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Author: Brian S McGowan, PhD

MANUSCRIPT: Transparency in medical error disclosure: the need for formal teaching in undergraduate medical education curriculum

As ‘practice makes perfect’, we believe that the incorporation of formal teaching of transparent medical error disclosure in medical curricula is greatly needed. Medical schools play central roles in cultivating the significance and developing the communication skills needed for proficient and effective medical error disclosure. Moreover, they play key roles in resolving all barriers that may hinder transparency and full disclosure of medical errors. Such an approach is expected to educate a safe physician workforce where intrinsic drives and capabilities to remain transparent at all times – regardless of consequences – will serve as the basis for enhancing patient–doctor relationships, limiting further harm and improving overall healthcare safety

via Transparency in medical error disclosure: the need for formal teaching in undergraduate medical education curriculum.

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MANUSCRIPT: New frontiers in medical education: simulation technology at Campbell University School of Osteopathic Medicine

Campbell University School of Osteopathic Medicine is using a variety of medical simulation systems in the training of its medical students. The simulators allow students to learn and practice skills in a controlled environment, and they enable faculty to challenge students with a broader range of conditions than might ordinarily be encountered during medical training.

via New frontiers in medical education: simula… [N C Med J. 2014 Jan-Feb] – PubMed – NCBI.

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ABSTRACT: A novel approach to needs assessment in curriculum development: Going beyond consensus methods

Background: Needs assessment should be the starting point for curriculum development. In medical education, expert opinion and consensus methods are commonly employed. Aim: This paper showcases a more practice-grounded needs assessment approach. Methods: A mixed-methods approach, incorporating a national survey, practice audit, and expert consensus, was developed and piloted in thrombosis medicine; Phase 1: National survey of practicing consultants, Phase 2: Practice audit of consult service at a large academic centre and Phase 3: Focus group and modified Delphi techniques vetting Phase 1 and 2 findings. Results: Phase 1 provided information on active curricula, training and practice patterns of consultants, and volume and variety of thrombosis consults. Phase 2’s practice audit provided empirical data on the characteristics of thrombosis consults and their associated learning issues. Phase 3 generated consensus on a final curricular topic list and explored issues regarding curriculum delivery and accreditation. Conclusions: This approach offered a means of validating expert and consensus derived curricular content by incorporating a novel practice audit. By using this approach we were able to identify gaps in training programs and barriers to curriculum development. This approach to curriculum development can be applied to other postgraduate programs.

via A novel approach to needs assessment in curriculum… [Med Teach. 2014] – PubMed – NCBI.

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ABSTRACT: Internal medicine rounding practices and the accreditation council for graduate medical education core competencies

BACKGROUND:
The Accreditation Council for Graduate Medical Education (ACGME) has established the requirement for residency programs to assess trainees’ competencies in 6 core domains (patient care, medical knowledge, practice-based learning, interpersonal skills, professionalism, and systems-based practice). As attending rounds serve as a primary means for educating trainees at academic medical centers, our study aimed to identify current rounding practices and attending physician perceived capacity of different rounding models to promote teaching within the ACGME core competencies.
METHODS:
We disseminated a 24-question survey electronically using educational and hospital medicine leadership mailing lists. We assessed attending physician demographics and the frequency with which they used various rounding models, as defined by the location of the discussion of the patient and care plan: bedside rounds (BR), hallway rounds (HR), and card-flipping rounds (CFR). Using the ACGME framework, we assessed the perceived educational value of each model.
RESULTS:
We received 153 completed surveys from attending physicians representing 34 institutions. HR was used most frequently for both new and established patients (61% and 43%), followed by CFR for established patients (36%) and BR for new patients (22%). Most attending physicians indicated that BR and HR were superior to CFR in promoting the following ACGME competencies: patient care, systems-based practice, professionalism, and interpersonal skills.
CONCLUSIONS:
HR is the most commonly employed rounding model. BR and HR are perceived to be valuable for teaching patient care, systems-based practice, professionalism, and interpersonal skills. CFR remains prevalent despite its perceived inferiority in promoting teaching across most of the ACGME core competencies

via Internal medicine rounding practices and the accr… [J Hosp Med. 2014] – PubMed – NCBI.

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ABSTRACT: How we implemented a resident-led medical simulation curriculum in a large internal medicine residency program

Abstract Mannequin-based simulation in graduate medical education has gained widespread acceptance. Its use in non-procedural training within internal medicine (IM) remains scant, possibly due to the logistical barriers to implementation of simulation curricula in large residency programs. We report the Massachusetts General Hospital Department of Medicine’s scale-up of a voluntary pilot program to a mandatory longitudinal simulation curriculum in a large IM residency program (n = 54). We utilized an eight-case curriculum implemented over the first four months of the academic year. An intensive care unit curriculum was piloted in the spring. In order to administer a comprehensive curriculum in a large residency program where faculty resources are limited, thirty second-year and third-year residents served as session facilitators and two senior residents served as chairpersons of the program. Post-session anonymous survey revealed high learner satisfaction scores for the mandatory program, similar to those of the voluntary pilot program. Most interns believed the sessions should continue to be mandatory. Utilizing residents as volunteer facilitators and program leaders allowed the implementation of a well-received mandatory simulation program in a large IM residency program and facilitated program sustainability.

via How we implemented a resident-led medical simulati… [Med Teach. 2014] – PubMed – NCBI.

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ABSTRACT: Developing an electronic teaching and training portfolio

Technological advances, in particular the rise of the internet, have led to dramatic changes in medical education. The recent global financial crisis and issues with medical staffing have meant that training programs and universities are increasingly exploring electronic means to provide efficient and cost effective education techniques. In this article, we explore methods by which orthopedic trainees can develop their educational portfolio through electronic resources and similarly, how training or residency programs can utilize these advances in technology to both increase efficiency and enhance their teaching reputation. Finally, we explore the merits of trainees keeping track of their careers through electronic portfolios.

via Developing an electronic teaching… [Curr Rev Musculoskelet Med. 2014] – PubMed – NCBI.

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MANUSCRIPT: Clinicians should be aware of their responsibilities as role models: a case report on the impact of poor role modeling

Background : Role modeling is an important and valuable educational method. It is predominant throughout under-graduate medical education, and attributes of exemplary medical role models are manifold. Aim : This article describes the impact of poor role modeling on medical students’ professional and personal development on the basis of a singular incident at an associated teaching hospital. In addition, scientific literature studying the effect of and the reasons behind poor role modeling in undergraduate and graduate medical education is analyzed and discussed. Results : To maximize the educational potential of clinical role modeling, medical schools have to consider strategies both on the individual as well as on the institutional level. Several suggestions are offered on both levels. Discussion/conclusion : Based on a case report of significantly poor role modeling, this article outlines strategies through which academic medical institutions may maximize the educational potential of role modeling and lastingly enhance teaching proficiency of clinical faculty.

via Clinicians should be aware of their responsi… [Med Educ Online. 2014] – PubMed – NCBI.

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MANUSCRIPT: eLearning among Canadian anesthesia residents: a survey of podcast use and content needs

BACKGROUND:
Podcasts are increasingly being used in medical education. In this study, we conducted a survey of Canadian anesthesia residents to better delineate the content needs, format preferences, and usage patterns among anesthesia residents.
METHODS:
10/16 Canadian anesthesia program directors, representing 443/659 Canadian anesthesia residents, allowed their residents to be included in the study. 169/659 (24%) residents responded to our survey. A 17-item survey tool developed by the investigators was distributed by email eliciting information on patterns of podcast use, preferred content, preferred format, and podcast adjuncts perceived to increase knowledge retention.
RESULTS:
60% (91/151) had used medical podcasts with 67% of these users spending up to 1 hour per week on podcasts. 72.3% of respondents selected ‘ability to review materials whenever I want’ was selected by the majority of respondents (72%) as the reason they found podcasts to be valuable. No clear preference was shown for audio, video, or slidecast podcasts. Physiology (88%) and pharmacology (87%) were the most requested basic science topics while regional anesthesia (84%), intensive care (79%) and crisis resource management (86%) were the most requested for procedural, clinical and professional topics respectively. Respondents stated they would most likely view podcasts that contained procedural skills, journal article summaries and case presentations and that were between 5-15 minutes in duration A significantly greater proportion of senior residents (81%) requested podcasts on ‘pediatric anesthesia’ compared to junior residents 57% (P = 0.007).
CONCLUSIONS:
The majority of respondents are using podcasts. Anesthesia residents have preferred podcast content, types, length and format that educators should be cognizant of when developing and providing podcasts.

via eLearning among Canadian anesthesia residents: … [BMC Med Educ. 2013] – PubMed – NCBI.

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ABSTRACT: Medical applications for pharmacists using mobile devices

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

via Medical applications for pharmacist… [Ann Pharmacother. 2013 Jul-Aug] – PubMed – NCBI.

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ABSTRACT: Survey of Medical Student Preference for Simulation Models for Basic Dermatologic Surgery Skills: Simulation Platforms in Medical Education.

BACKGROUND:
The authors investigated the use of simulator platforms in fourth-year medical student education.
OBJECTIVE:
To evaluate which simulation platform students preferred for learning dermatologic procedures and to assess the effectiveness of the exercise in terms of the change in confidence that the students had performing dermatologic procedures.
MATERIALS AND METHODS:
After medical students were instructed on how to perform a punch biopsy and then assisted in executing the task, they were surveyed to determine their preferred simulation platform and simulator properties. Students were surveyed at the beginning and completion of the teaching block.
RESULTS:
One hundred fifty-seven students completed the skills laboratory, and 78 completed the preference questionnaire. Of the 11 surveyed categories, students preferred the pig foot in eight categories. Seventy students responded to a surgical skills questionnaire that assessed their overall confidence in planning and executing the procedure before and after the skills laboratory. The students had a statistically significant increase in confidence in dermatologic procedural skills as a result of the activity.
CONCLUSION:
Preference data show that the pig foot model is preferred for teaching dermatologic surgical skills. These results re-affirm that the pig foot model is an effective, low-cost solution for training.

via Survey of Medical Student Preference for Simul… [Dermatol Surg. 2014] – PubMed – NCBI.

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