Group items tagged

"Every summer, a handful of medical students spends two weeks in a nursing home as a patient. That's part of what's been called "the life-altering education" established by Marilyn Gugliucci, Ph.D., the director of geriatrics education and research at the University of New England College of Osteopathic Medicine."

Patient Centered Learning: The solution is to permit alternatives to rigid institutions, utilize free internet programs, and have medical students assist practicing physicians by assisting practicing physicians in taking patient histories. These students would offer valuable, free services to doctors. At the same time, they would have a vivid learning experience by spending several hours each day interacting with actual patients. The Cost Of Medical Education Would Be Negligible. The expense of healthcare is directly proportional to the cost of the doctor's education. With the institutional bottleneck gone, there would be a greater number of doctors, and the cost of healthcare would plummet.

doctors aren't helping patients through remote means, instead insisting on seeing patients in the office for all medical issues, even the most routine of issues out of habit, out of fear, out of how to get paid.

New knowledge is rapidly altering the basic sciences that are fundamental to the practice of medicine. To address this concern, the Association of American Medical Colleges and the Howard Hughes Medical Institute convened a group of scientists, physicians, and science educators to identify the essential scientific background physicians in the 21st century will need. The resulting report, Scientific Foundations for Future Physicians, lays out a series of scientific competencies that students must master prior to attending medical school and medical students must understand upon completion of their M.D..

"The Patient Voices program was founded by social entrepreneurs Pip Hardy and Tony Sumner in 2003, and aims to facilitate the telling and the hearing of some of the unwritten and unspoken stories of ordinary people so that those who devise and implement strategy in health and social care, as well as the professionals and clinicians directly involved in care, may carry out their duties in a more informed and compassionate manner. We hope that, as a result of seeing the stories, patients, their carers and clinicians may meet as equals and work respectfully together for the benefit of all."

"To help us develop and use the techniques of feedback for personal growth, it is necessary to understand certain characteristics of the process. The following is a brief outline of some factors which may assist us in making better use of feedback, both as the giver and the receiver of feedback. This list is only a starting point. You may wish to add further items to it."

Considering the zones of proximal development model should drive educators to seek out and leverage more structured educational interventions, without which the limitations of learning and self-directed learner growth may be undermining the overall impact of the medical education we create.

With 2012 coming to an end, we have put together a list of innovative medical and healthcare apps - apps that gave us pause and represent the future of mobile medicine. These apps should also inspire developers and other healthcare providers to think outside the box when developing their own medical apps. Of note, most of the apps mentioned in this compilation are free to download.

"The language of these competencies has tended to adopt a prescriptive, rather than descriptive, approach. However, despite widespread agreement on the importance of competency-based education and more than two decades of study, this effort has not generated a dependable set of assessment tools."

"It may be postulated that the improvement in students' self-perceptions of equality and diversity over the past 12 years may have been influenced by a generational acceptance of cultural diversity and, the inclusion of diversity training courses within the medical curriculum. Diversity training related to race and sexual orientation should be expanded, including a follow-up survey to assess the effectiveness of any intervention."

Project of the ABIM Foundation, ACP-ASIM Foundation, and European Federation of Internal Medicine* in the Annals of Internal Medicine

This paper focuses on the constructive use of assessment to embed a pervasive and proactive culture of patient safety into practice, starting with the trainee and extending out into the practice years. This strategy is based on the adage that "assessment drives curriculum" and proposes a series of new assessment tools to be added to all phases of the training-practice continuum.

"Routine adoption of smartphones by residents appeared to improve efficiency over the use of pagers for physicians, nurses, and allied health professionals. This was balanced by negative communication issues of increased interruptions, a gap in perceived urgency, weakened interprofessional relationships, and unprofessional behavior. Further communication interventions are required that balance efficiency and interruptions while maintaining or even improving interprofessional relationships and professionalism."

"Eighty-five learners (53 undergraduate, 32 postgraduate) participated in 10 focus groups. Two main findings emerged. Firstly, the perceived effectiveness of formal and informal assessment activities in informing self-assessment appeared to be both person- and context-specific. No curricular activities were considered to be generally effective or ineffective. However, the availability of high-quality performance data and standards was thought to increase the effectiveness of an activity in informing self-assessment. Secondly, the fostering and informing of self-assessment was believed to require credible and engaged supervisors."

"It is important that the clinical teacher teaches trainees the specific skills sets of the expert general practitioner (e.g. synthesising skills, recognising prototypes, focusing on cues and clues, using community resources and dealing with uncertainty) in order to promote clinical reasoning in the context of general practice or family medicine. Clinical teachers need to understand their own reasoning processes as well as be able to convey that knowledge to their trainees. They also need to understand the developmental stages of clinical reasoning and be able to nurture each trainee's own expertise. Strategies for facilitating effective clinical reasoning in trainees include adequate exposure to patients, offering the trainees opportunity for reflection and feedback, and coaching on the techniques of reasoning in the general practice context."

A web-based tool, Continuity of Care Online Simulations (COCOS), was designed for use in a one-month, postgraduate clinical rotation in endocrinology. It is an interactive tool that simulates the continuing care of any patient with a chronic endocrine disease. Twenty-three residents in internal medicine participated in a study to investigate the effects of using COCOS during a clinical rotation in endocrinology on pre-post knowledge test scores and self-assessment of confidence.

In this article, the authors develop a definition of positive deviance, a foundational construct in positive organizational scholarship. They offer a normative definition of positive deviance: intentional behaviors that depart from the norms of a referent group in honorable ways. The authors contrast this normative perspective on deviance with statistical, supraconformity, and reactive perspectives on deviance. They also develop research propositions that differentiate positive deviance from related prosocial types of behaviors, including organizational citizenship, whistle-blowing, corporate social responsibility, and creativity/innovation. Finally, the authors offer some initial ideas on how to operationalize positive deviance.

"They review some classics including: "The rational clinical examination. Is this patient having a myocardial infarction?" in JAMA 1998. "The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease" in JAMA 2000. "Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis" in NEJM 2003. "The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma" in NEJM 2003. "Computed tomography of the head before lumbar puncture in adults with suspected meningitis" in NEJM 2001."

"SimMon is a medical simulator app that takes the form of a simple patient monitor. There are a number of physiological parameters that can be measured including ECG, arterial waveform, oxygen saturation, BP and more. One of the strengths of this app is that it can be remotely controlled by another iPhone or iPad."

"The authors identify a broad range of disrespectful conduct, suggesting six categories for classifying disrespectful behavior in the health care setting: disruptive behavior; humiliating, demeaning treatment of nurses, residents, and students; passive-aggressive behavior; passive disrespect; dismissive treatment of patients; and systemic disrespect."