miriam; Radu, Ioana
Educational approaches addressing environmental sustainability are of growing interest to management educators. The James Bay Cree in Canada offer a novel and ecologically embedded approach to management education as an inspiring template for integrating a deep sense-of-place within management education. The authors describe the Cree approach as…
Li Wang, Virginia; And Others
A continuing medical education program is discussed that addresses chronic obstructive pulmonary disease and that links primary care physicians to a source of needed clinical knowledge at a relatively low cost. The educational methods, evaluation design, diagnosis of educational needs, selection of program content and behavioral outcomes are…
Johna, Samir; Woodward, Brandon; Patel, Sunal
Medical literature has demonstrated the effectiveness of narrative writing in enhancing self-reflection and empathy, which opens the door for deeper understanding of patients' experiences of illness. Similarly, it promotes practitioner well-being. Therefore, it is no surprise that narrative writing finds a new home in medical education. The Accreditation Council of Graduate Medical Education (ACGME), through its Outcome Project, established six core competencies that every residency program must teach. However, no specific pedagogies were suggested. We explored the role that narrative writing can play in reconciling the ACGME core competencies with daily encounters in medical education. Our study suggests a hidden wealth in reflective writing through narratives with a promising potential for application in medical education. Reflective writing may turn out to be an innovative tool for teaching and evaluating ACGME core competencies.
Both students of health sciences (medical technology, nursing science, physical therapy, and occupational therapy) and medical students learn medical teamwork in the primary stage by joint practice in Shinshu University. The aim of this class is for students that will become medical staff to increase their necessary communication skills for medical teamwork in addition to understanding the mutual medical professional fields in a medical institution. The 242 students of the medical department (147 students of health sciences and 95 students of medicine) take 15 classes during their first term as freshers. One teacher takes charge of a group consisting of 14 students for tutorials by mutually cooperation between teachers of medicine and health sciences. Positive relationships are expected to develop in the group, raising sociality and ethics so that both students of health science and medicine experience interdisciplinary discussion in small groups as an ideal method for continuing health care in times of poor knowledge of medicine and health care.
Stanković, Slobodanka; Vesković, Miroslav; Klisurić, Olivera; Spasić, Vesna
Overview of new educational program and training in Medical Physics at the University of Novi Sad is presented, where the medical physics education from undergraduate to doctoral study is established in the last decade. Necessity for basic and additional education and hospital training for medical physicists becomes the evident subject in clinical practice in which physicists and physicians are in close collaboration to ensure high quality of patient care. Learning objectives: to incorporate the latest scientific and professional findings in the field of medical physics, medical diagnostics, therapy and instruments; to accomodate students' pursuits of individual fields by offering elective courses from different areas of current medical practice; to reflect the multidisciplinary spirit of the studies, since teaching is performed by experts from diverse fields.
Wellever, A L
This article presents an opinion on the need for middle-management education in the four basic functions of management: planning, organizing, directing, and controlling. Using nursing management as an example, the author describes the role of middle management in complex organizations and states that the job of management is to ensure the efficiency and effectiveness of work performed by others.
Recupero, Patricia Ryan; Heru, Alison M; Price, Marilyn; Alves, Jody
The prevalence and frequency of sexual harassment in medical education is well documented. On the graduation questionnaire administered by the Association of American Medical Colleges in 2003, 15% of medical students reported experiences of mistreatment during medical school. On items that specifically address sexual mistreatment, over 2% of students reported experiencing gender-based exclusion from training opportunities, and unwanted sexual advances and offensive sexist comments from school personnel. Sexual harassment of medical trainees by faculty supervisors is obviously unethical and may also be illegal under education discrimination laws. In two cases in 1998 and 1999, the U.S. Supreme Court clarified that schools may be held liable under Title IX of the Education Amendments of 1972 for the sexual harassment of their students. In 2001, the Office of Civil Rights of the Department of Education released revised policy guidelines on sexual harassment that reflect the Supreme Court rulings. Medical school administrators should undertake formal assessments of the educational environment in their training programs as a first step toward addressing the problem of sexual harassment. The authors recommend that medical schools implement measures to both prevent and remedy sexual harassment in their training programs. These constructive approaches include applying faculty and student education, establishing a system for notification and response, and creating an institutional structure to provide continuous evaluation of the educational environment.
Medical students use Facebook to interact with one another both socially and educationally. This study investigates how medical students in a UK medical school use Facebook to support their learning. In particular, it identifies the nature of their educational activities, and details their experiences of using an educational Facebook group. Twenty-four medical students who self-identified as being Facebook users were invited to focus groups to attain a general overview of Facebook use within an educational context. A textual analysis was then conducted on a small group of intercalating medical students who used a self-created Facebook group to supplement their learning. Five of these students participated in semi-structured interviews. Six common themes were generated. These included 'collaborative learning', 'strategic uses for the preparation for assessment', 'sharing experiences and providing support', 'creating and maintaining connections', 'personal planning and practical organization' and 'sharing and evaluating educational resources'. Evidence from this study shows that medical students are using Facebook informally to enhance their learning and undergraduate lives. Facebook has enabled students to create a supportive learning community amongst their peers. Medical educators wishing to capitalize on Facebook, as a platform for formal educational initiatives, should remain cautious of intruding on this peer online learning community.
Hudson River Center for Program Development, Glenmont, NY.
This document is intended to help adult education program managers throughout New York become oriented to the world of adult education, handle their new responsibilities as program managers, and obtain up-to-date information to assist them in making educational and administrative decisions. The following are among the topics discussed in the…
Axley, Stephen R.; McMahon, Timothy R.
This article critiques the mechanistic grounding of traditional management education and proposes complexity science as a fitting explanatory model for an age of complexity, contributing timely and important educational content and instructional processes to management education. It highlights some of those contributions and reviews instructional…
Medical schools are finally teaching about alcoholism, a disease implicated in 20-50 percent of hospital admissions and which is a problem in the medical profession itself. Recent discoveries on identifying/treating alcoholism have helped to change attitudes and lead to model problems for medical students at Johns Hopkins and Dartmouth. (DH)
Chetlen, Alison L; Mendiratta-Lala, Mishal; Probyn, Linda; Auffermann, William F; DeBenedectis, Carolynn M; Marko, Jamie; Pua, Bradley B; Sato, Takashi Shawn; Little, Brent P; Dell, Carol M; Sarkany, David; Gettle, Lori Mankowski
Simulation is a promising method for improving clinician performance, enhancing team training, increasing patient safety, and preventing errors. Training scenarios to enrich medical student and resident education, and apply toward competency assessment, recertification, and credentialing are important applications of simulation in radiology. This review will describe simulation training for procedural skills, interpretive and noninterpretive skills, team-based training and crisis management, professionalism and communication skills, as well as hybrid and in situ applications of simulation training. A brief overview of current simulation equipment and software and the barriers and strategies for implementation are described. Finally, methods of measuring competency and assessment are described, so that the interested reader can successfully implement simulation training into their practice.
de Fátima Wardenski, Rosilaine; de Espíndola, Marina Bazzo; Struchiner, Miriam; Giannella, Taís Rabetti
The objective of this study was to analyze first-year UFRJ medical students' perceptions about the implementation of a blended learning (BL) experience in their Biochemistry I course. During the first semester of 2009, three Biochemistry professors used the Constructore course management system to develop virtual learning environments (VLEs) for complementing course Modules I, II, and IV, using different resources and activities. Forty-nine students (46%) took part in the study. Results show that, in general, students gave positive evaluations to their experiences with BL, indicating that the VLEs have not only motivated but also facilitated learning. Most of the students reported that access to resources in the three modules provided a more in-depth approach to Biochemistry education and greater study autonomy. Students suggested that the VLEs could be better used for promoting greater communication among participants.
Prisciandaro, Joann I
Medical physicists are often involved in the didactic training of graduate students, residents (both physics and physicians), and technologists. As part of continuing medical education, we are also involved in maintenance of certification projects to assist in the education of our peers. As such, it is imperative that we remain current concerning available educational resources. Medical physics journals offer book reviews, allowing us an opportunity to learn about newly published books in the field. A similar means of communication is not currently available for online educational resources. This information is conveyed through informal means. This review presents a summary of online resources available to the medical physics community that may be useful for educational purposes.
Agarwal, Manoj; Mittal, Sankalp; Vijay, Sharmistha; Yadav, Pooja; Panwar, Vasim Raja; Gupta, Neha
Patients taking anticoagulant medication pose a challenge for the clinician. Dentists are often required to manage bleeding as part of routine oral surgery or dental procedures, and altered hemostasis can lead to complications. Nevertheless, use of these medications is generally important for the patient's health and any alteration in the anticoagulant regimen may have untoward sequelae. In addition, several medications can affect the clotting mechanism, potentially compromising hemostasis. This article will review a variety of anticoagulant medications and the medical conditions that necessitate their use.
Kronick, David A.
Machines themselves are not dehumanizing. Employed with proper management in total systems they enable us better to achieve human goals. Large libraries are complex systems involving man-machine relationships which must be studied with the new management techniques of systems analysis and operations research. Management science deals with a wide variety of problems encountered in the economy of the modern library. Librarians must know about these techniques if they are to fulfill their roles as managers of information services and systems. Good management also involves taking cognizance of the human factors in the old meaning of the term. Some parallels may be found between child rearing and personnel management, but the primary one is that managers must pay the same kind of thoughtful attention to their problems. Good management techniques may be learned empirically by trial and error, but they are better acquired systematically through consultation and study. PMID:5897259
Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua
Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.
Romme, A. Georges L.; Putzel, Roger
In management education the medium can be the message. Students can experience the concepts they are learning if the curriculum is organized and run according to the management and organization principles being taught. This article defines ideas and presents guidelines for the design-in-the-large of education in management and organization. These…
Seufert, Sabine; Seufert, Andreas
Confronted with the pressure of a rapidly changing environment, organizations demand new skills and capabilities of future managers. These demands and the findings of learning theory necessitate a corresponding change in education of tomorrow's managers. Future management education requires a balance between the imparting of knowledge to the…
Lim, Erle C H; Oh, Vernon M S; Koh, Dow-Rhoon; Seet, Raymond C S
Closure of medical schools or the barring of "live patient" contact during an epidemic or pandemic is potentially disruptive to medical education. During the SARS epidemic, the use of web-based learning, role play, video vignettes and both live and mannequin-based simulated patients minimised disruptions to medical education. This article examines the pedagogical innovations that allow clinical teaching to continue without medical students examining actual patients, and proposes a contingency plan in the event of future outbreaks that may necessitate similar containment measures.
Mahler, Cornelia; Freund, Tobias; Baldauf, Annika; Jank, Susanne; Ludt, Sabine; Peters-Klimm, Frank; Haefeli, Walter Emil; Szecsenyi, Joachim
Patients with chronic disease usually need to take multiple medications. Drug-related interactions, adverse events, suboptimal adherence, and self-medication are components that can affect medication safety and lead to serious consequences for the patient. At present, regular medication reviews to check what medicines have been prescribed and what medicines are actually taken by the patient or the structured evaluation of drug-related problems rarely take place in Germany. The process of "medication reconciliation" or "medication review" as developed in the USA and the UK aim at increasing medication safety and therefore represent an instrument of quality assurance. Within the HeiCare(®) project a structured medication management was developed for general practice, with medical assistants playing a major role in the implementation of the process. Both the structured medication management and the tools developed for the medication check and medication counselling will be outlined in this article; also, findings on feasibility and acceptance in various projects and experiences from a total of 200 general practices (56 HeiCare(®), 29 HiCMan,115 PraCMan) will be described. The results were obtained from questionnaires and focus group discussions. The implementation of a structured medication management intervention into daily routine was seen as a challenge. Due to the high relevance of medication reconciliation for daily clinical practice, however, the checklists - once implemented successfully - have been applied even after the end of the project. They have led to the regular review and reconciliation of the physicians' documentation of the medicines prescribed (medication chart) with the medicines actually taken by the patient.
Doroghazi, Robert M; Alpert, Joseph S
Every year that the training period can be shortened increases the value of a medical education. Tuition covers only a fraction of the cost of medical education, making the societal investment in older students less financially robust. Shortening training periods would immediately solve the shortage of residency training positions. With a few exceptions, a medical education is a good investment for women. We are skeptical of the proposals to address the skyrocketing student debt because they do not confront the primary problem. The best way to minimize debt is thrift, and the best way to make a career in medicine more desirable is to shorten the training time.
van Bergen, Leo; Groenewegen, Henk J; Meijman, Frans J
Medical consequences of war are prominent in the media. The United Nations and the World Medical Association have called for medical curricula to permanently include consideration of human rights, in particular human rights in war time. Information on the medical consequences of war and weapon systems is valuable knowledge. Courses on this subject are popular amongst medical students, a considerable number of whom are willing to spend a period working for organisations as the Red Cross, Doctors without Borders or the Military Health Service. In spite of this, none of the Dutch medical faculties has given the subject a permanent place in its curriculum. Gathering knowledge on the medical consequences of war depends completely on the efforts of individuals.
Liu, Donghua; Ma, Jianzhong; Zhang, Zongwang; Yu, Ailan; Chen, Xueli; Feng, Cuicui; Lei, Weifu
Abstract The aim of the study was to investigate current situation of postoperative pain management in medical institutions in Shandong Province.A questionnaire was developed on the basis of guidelines of acute pain and pain quality assessment scale. The questionnaire was used to obtain information regarding the nature and scale of the medical institution, structure of pain management organization, implementation of pain assessment, and analgesic techniques and processes used in clinical practice. A multistage stratified and cluster sampling method was employed to investigate the current situation of postoperative pain management in 168 medical institutions in Shandong Province. For acute pain service (APS), 32% of the hospitals established postoperative pain management organizations similar to APS. For pain evaluation, 57.1% of the hospitals evaluated pain as the fifth vital sign, and 47.0% of the hospitals evaluated pain at rest and during activity. Furthermore, 43.0% of the surveyed hospitals employed patient-controlled analgesia mode, of which hospitals employing brachial plexus block, lumbar plexus block, and femoral nerve block analgesia accounted for 5.0%, 1.0%, and 4.0%, respectively. The survey revealed that 51.0% of the hospitals educated patients about pain and pain management, of which patients were postoperatively educated by ward nurses in 5.0% and patients were educated by APS during ward rounds in 2.0%. There is a lack of standardized postoperative pain management, the involvement of nurses in pain management is scarce, and the pain assessment and education and application of advanced analgesic management techniques were found to be inadequate in medical institutions in Shandong Province. PMID:26871800
Pangaro, Louis N
The author argues that a particular kind of departmental leadership is needed lest medical education become hostage both to distant management through regulatory metrics (which can displace local, institutional creativity) and to the financial pressures within the institution. Departmental chairs themselves have often been seen as barriers to successful integration and redesign of medical school curricula. The vice-chair for education is a critical figure in achieving this new kind of leadership.The author describes three forms of curriculum planning and management: phase 1, where the department chair makes the decisions; phase 2, dominated by regulation from above (in part a reaction to problems with the phase 1 approach); and phase 3, the author's vision of an approach in which decisions occur within departments but with an awareness of the institution as a collaborative system, and grounded in educational theory and research. The vice-chair for education would have a key role, carrying out interdepartmental planning and assessment for the chairs, who would provide them the needed time, training (in leadership and in educational theory and practice), support (from professional educators, with advanced degrees in education), and routes to academic advancement.Responding effectively to a complex and changing environment requires senior leaders at the middle-management level (such as vice-chairs for education) who are well trained in both the content of their specialties and also in interpersonal and collaborative skills, and who have the desire to reach a common future.
Khandelwal, Priyank; Chaturvedi, Seemant
Internal carotid artery stenosis accounts for about 7-10 % of ischemic strokes. Conventional risk factors such as aging, hypertension, diabetes mellitus, and smoking increase the risk for carotid atherosclerosis. All patients with carotid stenosis should receive aggressive medical therapy. Carotid revascularization with either endarterectomy or stenting can benefit select patients with severe stenosis. New clinical trials will examine the contemporary role of carotid revascularization relative to optimal medical therapy.
Grady, Erin C.; Roise, Adam; Barr, Daniel; Lynch, Douglas; Lee, Katherine Bao-Shian; Daskivich, Timothy; Dhand, Amar; Butler, Paris D.
Background Scholarly activity is a requirement for accreditation by the Accreditation Council for Graduate Medical Education. There is currently no uniform definition used by all Residency Review Committees (RRCs). A total of 6 of the 27 RRCs currently have a rubric or draft of a rubric to evaluate scholarly activity. Objective To develop a definition of scholarly activity and a set of rubrics to be used in program accreditation to reduce subjectivity of the evaluation of scholarly activity at the level of individual residency programs and across RRCs. Methods We performed a review of the pertinent literature and selected faculty promotion criteria across the United States to develop a structure for a proposed rubric of scholarly activity, drawing on work on scholarship by experts to create a definition of scholarly activity and rubrics for its assessment. Results The literature review showed that academic institutions in the United States place emphasis on all 4 major components of Boyer's definition of scholarship: discovery, integration, application, and teaching. We feel that the assessment of scholarly activity should mirror these findings as set forth in our proposed rubric. Our proposed rubric is intended to ensure a more objective evaluation of these components of scholarship in accreditation reviews, and to address both expectations for scholarly pursuits for core teaching faculty and those for resident and fellow physicians. Conclusion The aim of our proposed rubric is to ensure a more objective evaluation of these components of scholarship in accreditation reviews, and to address expectations for scholarly pursuits for core teaching faculty as well as those for resident and fellow physicians. PMID:24294446
Kusurkar, Rashmi A; Croiset, Gerda
Background Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT) classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Discussion Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Conclusion Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.
Objectives The primary focus of this review was to discover what is already known about Emotional Intelligence (EI) and the role it plays within social relationships, as well as its importance in the fields of health care and health care education. This article analyzes the importance of EI in the field of health care and recommends various ways that this important skill can be built into medical programs. Methods Information was gathered using various database searches including EBSCOHOST, Academic Search Premier and ERIC. The search was conducted in English language journals from the last ten years. Descriptors include: Emotional Intelligence, medical students and communication skills, graduate medical education, Emotional Intelligence and graduate medical education, Emotional Intelligence training programs, program evaluation and development. Results Results of the study show a direct correlation between medical education and emotional intelligence competencies, which makes the field of medical education an ideal one in which to integrate further EI training. Conclusions The definition of EI as an ability-based skill allows for training in specific competencies that can be directly applied to a specialized field. When EI is conceptualized as an ability that can be taught, learned, and changed, it may be used to address the specific aspects of the clinician–patient relationship that are not working well. For this reason, teaching EI should be a priority in the field of medical education in order to better facilitate this relationship in the future. PMID:26638080
Highlights: • Attached office nurses more recovered medical waste from patients’ homes. • Most nurses educated their patients on how to store home medical care waste in their homes and on how to separate them. • Around half of nurses educated their patients on where to dispose of their home medical care waste. - Abstract: To determine current practices in the disposal and handling of home medical care (HMC) waste, a questionnaire was mailed to 1965 offices nationwide. Of the office that responded, 1283 offices were analyzed. Offices were classified by management configuration: those attached to hospitals were classified as ”attached offices” and others as “independent offices”. More nurses from attached offices recovered medical waste from patients’ homes than those from independent offices. Most nurses educated their patients on how to store HMC waste in their homes (79.3% of total) and on how to separate HMC waste (76.5% of total). On the other hand, only around half of nurses (47.3% from attached offices and 53.2% from independent offices) educated their patients on where to dispose of their HMC waste. 66.0% of offices replied that patients had separated their waste appropriately. The need for patient education has emerged in recent years, with education for nurses under the diverse conditions of HMC being a key factor in patient education.
Greysen, S Ryan; Chen, Candice; Mullan, Fitzhugh
Over the last 50 years, medical student debt has become a problem of national importance, and obtaining medical education in the United States has become a loan-dependent, individual investment. Although this phenomenon must be understood in the general context of U.S. higher education as well as economic and social trends in late-20th-century America, the historical problem of medical student debt requires specific attention for several reasons. First, current mechanisms for students' educational financing may not withstand debt levels above a certain ceiling which is rapidly approaching. Second, there are no standards for costs of medical school attendance, and these can vary dramatically between different schools even within a single city. Third, there is no consensus on the true cost of educating a medical student, which limits accountability to students and society for these costs. Fourth, policy efforts to improve physician workforce diversity and mitigate shortages in the primary care workforce are inhibited by rising levels of medical student indebtedness. Fortunately, the current effort to expand the U.S. physician workforce presents a unique opportunity to confront the unsustainable growth of medical student debt and explore new approaches to the financing of medical students' education.
Bush, Tony, Ed.; Bell, Les, Ed.
This book examines the main themes in educational management and leadership, including strategy, human resources, teaching and learning, finance, external relations, and quality. The 19 chapters are divided into 7 sections: "The Context of Educational Management,""Leadership and Strategic Management,""Human Resource Management,""Managing Learning…
Tsumoto, Shusaku; Matsuoka, Kimiko; Yokoyama, Shigeki
This paper proposes an application of data mining to medical risk management, where data mining techniques were applied to detection, analysis and evaluation of risks potentially existing in clinical environments. We applied this technique to the following two medical domains: risk aversion of nurse incidents and infection control. The results show that data mining methods were effective to detection and aversion of risk factors.
Orwig, Denise; Brandt, Nicole; Gruber-Baldini, Ann L.
Purpose: The purpose of this study was to describe the Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) and to provide results of reliability and validity testing. Design and Methods: Participants were 50 older adults, aged 65 and older, who lived in the community, took at least one prescription medication, and were then…
Toyota, Brian D
Medical subspecialization is a response to rapidly expanding technology and knowledge. Although beneficial to patient care, it poses a challenge to the current infrastructure of resident education. This article analyzes the advent of subspecialization, the current template of postgraduate neurosurgical education, the impact of subspecialization on postgraduate neurosurgical education, and, finally, suggests strategies to optimize professional education in the face of an increasingly subspecialized field.
Gonnella, Joseph S.; Hojat, Mohammadreza
Although the medical education curriculum varies internationally, we suggest that it is desirable for medical educators to share a universal responsibility to prepare physicians to perform three distinct, yet interrelated professional roles. The first is that of a clinician who has the knowledge and technical skills to care for individual patients, as well as the public. The second role can be viewed as that of an educator, a teacher, or a consultant who has the interpersonal skills and personal qualities to teach, advise and counsel patients and the public about their health and illness, risk factors and healthy lifestyle. The third role is that of a resource manager to enable physicians to care for patients and serve the public not only by drawing on available material assets but also by prudent use of the resources for better serving the most number of people at the least expense without compromising the quality of care. The very nature of the medical profession also obligates medical educators through the world to sensitize medical students and physicians to the ethical responsibilities that are implicit to each of the three aforementioned roles. Although the basic ethical responsibilities of do no harm and confidentiality are universal, certain global changes, such as rapid advancements in biotechnology and resource allocation, are now reshaping medical ethics on every continent. Spawned by the rapid advances in the biomedical sciences, biotechnology is revolutionizing human reproduction, sustaining human life, cloning human beings, and mapping the entire human genetic terrain. These advances imply changes in medical education and formal preparation of physicians in performing their roles as clinicians, educators and resource managers. These biotechnological developments, coupled with the increasing cost of healthcare and maldistribution of resources worldwide, present unprecedented ethical-social challenges that need to be addressed in the education of the
Council on Graduate Medical Education.
This report reassesses recommendations made by the Council on Graduate Medical Education in earlier reports which had, beginning in 1992, addressed the problems of physician oversupply. In this report physician supply and requirements are examined in the context of a health care system increasingly dominated by managed care. Patterns of physician…
Barnes, Barbara E.; Cole, Jeanne G.; King, Catherine Thomas; Zukowski, Rebecca; Allgier-Baker, Tracy; Rubio, Doris McGartland; Thorndyke, Luanne E.
Introduction: Heightened concerns about industry influence on continuing medical education (CME) have prompted tighter controls on the management of commercial funding and conflict of interest. As a result, CME providers must closely monitor their activities and intervene if bias or noncompliance with accreditation standards is likely. Potential…
The subject of the cost and value of medical education is becoming increasingly important. However, this subject is not a new one. Fifty years ago, Mr. DH Patey, Dr. OF Davies, and Dr. John Ellis published a report on the state of postgraduate medical education in the UK. The report was wide-ranging, but it made a considerable mention of cost. In this short article, I have presented the documentary research that I conducted on their report. I have analyzed it from a positivist perspective and have concentrated on the subject of cost, as it appears in their report. The authors describe reforms within postgraduate medical education; however, they are clear from the start that the issue of cost can often be a barrier to such reforms. They state the need for basic facilities for medical education, but then outline the financial barriers to their development. The authors then discuss the costs of library services for education. They state that the "annual spending on libraries varies considerably throughout the country." The authors also describe the educational experiences of newly graduated doctors. According to them, the main problem is that these doctors do not have time to attend formal educational events, and that this will not be possible until there is "a more graduated approach to responsible clinical work," something which is not possible without financial investment. While concluding their report, the authors state that the limited money invested in postgraduate medical education and continuing medical education has been well spent, and that this has had a dual effect on improving medical education as well as the standards of medical care.
The subject of the cost and value of medical education is becoming increasingly important. However, this subject is not a new one. Fifty years ago, Mr. DH Patey, Dr. OF Davies, and Dr. John Ellis published a report on the state of postgraduate medical education in the UK. The report was wide-ranging, but it made a considerable mention of cost. In this short article, I have presented the documentary research that I conducted on their report. I have analyzed it from a positivist perspective and have concentrated on the subject of cost, as it appears in their report. The authors describe reforms within postgraduate medical education; however, they are clear from the start that the issue of cost can often be a barrier to such reforms. They state the need for basic facilities for medical education, but then outline the financial barriers to their development. The authors then discuss the costs of library services for education. They state that the "annual spending on libraries varies considerably throughout the country." The authors also describe the educational experiences of newly graduated doctors. According to them, the main problem is that these doctors do not have time to attend formal educational events, and that this will not be possible until there is "a more graduated approach to responsible clinical work," something which is not possible without financial investment. While concluding their report, the authors state that the limited money invested in postgraduate medical education and continuing medical education has been well spent, and that this has had a dual effect on improving medical education as well as the standards of medical care. PMID:25802685
Wilson, S; Reece, A; Sykes, A; Noble, A
The Leeds Undergraduate Medical Education Conference (LUMEC) was held on 7-8 July 1995. This conference, devoted entirely to undergraduate medical education, was unique in that it was organized entirely by four medical students. It attracted a wide and enthusiastic audience and excellent speakers. Professor Charles George (Chairman, Education Committee, General Medical Council) spoke about Tomorrow's Doctors, Dr Mark Bailey (Part-chairman, Medical Students' Committee of the British Medical Association) responded with 'Today's Students on Tomorrow's Doctors', and Dr Fleur Fisher (Ethics, Science and Information Division, British Medical Association) focused on the central place of ethics and communication skills in medicine. Professor Sam Leinster (Director of Medical Studies, Liverpool University) and Professor Tim de Dombal (Director, Clinical Information Science Unit, Leeds University) debated the need for new technology and radical change in the curriculum. Finally, Dr Stella Lowry (International Division, British Medical Association) considered the assessment of staff and Mrs Joy Crosby (Curriculum Facilitator, Dundee Medical School) discussed the assessment of students. Discussions focused on a variety of areas, including the need for change, the control of the money available for teaching and the problems of assessment.
McKibbon, K Ann; Lokker, Cynthia; Handler, Steve M; Dolovich, Lisa R; Holbrook, Anne M; O'Reilly, Daria; Tamblyn, Robyn; J Hemens, Brian; Basu, Runki; Troyan, Sue; Roshanov, Pavel S; Archer, Norman P; Raina, Parminder
OBJECTIVES The objective of the report was to review the evidence on the impact of health information technology (IT) on all phases of the medication management process (prescribing and ordering, order communication, dispensing, administration and monitoring as well as education and reconciliation), to identify the gaps in the literature and to make recommendations for future research. DATA SOURCES We searched peer-reviewed electronic databases, grey literature, and performed hand searches. Databases searched included MEDLINE®, Embase, CINAHL (Cumulated Index to Nursing and Allied Health Literature), Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts, Compendex, Inspec (which includes IEEE Xplore), Library and Information Science Abstracts, E-Prints in Library and Information Science, PsycINFO, Sociological Abstracts, and Business Source Complete. Grey literature searching involved Internet searching, reviewing relevant Web sites, and searching electronic databases of grey literatures. AHRQ also provided all references in their e-Prescribing, bar coding, and CPOE knowledge libraries. METHODS Paired reviewers looked at citations to identify studies on a range of health IT used to assist in the medication management process (MMIT) during multiple levels of screening (titles and abstracts, full text and final review for assignment of questions and data abstrction). Randomized controlled trials and cohort, case-control, and case series studies were independently assessed for quality. All data were abstracted by one reviewer and examined by one of two different reviewers with content and methods expertise. RESULTS 40,582 articles were retrieved. After duplicates were removed, 32,785 articles were screened at the title and abstract phase. 4,578 full text articles were assessed and 789 articles were included in the final report. Of these, 361 met only content criteria and were listed without further abstraction. The final report included data
Shaham, Oded; Melament, Alex; Barak-Corren, Yuval; Kostirev, Igor; Shmueli, Noam; Peres, Yardena
Management of medical images increasingly involves the need for integration with a variety of information systems. To address this need, we developed Content Management Offering (CMO), a platform for medical image management supporting interoperability through compliance with standards. CMO is based on the principles of service-oriented architecture, implemented with emphasis on three areas: clarity of business process definition, consolidation of service configuration management, and system scalability. Owing to the flexibility of this platform, a small team is able to accommodate requirements of customers varying in scale and in business needs. We describe two deployments of CMO, highlighting the platform's value to customers. CMO represents a flexible approach to medical image management, which can be applied to a variety of information technology challenges in healthcare and life sciences organizations.
Rao, R Harsha
The current shortcomings in Japanese medical education are highlighted by identifying four major areas of concern, based on the author's personal observations at Keio University Hospital. The first of these is a woeful lack of clinical skills among Japanese medical students and residents. This lack springs directly from the complete absence of any bedside clinical instruction, which constitutes the second area of concern. The third is the attitude of faculty towards teaching as a burden that detracts and diverts them from their primary goal of academic advancement through research. Finally, there is no recognition of the value of a problem-based approach to teaching clinical medicine, so that clinical problem-solving skills have atrophied to the point of near-extinction in the current generation of Japanese physicians. The promise of problem-based learning (PBL) provides a crucial starting point for efforts to change the system. PBL emphasizes the importance of an integrated approach to clinical problems, and a reliance on critical thinking--the basis of primary care. This contrasts with the selective and highly specialized approach to disease, and reliance on sophisticated technology, which are hallmarks of specialty care. The effort to reform medical education will fail without visionary leadership and without the willingness to confront the truth, as unpleasant as it may seem to be. Both these crucial elements exist at Keio University at this critical juncture. It is this happy confluence that emboldens the author to hope that the future of reform is in good hands at this august institution.
Bopp, K D; Allcorn, S
This article considers the pragmatic aspects of conducting a situation/marketing audit for group medical practices. This audit is a key component in the formulation of a competitive strategy and the development of a marketing program. Given are a series of questions that may be used by medical groups to guide assessment of the opportunities and threats present in the environment as well as the strengths and weaknesses of the organization in meeting the environmental challenges. Furthermore, the article provides a framework for thinking about strategy and the variables that should be considered and aligned to achieve effective implementation of strategy. Finally, the parameters are outlined for deciding on a marketing program: the mix of marketing tools (service design, distribution channels, pricing and promotion) that should be employed to offensively and/or defensively position the medical group in the competitive marketplace.
A new masters-level course, 'Medicine and the Arts" will be offered in 2014 at the University of Cape Town, setting a precedent for interdisciplinary education in the field of medical humanities in South Africa. The humanities and social sciences have always been an implicit part of undergraduate and postgraduate education in the health sciences, but increasingly they are becoming an explicit and essential component of the curriculum, as the importance of graduate attributes and outcomes in the workplace is acknowledged. Traditionally, the medical humanities have included medical ethics, history, literature and anthropology. Less prominent in the literature has been the engagement with medicine of the disciplines of sociology, politics, philosophy, linguistics, education, and law, as well as the creative and expressive arts. The development of the medical humanities in education and research in South Africa is set to expand over the next few years, and it looks as if it will be an exciting inter-disciplinary journey.
Talley, Robert C.
Data are reported suggesting that a change in practice patterns did occur subsequent to a continuing medical education program. Twenty-eight physicians took a course in pulmonary artery pressure monitoring and followup surveys indicate its objectives were met. (LBH)
Storey, Patrick B.
This article provides an attempt to project the way in which a computer-based approach to continuing medical education might emerge based on the present perception of what patient care, teaching, and learning are like. (SSH)
In this paper we consider the significance and mission of medical humanities in medical education from the following six viewpoints: (1) misunderstanding of the medical humanities; (2) its historical development; (3) the criteria for the ideal physician; (4) the contents of current Medical Humanities education; (5) the basic philosophy; and (6) its relation to medical professionalism. Medical humanities consists of the three academic components of bioethics, clinical ethics and medical anthropology, and it is a philosophy and an art which penetrate to the fundamental essence of medicine. The purpose of medical humanities is to develop one's own humanity and spirituality through medical practice and contemplation by empathizing with patients' illness narratives through spiritual self-awakening and by understanding the mutual healing powers of human relations by way of the realization of primordial life. The basic philosophy is "the coincidence of contraries". The ultimate mission of medical humanities is to cultivate physicians to educate themselves and have a life-long philosophy of devotion to understanding, through experience, the coincidence of contraries.
CONFLICT OF INTEREST: NONE DECLARED Distance learning refers to use of technologies based on health care delivered on distance and covers areas such as electronic health, tele-health (e-health), telematics, telemedicine, tele-education, etc. For the need of e-health, telemedicine, tele-education and distance learning there are various technologies and communication systems from standard telephone lines to the system of transmission digitalized signals with modem, optical fiber, satellite links, wireless technologies, etc. Tele-education represents health education on distance, using Information Communication Technologies (ICT), as well as continuous education of a health system beneficiaries and use of electronic libraries, data bases or electronic data with data bases of knowledge. Distance learning (E-learning) as a part of tele-education has gained popularity in the past decade; however, its use is highly variable among medical schools and appears to be more common in basic medical science courses than in clinical education. Distance learning does not preclude traditional learning processes; frequently it is used in conjunction with in-person classroom or professional training procedures and practices. Tele-education has mostly been used in biomedical education as a blended learning method, which combines tele-education technology with traditional instructor-led training, where, for example, a lecture or demonstration is supplemented by an online tutorial. Distance learning is used for self-education, tests, services and for examinations in medicine i.e. in terms of self-education and individual examination services. The possibility of working in the exercise mode with image files and questions is an attractive way of self education. Automated tracking and reporting of learners’ activities lessen faculty administrative burden. Moreover, e-learning can be designed to include outcomes assessment to determine whether learning has occurred. This review article
McPherson, Maggie; Nunes, Jose Miguel Baptista
Presents the Educational Management Action Research model, which is intended to support action research into issues relating to the management of distance learning programs. Describes its successful use in a particular information technology course. (EV)
A national study of 578 dentists showed the most frequently used sources of information about dental patient medication and other medical management issues were the consultant network, the patient's physician, and "Physician's Desk Reference." Professional meetings, professional journals, and pharmaceuticals representatives were less…
Cherian, J; Rao, A R; Thwaini, A; Kapasi, F; Shergill, I S; Samman, R
Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation. Pathologically and clinically, two subtypes are seen—the high flow (non‐ischaemic) variety and the low flow (ischaemic) priapism. The low flow type is more dangerous, as these patients are susceptible to greater complications and the long term recovery of erectile function is dependent on prompt and urgent intervention. Many of the causes of priapism are medical, including pharmacological agents, and as such, priapism should be considered as a medical and surgical emergency. PMID:16461470
Viseltear, A. J.
This paper considers the early years of the Yale Plan of Medical Education, which has come to be called the Yale System. It chronicles and analyzes the incremental development of the System and considers evaluations of the plan and modifications introduced over time. Also considered are external factors which influenced design and implementation. The paper covers the period of medical education at Yale from the 1920s to the early 1950s. PMID:3538682
This article is a plea for education toward a greater understanding of each other's disciplines for both physicians and social workers. It describes the 1971 summer experience of two medical students, whose perceptions changed over the course of the summer, not only towards social workers, but towards their own treatment approach. Sociology is too generalized and abstract for inclusion in medical education. Social work is more clinical, and should therefore be included. PMID:20468923
Harless, William G.; Zier, Marcia A.; Duncan, Robert C.
The TIME Project of the Lister Hill National Center for Biomedical Communications is using interactive videodisc, microprocessor and voice recognition technology to create patient simulations for use in the training of medical students. These interactive case studies embody dramatic, lifelike portrayals of the social and medical conditions of a patient and allow uncued, verbal intervention by the student for independent clinical decisions.
Straus, Christopher M; Webb, Emily M; Kondo, Kimi L; Phillips, Andrew W; Naeger, David M; Carrico, Caroline W; Herring, William; Neutze, Janet A; Haines, G Rebecca; Dodd, Gerald D
The ACR Task Force on Medical Student Education in Radiology, in partnership with the Alliance of Medical Student Educators in Radiology, investigated the current status of how and to what extent medical imaging was being taught in medical schools. The task force executed a 3-part survey of medical school deans, radiology department chairs, and intern physicians. The results provided an updated understanding of the status of radiology education in medical schools in the United States. This summary includes recommendations about how individual radiology departments and ACR members can assist in advancing the specialty of diagnostic radiology through medical student education.
Gellhorn, A., Ed.; And Others
This publication is a World Health Organization (WHO) document. The first part contains the proceedings of the 10th Round Table Conference of the Council of International Organizations of Medical Sciences (CIOMS), held in Germany in July 1976, to examine the potential contribution and limitations of medical education in meeting the needs of…
Goswami, Sribas; Sahai, Manjari
As India marches towards an exciting new future of growth and progress, medical education will play a pivotal role in crafting a sustained development agenda. The idea of creating a healthy society is no longer a debatable luxury; its significance has been grasped by policy shapers worldwide. In a developing nation like India, medical services…
Foley, Sallie; Wittmann, Daniela; Balon, Richard
Objective: Addressing sexual health concerns in medical practice has been an emerging concept for the past two decades. However, there have been very few educational opportunities in medical training that would prepare future physicians for such a responsibility. Since assessing and treating sexual problems requires knowledge that encompasses many…
O'Neil, Edward H.; Seifer, Sarena D.
Health care reforms will dramatically change the culture of medical schools in areas of patient care, research, and education programs. Academic medical centers must construct mutually beneficial partnerships that will position them to take advantage of the opportunities rather than leave them without the diversity of resources needed to make…
Borges, Nicole J.; Hartung, Paul J.
Although medical education has long recognized the importance of community service, most medical schools have not formally nor fully incorporated service learning into their curricula. To address this problem, we describe the initial design, development, implementation, and evaluation of a service-learning project within a first-year medical…
The aims of this report are to highlight the shortcomings in medical education. To use a student made short film as an example of how issues that cause medical student distress can be displayed. To show that the process of film-making is a useful tool in reflection. To display that film is an effective device in raising awareness. (Contains 3…
For decades, debates over medical curriculum reform have centred on the role of science in medical education, but the meaning of "science" in this domain is vague and the persistence of the debate has not been explained. Following Bourdieu, this paper examines struggles over legitimate knowledge and the forms of capital associated with…
Lange, R.; Verhulst, S. J.; Roberts, N. K.; Dorsey, J. K.
The use of students' "consumer feedback" to assess faculty behavior and improve the process of medical education is a significant challenge. We used quantitative Rasch measurement to analyze pre-categorized student comments listed by 385 graduating medical students. We found that students differed little with respect to the number of…
Heath, John M.; Dyer, Carmel B.; Kerzner, Lawrence J.; Mosqueda, Laura; Murphy, Carole
Describe four models of incorporating elder-mistreatment curriculum and collaboration with adult protective services into geriatrics medical education. Draws on efforts at the University of Medicine and Dentistry of New Jersey--Robert Wood Johnson Medical School; the University of California, Irvine College of Medicine; Hennepin County Medical…
Jaspers, Fr C A
The university teaching hospitals are legally commissioned for the development and implementation of the initial medical training for doctors and for the training of specialist registrars, i.e. graduate medical education. They are able to carry out this task partly due to the professionals' collective sense of ambition and a strongly focussed organization that has the necessary critical mass at its disposal.
Labrecque, Michel; Lafortune, Valerie; Lajeunesse, Judith; Lambert-Perrault, Anne-Marie; Manrique, Hermes; Blais, Johanne; Legare, France
Introduction: Defined as reviews of clinical aspects of a specific health problem published in peer-reviewed and non-peer-reviewed medical journals, offered without charge, continuing medical education (CME) articles form a key strategy for translating knowledge into practice. This study assessed CME articles for mention of evidence-based…
Churton, Michael W.
The costs for providing medical school education and services in Vietnam's universities continue to increase. Through a collaborative project between the Government of the Netherlands and Vietnam's Ministry of Health, a five year experimental program to develop in-country capacity and reduce the dependence upon a foreign medical service delivery…
Purpose: To enhance the understanding of medical physics concepts and develop higher levels of learning relating to invisible physics phenomena such as radiation. To provide medical physics educators in all countries of the world with understanding of knowledge structures in the human brain, the different levels of learning, and the types of knowledge required for higher level functions such as problem solving, creative innovations, and applied clinical applications. To provide medical physics educators with an open access resource (tool) that they can use in their teaching activities to enrich and elevate the level of learning for their students, residents, etc. with respect to the invisible realm of medical physics. Methods: An experienced clinical medical physicist and educator has created and provided with open access three complementary web-based resources to achieve the purposes described above. One is a module focusing on the medical physics learning process with respect to mental knowledge structures, how they relate to outcomes and applications, and learning activities that are required to develop the required knowledge structures. The second is an extensive set of visuals that educators can use in their activities (classes, small group discussions, etc.) to visualize the invisible. The third is an interactive online simulation where learners can adjust factors and visually observe changes in x-radiation.These resources are available online at www.BLINDED FOR REVIEW . Results: Medical physics education, especially for non-physicists, is becoming much more interesting and useful especially with respect to invisible radiation. The global impact is that medical imaging professionals can be more effective in optimizing x-ray imaging procedures and risk management when they have knowledge levels that enhance problem solving, innovation, and creativity. Conclusion: Medical physics educators in all institutions can be much more effective and efficient in the
Strickland, Colin D; Lowry, Peter A; Petersen, Brian D; Jesse, Mary K
OBJECTIVE. This article describes the creation of a virtual workstation for use by medical students and implementation of that workstation in the reading room. CONCLUSION. A radiology virtual workstation for medical students was created using OsiriX imaging software to authentically simulate the experience of interacting with cases selected to cover important musculoskeletal imaging diagnoses. A workstation that allows the manipulation and interpretation of complete anonymized DICOM images may enhance the educational experience of medical students.
Cohen, Jordan J
Medical educators are facing a challenge today that is quite analogous to that addressed by Abraham Flexner, namely how to transform a legacy system of education that is no longer preparing future physicians adequately to meet contemporary expectations and responsibilities. In facing up this challenge, however, today's educators not only must equip students to deal effectively with the rapidly changing paradigms in health care and medical practice, they also must adapt their curricula and pedagogical methods to the demanding new paradigms of medical education. Their success in addressing these dual imperatives will determine whether the educational transformations currently underway will have as momentous an effect on the public's health as did those stimulated by Flexner a century ago.
Tinney, Veronica A; Paulson, Jerome A; Bathgate, Susanne L; Larsen, John W
Obstetricians-gynecologists can protect the reproductive health of women, men, and their offspring from environmental hazards through preconception and prenatal counseling and encouraging patients to take actions to reduce environmental exposures. Although obstetricians-gynecologists are well positioned to prevent hazardous exposures, education on environmental health in medical education is limited. The Mid-Atlantic Center for Children's Health and the Environment and the Department of Obstetrics and Gynecology of George Washington University convened a meeting to begin integration of environmental health topics into medical education for obstetricians-gynecologists. Several avenues were identified to incorporate environmental health topics into medical education including continuing education requirements, inclusion of environmental health questions on board certification examinations and the creation of a curriculum on environmental health specific to obstetrics-gynecology.
Bleakley, Alan; Bligh, John
Medical students must be prepared for working in inter-professional and multi-disciplinary clinical teams centred on a patient's care pathway. While there has been a good deal of rhetoric surrounding patient-centred medical education, there has been little attempt to conceptualise such a practice beyond the level of describing education of communication skills and empathy within a broad 'professionalism' framework. Paradoxically, while aiming to strengthen patient-student interactions, this approach tends to refocus on the role modelling of the physician, and opportunities for potentially deep collaborative working relationships between students and patients are missed. A radical overhaul of conventional doctor-led medical education may be necessary, that also challenges the orthodoxies of individualistic student-centred approaches, leading to an authentic patient-centred model that shifts the locus of learning from the relationship between doctor as educator and student to the relationship between patient and student, with expert doctor as resource. Drawing on contemporary poststructuralist theory of text and identity construction, and on innovative models of work-based learning, the potential quality of relationship between student and patient is articulated in terms of collaborative knowledge production, involving close reading with the patient as text, through dialogue. Here, a medical 'education' displaces traditional forms of medical 'training' that typically involve individual information reproduction. Students may, paradoxically, improve clinical acumen through consideration of silences, gaps, and contradictions in patients as texts, rather than treating communication as transparent. Such paradoxical effects have been systematically occluded or denied in traditional medical education.
Frank, Jason R; Snell, Linda S; Cate, Olle Ten; Holmboe, Eric S; Carraccio, Carol; Swing, Susan R; Harris, Peter; Glasgow, Nicholas J; Campbell, Craig; Dath, Deepak; Harden, Ronald M; Iobst, William; Long, Donlin M; Mungroo, Rani; Richardson, Denyse L; Sherbino, Jonathan; Silver, Ivan; Taber, Sarah; Talbot, Martin; Harris, Kenneth A
Although competency-based medical education (CBME) has attracted renewed interest in recent years among educators and policy-makers in the health care professions, there is little agreement on many aspects of this paradigm. We convened a unique partnership - the International CBME Collaborators - to examine conceptual issues and current debates in CBME. We engaged in a multi-stage group process and held a consensus conference with the aim of reviewing the scholarly literature of competency-based medical education, identifying controversies in need of clarification, proposing definitions and concepts that could be useful to educators across many jurisdictions, and exploring future directions for this approach to preparing health professionals. In this paper, we describe the evolution of CBME from the outcomes movement in the 20th century to a renewed approach that, focused on accountability and curricular outcomes and organized around competencies, promotes greater learner-centredness and de-emphasizes time-based curricular design. In this paradigm, competence and related terms are redefined to emphasize their multi-dimensional, dynamic, developmental, and contextual nature. CBME therefore has significant implications for the planning of medical curricula and will have an important impact in reshaping the enterprise of medical education. We elaborate on this emerging CBME approach and its related concepts, and invite medical educators everywhere to enter into further dialogue about the promise and the potential perils of competency-based medical curricula for the 21st century.
Prescott, Lauren S.; Dickens, Andrea S.; Guerra, Sandra L.; Tanha, Jila M.; Phillips, Desiree G.; Patel, Katherine T.; Umberson, Katie M.; Lozano, Miguel A.; Lowe, Kathryn B.; Brown, Alaina J.; Taylor, Jolyn S.; Soliman, Pamela T.; Garcia, Elizabeth A.; Levenback, Charles F.; Bodurka, Diane C.
Objective Shared medical appointments offer a novel approach to improve efficiency and quality of care consistent with the goals of the Institute of Medicine. Our objective was to develop and implement a shared medical appointment for gynecologic cancer patients initiating chemotherapy. Methods We first assessed the level of interest in shared medical appointments among our patients and providers through qualitative interviews. Both patients and providers identified pre-chemotherapy as an optimal area to pilot shared medical appointments. We subsequently created a multidisciplinary team comprised of physicians, advanced practice providers, nurses, pharmacists, administrators, health education specialists and members of the Quality Improvement Department to establish a Shared Medical Appointment and Readiness Teaching (SMART) program for all gynecologic oncology patients initiating chemotherapy with platinum- and/or taxane-based regimens. We developed a standardized chemotherapy education presentation and provided patients with a tool kit that consisted of chemotherapy drug education, a guide to managing side effects, advance directives, and center contact information. Results From May 9, 2014 to June 26, 2015, 144 patients participated in 51 SMART visits. The majority of patients had ovarian cancer and were treated with carboplatin/paclitaxel. Surveyed patients reported being highly satisfied with the group visit and would recommend shared medical appointments to other patients. Conclusions This model of care provides patient education within a framework of social support that empowers patients. Shared medical appointments for oncology patients initiating chemotherapy are both feasible and well accepted. PMID:26549108
Beigy, Maani; Pishgahi, Ghasem; Moghaddas, Fateme; Maghbouli, Nastaran; Shirbache, Kamran; Asghari, Fariba; Abolfat-H Zadeh, Navid
It has long been a common goal for both medical educators and ethicists to develop effective methods or programs for medical ethics education. The current lecture-based courses of medical ethics programs in medical schools are demonstrated as insufficient models for training "good doctors''. In this study, we introduce an innovative program for medical ethics education in an extra-curricular student-based design named Students' Medical Ethics Rounds (SMER). In SMER, a combination of educational methods, including theater-based case presentation, large group discussion, expert opinions, role playing and role modeling were employed. The pretest-posttest experimental design was used to assess the impact of interventions on the participants' knowledge and attitude regarding selected ethical topics. A total of 335 students participated in this study and 86.57% of them filled the pretest and posttest forms. We observed significant improvements in the knowledge (P < 0.0500) and attitude (P < 0.0001) of participants. Interestingly, 89.8% of participants declared that their confidence regarding how to deal with the ethical problems outlined in the sessions was increased. All of the applied educational methods were reported as helpful. We found that SMER might be an effective method of teaching medical ethics. We highly recommend the investigation of the advantages of SMER in larger studies and interdisciplinary settings.
Beigy, Maani; Pishgahi, Ghasem; Moghaddas, Fateme; Maghbouli, Nastaran; Shirbache, Kamran; Asghari, Fariba; Abolfat-h Zadeh, Navid
It has long been a common goal for both medical educators and ethicists to develop effective methods or programs for medical ethics education. The current lecture-based courses of medical ethics programs in medical schools are demonstrated as insufficient models for training “good doctors’’. In this study, we introduce an innovative program for medical ethics education in an extra-curricular student-based design named Students’ Medical Ethics Rounds (SMER). In SMER, a combination of educational methods, including theater-based case presentation, large group discussion, expert opinions, role playing and role modeling were employed. The pretest-posttest experimental design was used to assess the impact of interventions on the participants’ knowledge and attitude regarding selected ethical topics. A total of 335 students participated in this study and 86.57% of them filled the pretest and posttest forms. We observed significant improvements in the knowledge (P < 0.0500) and attitude (P < 0.0001) of participants. Interestingly, 89.8% of participants declared that their confidence regarding how to deal with the ethical problems outlined in the sessions was increased. All of the applied educational methods were reported as helpful. We found that SMER might be an effective method of teaching medical ethics. We highly recommend the investigation of the advantages of SMER in larger studies and interdisciplinary settings. PMID:27471586
Zhang, Hao-Jun; Zhang, Ying-Hua; Wang, Yan; Yang, Ya-Hong; Zhang, Jian; Wang, Yao-Ling; Wang, Jun-Ling
Medical waste is a special category of waste with potential health and environment risks. The present study aimed to explore the current status of medical waste management in western China. Seventy-four healthcare facilities were selected to assess the general status of medical waste management based upon a designed questionnaire survey. The surveyed results showed that the quantities of average medical waste generation were 0.79, 0.59 and 0.61 kg bed(-1) day(-1) in tertiary, secondary and primary hospitals, respectively. The incomplete segregation of domestic and medical waste generated a higher quantity of medical waste in primary hospitals (0.61 kg bed(-1) day(-1)) than that in secondary hospitals. Furthermore, the effective implementation of the medical waste management system depended on national regulations, occupational safety, internal policies and administration and the qualifications and competence of the directors of the waste management department in the healthcare facilities. Therefore, sufficient training programmes and protective measures should be provided by healthcare facilities to all relevant personnel and adequate financial support and effective administrative monitoring should be performed by local authorities.
McDonald, Walter J.
The Council of Medical Specialty Societies (CMSS) recognizes the need for continuing medical education (CME) reform and intends to be actively engaged in that process. While recognizing that CME reform must involve many organizations, the CMSS and particularly the 23 societies that make up the CMSS are in a position to affect many of the needed…
Birpinar, Mehmet Emin; Bilgili, Mehmet Sinan; Erdoğan, Tuğba
The objective of this study was to analyze the present status of medical waste management in the light of the Medical Waste Control Regulation (MWCR) in Istanbul, the largest city in Turkey. About 17% of the hospitals, 20% of bed capacity, and 54% of private hospitals in Turkey are located in Istanbul. The first regulation about medical waste management in Turkey was published in 1993, and as a candidate state, it was changed in 2005 in accordance with EU Environmental Directives. In this work, a survey of 14 questions about the amount, collection, and temporary storage of medical wastes was applied to 192 hospitals in Istanbul through face-to-face interviews. It was found that the estimated quantity of medical waste from the hospitals is about 22tons/day and the average generation rate is 0.63kg/bed-day. Recyclable materials are collected separately at a rate of 83%. Separate collection of different types of wastes is consistently practiced, but 25% of the hospitals still use inappropriate containers for medical waste collection. Almost 77% of the hospitals use appropriate equipment for the medical waste collection personnel. The percentage of the hospitals that have temporary storage depots is 63%. Medical waste management in Istanbul is carried out by applying the MWCR.
Huwendiek, Sören; Hahn, Eckhart G.; Tönshoff, Burkhard; Nikendei, Christoph
Background: Despite the increasing interest in medical education in the German-speaking countries, there is currently no information available on the challenges which medical educators face. To address this problem, we carried out a web-based survey among the members of the Association for Medical Education (Gesellschaft für medizinische Ausbildung, GMA). Methods: A comprehensive survey was carried out on the need for further qualifications, expertise and the general conditions of medical educators in Germany. As part of this study, the educators were asked to list the three main challenges which they faced and which required urgent improvement. The results were analysed by means of qualitative content analysis. Results: The questionnaire was completed by 147 of the 373 members on the GMA mailing list (response rate: 39%). The educators named a total of 346 challenges and emphasised the following areas: limited academic recognition for engagement in teaching (53.5% of educators), insufficient institutional (31.5%) and financial support (28.4%), a curriculum in need of reform (22.8%), insufficient time for teaching assignments (18,9%), inadequate teacher competence in teaching methods (18.1%), restricted faculty development programmes (18.1%), limited networking within the institution (11.0%), lack of teaching staff (10.2%), varying preconditions of students (8.7%), insufficient recognition and promotion of medical educational research (5.5%), extensive assessment requirements (4.7%), and the lack of role models within medical education (3.2%). Conclusion: The medical educators found the biggest challenges which they faced to be limited academic recognition and insufficient institutional and financial support. Consequently, improvements should be implemented to address these issues. PMID:24062818
Julius, Anthony; Longfellow, Katelan
Movement disorders can be challenging to manage and often use a specific set of medications. Because it is a complex and broad field within neurology, many providers are unfamiliar with the classes of medications. This paper details medications used for specific conditions, explains why these medications are helpful, and shares pearls and pitfalls related to each agent, focusing on parameters such as dose titration, side effect profiles, and specific drug-drug interactions and challenges. We focus on the most commonly encountered movement disorders, including essential tremor, Parkinson's disease, rapid eye movement sleep behavior disorder, and restless leg syndrome.
Hercigonja-Szekeres, Mira; Marinović, Darko; Kern, Josipa
Five generations of second year students at the Zagreb University School of Medicine were interviewed through an anonymous questionnaire on their use of personal computers, Internet, computer laboratories and computer-assisted education in general. Results show an advance in students' usage of information and communication technology during the period from 1998/99 to 2002/03. However, their positive opinion about computer laboratory depends on installed capacities: the better the computer laboratory technology, the better the students' acceptance and use of it.
Jia, Guo-Lliang; Ge, Yi; Deng, Hou-Bin
We expatiate on an initiative management mode of medical instruments and equipments' operation and maintenace, which is different from the usual passive management. The application of this mode is helpful for keeping them in good condition and increasing the activity ratio, and thus to increase their economic and social benefits.
Price, David W.; Wagner, Dianne P.; Krane, N. Kevin; Rougas, Steven C.; Lowitt, Nancy R.; Offodile, Regina S.; Easdown, L. Jane; Andrews, Mark A. W.; Kodner, Charles M.; Lypson, Monica; Barnes, Barbara E.
Background Derived from multiple disciplines and established in industries outside of medicine, Implementation Science (IS) seeks to move evidence-based approaches into widespread use to enable improved outcomes to be realized as quickly as possible by as many as possible. Methods This review highlights selected IS theories and models, chosen based on the experience of the authors, that could be used to plan and deliver medical education activities to help learners better implement and sustain new knowledge and skills in their work settings. Results IS models, theories and approaches can help medical educators promote and determine their success in achieving desired learner outcomes. We discuss the importance of incorporating IS into the training of individuals, teams, and organizations, and employing IS across the medical education continuum. Challenges and specific strategies for the application of IS in educational settings are also discussed. Conclusions Utilizing IS in medical education can help us better achieve changes in competence, performance, and patient outcomes. IS should be incorporated into curricula across disciplines and across the continuum of medical education to facilitate implementation of learning. Educators should start by selecting, applying, and evaluating the teaching and patient care impact one or two IS strategies in their work. PMID:25911282
Wankel, Charles, Ed.; DeFillippi, Robert, Ed.
This volume demonstrates how technology is impacting management education and learning in a variety of educational contexts. Some of the issues and trends in management education addressed include: technotrends; web-based management learning; the changing nature of the web as a context for learning; online simulations; web-format case studies;…
Chu, Larry F; Erlendson, Matthew J; Sun, John S; Clemenson, Anna M; Martin, Paul; Eng, Reuben L
Today's educators are faced with substantial challenges in the use of information technology for anaesthesia training and continuing medical education. Millennial learners have uniquely different learning styles than previous generations of students. These preferences distinctly incorporate the use of digital information technologies and social technologies to support learning. To be effective teachers, modern educators must be familiar with these new information technologies and understand how to use them for medical education. Examples of new information technologies include learning management systems, lecture capture, social media (YouTube, Flickr), social networking (Facebook), Web 2.0, multimedia (video learning triggers and point-of-view video) and mobile computing applications. The information technology challenges for educators in the twenty-first century include: (a) understanding how technology shapes the learning preferences of today's anaesthesia residents, (b) distinguishing between the function and properties of new learning technologies and (c) properly using these learning technologies to enhance the anaesthesia curriculum.
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Gibbs, Trevor; McLean, Michelle
As new developments in medical education move inexorably forward, medical schools are being encouraged to revisit their curricula to ensure quality graduates and match their outcomes against defined standards. These standards may eventually be transferred into global accreditation standards, which allow 'safe passage' of graduates from one country to another [Educational Commission for Foreign Medical Graduates (ECFMG) 2010. Requiring medical school accreditation for ECFMG certification--moving accreditation forward. Available from: http://www.ecfmg.org/accreditation/rationale.pdf]. Gaining much attention is the important standard of social accountability--ensuring that graduates' competencies are shaped by the health and social needs of the local, national and even international communities in which they will serve. But, in today's 'global village', if medical schools address the needs of their immediate community, who should address the needs of the wider global community? Should medical educators and their associations be looking beyond national borders into a world of very unequal opportunities in terms of human and financial resources; a world in which distant countries and populations are very quickly affected by medical and social disasters; a world in which the global playing field of medical education is far from level? With medical schools striving to produce fit-for-purpose graduates who will hopefully address the health needs of their country, is it now time for the medical education fraternity to extend their roles of social accountability to level this unlevel playing field? We believe so: the time has come for the profession to embrace a global accountability model and those responsible for all aspects of healthcare professional development to recognise their place within the wider global community.
Rogers, Chad; Bush, Nathania
Heart failure (HF) is a debilitating chronic disease and is expected to increase in upcoming years due to demographic changes. Nurses in all settings have an essential role in supporting patients in managing this disease. This article describes the pathophysiology of HF, diagnosis, medical management, and nursing interventions. It is crucial for nurses to understand the pathophysiology of HF and the importance that nursing actions have on enhancing medical management to alleviate symptoms and to deter the advancement of the pathophysiologic state. Such an understanding can ultimately reduce morbidity and mortality and optimize quality of life in patients with HF.
Cantisani, V.; Dietrich, C. F.; Badea, R.; Dudea, S.; Prosch, H.; Cerezo, E.; Nuernberg, D.; Serra, A. L.; Sidhu, P. S.; Radzina, M.; Piscaglia, F.; Bachmann Nielsen, M.; Ewertsen, C.; Săftoiu, A.; Calliada, F.; Gilja, O. H.
The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) recommends that ultrasound should be used systematically as an easy accessible and instructive educational tool in the curriculum of modern medical schools. Medical students should acquire theoretical knowledge of the modality and hands-on training should be implemented and adhere to evidence-based principles. In this paper we report EFSUMB policy statements on medical student education in ultrasound that in a short version is already published in Ultraschall in der Medizin 1. PMID:27689163
Gluck, Jeannine Cyr
Much of the literature relating to continuing medical education programs laments the lack of effectiveness of traditional lecture-based format, the most often used method of presentation in hospitals. A gap exists between the content taught in lectures and the application of that knowledge in actual patient care. The services of the medical librarian, already employed in most hospitals, can help ameliorate this problem. Further, libraries help to support quality improvement efforts. These three functions (library services, continuing medical education, and quality improvement) are interdependent. Each lends strength to the other, and, ideally, all are coordinated within the hospital structure.
Chernaia, N L; Ivanova, I V; Dadaeva, O B; Shtaniuk, M G
The major issues of the medical follow-up in the children educational institutions are discussed. The data related to the need of the development and enhancement of preventive course is presented. The main possible ways to resolve the existing problems are enumerated. The necessity of implementing the new screening diagnostical technologies during the procedure of preventive examinations is proved. The using of the efficient diet and the physical education, the development of the dominant of healthy life style and the targeted preventive activities among children of medical social, medical psychological and biological risk groups is substantiated.
Hyoguchi, Naomi; Kobayashi, Daisuke; Kubota, Toshio; Shimazoe, Takao
Deaf people often experience difficulty in understanding medication information provided by pharmacists due to communication barriers. We held medication education lectures for deaf and hard of hearing (HH) individuals and examined the extent to which deaf participants understood medication-related information as well as their attitude about medication. We used two questionnaires to compare the results from the deaf participants with those from the HH and hearing participants. We found that before the lecture, the deaf participants' understanding of medication use was lower than that of the HH and hearing participants. The deaf participants' knowledge increased after the lecture, but did not improve to the level exhibited by the HH participants. However, the deaf participants felt confident using medication despite their low comprehension levels. In conclusion, adjusting the medication information provided by pharmacists according to the recipient's reading level could help improve deaf patients' knowledge; however, such measures might not increase deaf patients' comprehension levels sufficiently.
Cooper, John A. D.; Yingang, Lin
The three types of physicians trained in the People's Republic of China (practitioners in Chinese medicine, traditional Mongolian medicine, and western-style medicine) and the design of the medical schools and programs are discussed. (MSE)
Stentoft, Diana; Duroux, Meg; Fink, Trine; Emmersen, Jeppe
Problem-based learning (PBL) based on patient cases has become a well-established worldwide educational approach in medical education. Recent studies indicate that case-based PBL when used throughout an entire curriculum may develop into a counter-productive routine for students as well as teachers. Consequently, there is a need to develop PBL…
Yeung, Alexander Seeshing; Li, Bingyi; Wilson, Ian; Craven, Rhonda G.
Much research has acknowledged the importance of self-concept for adolescents' academic behaviour, motivation and aspiration, but little is known about the role of self-concept underpinning the motivation and aspiration of higher education students in a specialised field such as medical education. This article draws upon a programme of research…
Weinberg, Armin D.; And Others
A film describing tachypea as an early manifestation of congenital heart disease was shown to physicians and nurses at 27 hospitals during regular continuing medical education activities. Findings from pre-test and post-test data show that need-oriented educational programs can measurably improve the quality of patient care. (Author/LBH)
Medical education is a rapidly expanding discipline with its practitioners drawn from a mix of backgrounds. Among them there is an increased understanding of the centrality of the curriculum process in the translation of educational ideas in practice. There are four main trends that underlie this increased understanding: a widened conception of…
Kavanaugh, J. F.
A formal education plan with two admission steps is outlined. Animal agriculture and the basic sciences are combined in a two-year middle stage. The medical education (third stage) that specifically addresses pathology and the clinical sciences encompasses three years. (Author/LBH)
Ferris, Helena; O'Flynn, Dermot
Within the arena of medical education, it is generally acknowledged that assessment drives learning. Assessment is one of the most significant influences on a student's experience of higher education and improving assessment has a huge impact on the quality of learning (Liu, N. and Carless, D, 2006). Ideally we want to enhance student's capacity…
Quinn, Jane M.; Sklarew, Bruce H.
An elective clinical practicum in sex education is reported. Staff from the D.C. Department of Human Resources and Planned Parenthood train third- and fourth-year medical students in sex education techniques and supervise their work with public school children, mostly fifth- and sixth-grade pupils. (Author/LBH)
Portfolios are increasingly used in postgraduate medical education and in gastroenterology training as an assessment tool, as documentation of competence, a database of procedure experience (for example endoscopy experience) and for revalidation purposes. In this paper the educational theory behind their use is described and the evidence for their use is discussed.
Hauer, Karen E.; Wachter, Robert M.
Proposes a research agenda to investigate the educational impact for medical students of the hospitalist model, suggests strategies to mitigate the limitations in students' exposures to subspecialty faculty, and recommends professional development in teaching for hospitalists to ensure that student education thrives in this new environment of…
Hendler, B H; Rose, L F
A four-week hospital-based program offers a comprehensive course for dental students in the evaluation and management of medical emergencies. The program first emphasizes medical evaluation with the taking of accurate, comprehensive patient histories and the performance of physical examinations; information about supportive care, including intravenous techniques and airway maintenance, is given. The diagnostic signs and treatment of common medical emergencies, as taught in the program, are described.
Collett, T J; McLachlan, J C
This study aimed at evaluating how doing poetry could affect students' understanding of medical practice and at assessing the effectiveness of the evaluation method used. Qualitative research was carried out on the experiences of medical students participating in a poetry workshop, followed by some quantitative analysis. The study was conducted at Peninsula Medical School and St Ives, Cornwall, UK, with three medical students, a poet and a pathologist as participants. Data were collected by interviews, observation and web access. "Doing poetry" with a professional poet was found to assist communication between doctors and patients as it enhanced skills of observation, heightened awareness of the effect of language and fostered deep reflection. Poetry was also found to offer an outlet for medics and patients. The voluntary workshop attracted three participants; however, it might have had an effect on the wider student community because the poetry website received 493 hits in four months. Qualitative methods worked well as a tool for evaluation. "Doing poetry for poetry's sake" seemed to foster the development of skills related to empathy. The opportunity to do poetry should be made available to medical students as part of a wider arts and humanities programme.
... 42 Public Health 3 2012-10-01 2012-10-01 false Drug utilization management, quality assurance, and... Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). (a... D plan, a drug utilization management program, quality assurance measures and systems, and an...
... 42 Public Health 3 2013-10-01 2013-10-01 false Drug utilization management, quality assurance, and... Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). (a... D plan, a drug utilization management program, quality assurance measures and systems, and an...
... 42 Public Health 3 2014-10-01 2014-10-01 false Drug utilization management, quality assurance, and... Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). (a... D plan, a drug utilization management program, quality assurance measures and systems, and an...
... 42 Public Health 3 2011-10-01 2011-10-01 false Drug utilization management, quality assurance, and... management, quality assurance, and medication therapy management programs (MTMPs). (a) General rule. Each... utilization management program, quality assurance measures and systems, and an MTMP as described in...
... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and... management, quality assurance, and medication therapy management programs (MTMPs). (a) General rule. Each... utilization management program, quality assurance measures and systems, and an MTMP as described in...
Peery, Thomas M.; Green, Alan C.
Planning and design procedures which one medical education center employed in translating its educational objectives, philosophy and techniques into laboratory, classroom and clinic facilities are described. Basic planning considerations included--(1) determination of the curriculum, (2) facility utilization rate, (3) housing of research…
Arbogast, Gary; Chandler, Judy P.
All teachers desire to keep their students on task and focused on meeting lesson objectives. Classroom management, perhaps the most critical factor involved in a lesson's success, includes several considerations. In this article, the authors, who are physical education teacher educators themselves, discuss the five management practices, which they…
Highlights the manner in which different models for financing higher education can contribute to the management of higher education in Germany. Includes discussions of the management of student distribution within a given university and the development of systems for performance analysis. (SLD)
Farooq, M. S.; Akhtar, M. S.; Ullah, S. Zia; Memon, R. A.
The purpose of the paper is to analyzing thoughts of the modern management paradigm "Total Quality Management" (TQM), and its application in the field of education. The basic theme of TQM is participatory approach to address the question(s) of quality in business aswell as in the field of education. Reviewing fresh literature from the internet …
Dennison, W. F.; Shenton, Ken
Until recently, most educational managers, including head teachers and senior staff in schools, have performed their tasks without formal training. Today, however, many new courses are being established for the training of educational managers. This book provides a framework for such a course. It selects from existing literature, theory, and…