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Author: Brian S McGowan, PhD

ABSTRACT: If Exercise is Medicine®, Where is Exercise in Medicine? Review of U.S. Medical Education Curricula for Physical Activity-Related Content.

BACKGROUND:
This study provides an update on the amount and type of physical activity education occurring in medical education in the United States in 2013. It is the first study to do so since 2002.
METHODS:
Applying content analysis methodology, we reviewed all accessible accredited doctor of medicine and doctor of osteopathic medicine institutions’ websites for physical activity education related coursework (N = 118 fully accessible; 69.41%).
RESULTS:
The majority of institutions did not offer any physical activity education-related courses. When offered, they were rarely required. Courses addressing sports medicine and exercise physiology were offered more than courses in other content domains. Most courses were taught using a clinical approach. No differences were observed between MD and DO institutions, or between private and public institutions.
CONCLUSIONS:
Over half of the physicians trained in the United States in 2013 received no formal education in physical activity and may, therefore, be ill-prepared to assist their patients in a manner consistent with Healthy People 2020, the National Physical Activity Plan, or the Exercise is Medicine® initiative. The Bipartisan Policy Center, American College of Sports Medicine, and the Alliance for a Healthier Generation called for a reversal of this situation on June 23, 2014.

via If Exercise is Medicine®, Where is Exercise in Medicine? Review of … – PubMed – NCBI.

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ABSTRACT: Systems-based practice: learning the concepts using a teamwork competition model.

BACKGROUND:
Systems-based practice (SBP) is a core competency of the Accreditation Council for Graduate Medical Education (ACGME) that must be integrated into residency training. We sought to develop a method to improve resident understanding using a teamwork competition model.
METHODS:
The residents were given a pretest to assess their understanding of SBP followed by a didactic lecture. They were then divided into teams to solve a programmatic “problem” in the residency. Each team had to prove that their solution best fulfilled the expectations of SBP. Their solutions were then presented at a departmental conference followed by a post-test to evaluate knowledge.
RESULTS:
In the pretest, 33% of the residents understood what SBP meant and only 15% knew the components of SBP. In the post-test, this increased to 85% and 89%, respectively.
CONCLUSIONS:
SBP is a competency mandated by the Accreditation Council for Graduate Medical Education in residency training. Using a novel approach, we were able to improve the residents’ understanding of SBP.

via Systems-based practice: learning the concepts using a teamwork comp… – PubMed – NCBI.

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ABSTRACT: [Exponential use of social media in medicine: Example of the interest of Twitter© in urology.]

AIM:
Social media (#SoMe) has changed the face of modern medicine. Our purpose was to asses the potential interest of Twitter in the field of urology.
MATERIAL AND METHODS:
A systematic review of the literature has been performed using PubMed without timeline restriction with the following keywords (MeSH): social media; Web 2.0; Twitter; Internet; network; urology; journal club; education.
RESULTS:
There were 3 categories of interest of Twitter in the field of urology: spread of scientific knowledge, scientific interaction during medical conferences and medical education and international medical debates. The unique spread of evidence-based-medecine through traditional scientific journals in paper version is over. Main scientific journals in urology and scientific societies are now using a Twitter account and became virtual. They use new bibliometrics available on #SoMe to estimate the social impact. Twitter allows for a better interactivity of doctors attending scientific conferences. Exponential use of Twitter is in the interest of speakers and leaders, audience and scientific societies. Lastly, medical academic education and continuing medical education can be achieved through #SoMe. Twitter became a lively virtual platform for scientific debates for complex oncological cases (dematerialized tumor board). Twitter is also a place for intense scientific discussion during virtual journal club without geographic or timeline restriction.
CONCLUSION:
Physicians need to respect the rules for a wise use of #SoMe in order not to break the Hippocratic Oath. There is a revolution around #SoMe and Twitter in the spread of scientific knowledge and academic teaching. International urologists are already committed in this evolution and France should also get involved.

via [Exponential use of social media in medicine: Example of the intere… – PubMed – NCBI.

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ABSTRACT: A Patient-centered Approach to Managing Patients with Type 2 Diabetes

Despite the availability of a number of therapeutic options, management of type 2 diabetes (T2DM) and hyperglycemia remains suboptimal. Evidence shows that physicians are not adequately individualizing incretin-based therapies as there is lack of clear understanding of the similarities and differences between various incretin-based therapies. Additionally, sodium-dependent glucose co-transporter 2 (SGLT2) inhibitors, a very recent addition to the therapeutic armamentarium, are not adequately utilized in managing patients with T2DM due to a lack of awareness or an increased concern regarding their safety, efficacy, and the mechanism of action. Insulin therapy is also not initiated or intensified appropriately due to a lack of clear understanding on when to add and how to intensify them and, more importantly, due to fear of increasing the risk of hypoglycemia in patients. To address these gaps, in the first section of this educational activity, the expert faculty will review the current understanding of the risks associated with hypoglycemia-one of the main factors that limit the successful use of insulin therapy-and when to initiate insulin therapy, as well as the available data on the risk of hypoglycemia with emerging agents. The expert faculty will also provide practical strategies on how to minimize the risk of hypoglycemia in patients. In the second section, the expert faculty will highlight the differences between the various incretin-based therapies in addition to providing strategies for physicians to individualize their choice of incretin-based therapy. The expert faculty will also review the mechanism of action, safety, efficacy, and the appropriate place for this class of therapies in the treatment continuum. In the third section, the expert faculty will discuss the mechanism of action, safety, and efficacy of the currently available SGLT2 inhibitors as well as the appropriate use of these newer agents in T2DM management.

via A Patient-centered Approach to Managing Patients with Type 2 Diabetes. – PubMed – NCBI.

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ABSTRACT: Polycystic ovary syndrome: A review for dermatologists: Part II. Treatment

Dermatologists are in a key position to treat the manifestations of polycystic ovary syndrome (PCOS). The management of PCOS should be tailored to each woman’s specific goals, reproductive interests, and particular constellation of symptoms. Therefore, a multidisciplinary approach is recommended. In part II of this continuing medical education article, we present the available safety and efficacy data regarding treatments for women with acne, hirsutism, and androgenetic alopecia. Therapies discussed include lifestyle modification, topical therapies, combined oral contraceptives, antiandrogen agents, and insulin-sensitizing drugs. Treatment recommendations are made based on the current available evidence.

via Polycystic ovary syndrome: A review for dermatologists: Part II. Tr… – PubMed – NCBI.

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ABSTRACT: Polycystic ovary syndrome: A review for dermatologists: Part I. Diagnosis and manifestations.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder among women who are of reproductive age. The pathogenesis involves several associated hormonal pathways that culminate in metabolic, reproductive, and cardiovascular effects. The hallmark features of hyperandrogenism and hyperinsulinemia have systemic long-term implications. Dermatologists frequently evaluate and manage the cutaneous manifestations of PCOS (ie, acanthosis nigricans, hirsutism, acne, and alopecia), and therefore play a key role in its diagnosis and management. In part I of this continuing medical education article, we review the definition, etiology, pathogenesis, and clinical features of PCOS.

via Polycystic ovary syndrome: A review for dermatologists: Part I. Dia… – PubMed – NCBI.

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ABSTRACT: Embedding Quality and Safety in Otolaryngology-Head and Neck Surgery Education

Education in patient safety (PS) and quality improvement (QI) helps both medical students and residents understand the health care environment in the United States, where these concepts are now incorporated into virtually every aspect of patient care. The Accreditation Council of Graduate Medical Education has made PS/QI a mandatory component of resident education, and a number of specialties have published their experiences with incorporating PS/QI into their training programs. In otolaryngology-head and neck surgery, a strong curriculum can be built by teaching residents about the principles of PS/QI through both didactic and experiential learning, and morbidity and mortality and QI conferences can serve as the cornerstone of this curriculum. Understanding the potential challenges in PS/QI education can allow training programs to plan their strategy effectively for successful incorporation into their existing curricula.

via Embedding Quality and Safety in Otolaryngology-Head and Neck Surger… – PubMed – NCBI.

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ABSTRACT: Variability in Spine Surgery Procedures Performed During Orthopaedic and Neurological Surgery Residency Training: An Analysis of ACGME Case Log Data

BACKGROUND:

Current spine surgeon training in the United States consists of either an orthopaedic or neurological surgery residency, followed by an optional spine surgery fellowship. Resident spine surgery procedure volume may vary between and within specialties.

METHODS:

The Accreditation Council for Graduate Medical Education surgical case logs for graduating orthopaedic surgery and neurosurgery residents from 2009 to 2012 were examined and were compared for spine surgery resident experience.

RESULTS:

The average number of reported spine surgery procedures performed during residency was 160.2 spine surgery procedures performed by orthopaedic surgery residents and 375.0 procedures performed by neurosurgery residents; the mean difference of 214.8 procedures (95% confidence interval, 196.3 to 231.7 procedures) was significant (p = 0.002). From 2009 to 2012, the average total spinal surgery procedures logged by orthopaedic surgery residents increased 24.3% from 141.1 to 175.4 procedures, and those logged by neurosurgery residents increased 6.5% from 367.9 to 391.8 procedures. There was a significant difference (p < 0.002) in the average number of spinal deformity procedures between graduating orthopaedic surgery residents (9.5 procedures) and graduating neurosurgery residents (2.0 procedures). There was substantial variability in spine surgery exposure within both specialties; when comparing the top 10% and bottom 10% of 2012 graduates for spinal instrumentation or arthrodesis procedures, there was a 13.1-fold difference for orthopaedic surgery residents and an 8.3-fold difference for neurosurgery residents.

CONCLUSIONS:

Spine surgery procedure volumes in orthopaedic and neurosurgery residency training programs vary greatly both within and between specialties. Although orthopaedic surgery residents had an increase in the number of spine procedures that they performed from 2009 to 2012, they averaged less than half of the number of spine procedures performed by neurological surgery residents. However, orthopaedic surgery residents appear to have greater exposure to spinal deformity than neurosurgery residents. Furthermore, orthopaedic spine fellowship training provides additional spine surgery case exposure of approximately 300 to 500 procedures; thus, before entering independent practice, when compared with neurosurgery residents, most orthopaedic spine surgeons complete as many spinal procedures or more. Although case volume is not the sole determinant of surgical skills or clinical decision making, variability in spine surgery procedure volume does exist among residency programs in the United States.

via Variability in Spine Surgery Procedures Performed During Orthopaedi… – PubMed – NCBI.

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ABSTRACT: Happiness, stress, a bit of vulgarity, and lots of discursive conversation: A pilot study examining nursing students’ tweets about nursing education posted to Twitter.

BACKGROUND:
The use of social media platforms like Twitter within/for nursing education has become more common in recent years. Regardless, it is unclear how nursing students use technology like Twitter during the course of their nursing education.
AIM:
The aim of this paper was to explore how nursing students describe elements of their nursing education via the social media platform, Twitter.
METHODS:
Tweets about nursing courses, classes, and clinical were collected in October 2011 and analyzed for themes. Overall, 498 tweets were collected over a collective six day period, and 189 tweets were codified into five thematic representations.
FINDINGS:
Nursing students were found to discuss a variety of elements related to their nursing education, including events and situations they perceived to be positive or exciting. Stress and annoyance messaging was also noted as a salient theme expressed by nursing students when describing their education. Vulgarity and derogative messaging targeting elements of nursing education (including courses, students, and faculty) were found in a subset of tweets. The majority of the tweets collected in this study contained random discursive conversations regarding nursing education, including information seeking requests and declarative statements about temporal events.
CONCLUSIONS:
The findings of this study point to a need for educators to explore aspects surrounding eProfessionalism within nursing education. Similarly, this paper also highlights the growing requirement for nursing educators to learn more about how social media is being used by nursing students within/for their education, in order to better develop learning and networking opportunities for students. Without this, nursing education may miss a significant opportunity to help shape students’ professional use of social media technology like Twitter.

via Happiness, stress, a bit of vulgarity, and lots of discursive conve… – PubMed – NCBI.

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ABSTRACT: An exploration of the use of social media by surgical colleges

Background: Social media use has become common for organisations in surgery, however the nature and reach of these communications is unknown. This study aimed to characterise and compare the use of “Twitter” by five prominent organisations in surgery. Study Design: Data were collected from Twitter and the scale, reach, nature and sentiment of messages analysed. Message influence was determined and content analysed by frequency and association using hierarchical clustering and network analysis. Poisson regression was used to compare institutional message and “re-tweet” counts. Results: 7712 messages were analysed from a four-year period up to 13th April 2013. The American College of Surgeons (ACS) had tweeted most and posted the greatest number of messages per day (3.3/day). The number of followers reflects social reach and the Royal College of Surgeons of England (RCSEng) had the greatest number (11,600) followed by the ACS (7320). The number of “retweets” a message receives is a measure of influence with the RCSEng (2.0) demonstrating a significantly greater count than the Royal College of Surgeons of Ireland (RCSI; 0.8, p < 0.001) and the ACS (1.3, p < 0.001). Followers of the RCSEng and ACS appeared most influential. Terms relating to education feature prominently in messages posted by the RCSEng and RCSEd, but less so in those from the RCSI and ACS. Education and training terms were highly correlated with “events”. Conclusions: Surgical colleges have significant international reach through social media. UK colleges frequently communicate about education/training opportunities while the ACS focuses on patient-related matters. Only one organisation was found to have an explicit social media policy, which would be considered best practice and can focus on-line activity.

via An exploration of the use of social media by surgical colleges. – PubMed – NCBI.

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