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Biomedical subjects

G Barley

Publications and source records attributed to G Barley.

10 recordsLinked to original sources
PubMed2001

Improving medical students' communication with limited-literacy patients: project development and implementation.

BACKGROUND: Physicians may not realize that some of their patients have limited reading abilities. The AMC Cancer Research Center and the Primary Care Curriculum at the University of Colorado collaborated to develop and implement a project to teach medical students to identify and effectively communicate with limited-literacy patients regarding cancer screening. METHOD: The project incorporated two standardized-patient (SP) cases on cancer screening and literacy into the existing curriculum for second-year students. A small-group, interactive problem-based learning (PBL) case on breast cancer screening and literacy introduced the concept of communicating about cancer screening and literacy issues. A clinical practice examination on colorectal cancer screening and literacy was given at the end of the year. RESULTS: The collaborative project proved successful in incorporating literacy and cancer screening into a medical school curriculum. Time spent training SPs to play the role of adults with limited literacy was very important, as was time spent pre-testing the cases. The PBL case effectively promoted group discussion of cancer screening and literacy. CONCLUSION: The project succeeded in making students aware of literacy and cancer screening issues. Outcome results are being analyzed.

Communication↗
PubMed2001

What did we learn about early clinical experience?

This article explores the lessons learned by ten demonstration schools regarding the early clinical experience (ECE) component of the Interdisciplinary Generalist Curriculum (IGC) PROJECT: Students in ECE at these schools participated in longitudinal, one-to-one or two-on-one preceptorships with primary care physician preceptors in outpatient settings. Development of an ECE was a key component of curricular change at each of the IGC Project schools. Shattering the traditional barrier between preclinical and clinical years of the 2 + 2 medical curriculum model helped create a leading edge for innovation at each of the schools. In this article, the authors incorporated evaluation information from several sources, including the external evaluation reports of the IGC Project, final annual reports from demonstration schools, and curriculum evaluations from the coauthors' schools (the University of Colorado School of Medicine, Nova Southeastern University College of Osteopathic Medicine, and the University of California, San Francisco School of Medicine).

Curriculum↗
PubMed2001

What did we learn about the impact on students' clinical education?

Analysis of the impact of the Interdisciplinary Generalist Curriculum (IGC) Project would be incomplete without discussion of how it affected students' clinical education. This article explores the impact of the IGC Project on medical students' clinical education at the ten IGC schools. The schools typically lacked pre-IGC Project baseline data for comparison, although they all collected data on the impact of the new curriculum on the clinical education of students. Measures included some objective indicators and various subjective measures of the perceptions of the students, faculty, and community preceptors. The impact of curricular innovations at the IGC Project schools on students was immediate as they began to see patients early and continuously as part of their medical education. Students, faculty, and community preceptors who interacted with these students during their third year believed they were "different" because of their participation in the IGC. Not only did the IGC students approach patients with better integrated basic science knowledge, but also a different kind of student arrived at the third year, the traditional beginning of clinical experiences in medical education.

Curriculum↗
PubMed2001

What did we learn about leadership in medical education? Effecting institutional change through the Interdisciplinary Generalist Curriculum Project.

The Interdisciplinary Generalist Curriculum (IGC) Project required significant collaboration and cooperation at many levels of leadership to accommodate early clinical experiences in the curriculum. Three elements of institutional change are discussed: the context for desired early clinical experiences in medical education, structural elements required of the IGC Project schools, and leadership within the demonstration schools. Lessons learned from these interdisciplinary projects include the importance of supportive leadership from the top levels, establishing broad buy-in across sectors of the school, creating a team administrative structure that fosters participation by all groups, and central (rather than departmental) administration. The processes needed to establish collaborative leadership and full participation by the generalist departments and cooperation of diverse constituencies, such as basic science faculty, were labor-intensive and required more time to ensure successful program implementation. Uniformly, strong support at the highest levels of the organization, especially the medical schools' deans, was cited as a key element in the success of the IGC Project. An interesting unanticipated outcome of the project was the movement of the interdisciplinary course administration into a central location (dean's office) by the end of the project for all schools. This change may reflect a practical advantage for administration of interdisciplinary programs located at the level of the school or college, rather than housed within departments.

Administrative Personnel↗
PubMed2001

The Interdisciplinary Generalist Curriculum Project at the University of Colorado School of Medicine.

The University of Colorado School of Medicine first considered a longitudinal primary care preceptorship in 1992, when the dean formed the dean's Ad Hoc Committee to launch the "generalist initiative," to include a three-year required longitudinal generalist preceptorship. Being awarded an Interdisciplinary Generalist Curriculum (IGC) Project contract provided the dean's Ad Hoc Committee with the momentum it needed to enact the curriculum. This article describes the IGC Project at the University of Colorado as it was originally proposed and the intended and unintended outcomes over time. Intended outcomes included establishing early continuous clinical experiences as a vital part of the curriculum and increased exposure to primary care, while examples of unintended outcomes were the development of a longitudinal skill and behavior evaluation process and the integration of problem-based learning in the curriculum. The article concludes with a description of what is ahead for the curriculum.

Colorado↗
PubMed1999

Effect of a longitudinal course on student performance in clerkships.

OBJECTIVE: To determine the effect that a 3-year primary-care course experience with family medicine, internal medicine, or pediatric preceptors would have on clerkship performance in pediatrics and internal medicine. DESIGN: In 1 academic year, third-year students were divided retrospectively into 3 groups based on preceptor type in the primary care course. An analysis of variance was conducted. When the analysis of variance showed statistical significance, a multiple-comparison t test was performed. SETTING: University medical school with a longitudinal preceptor experience. PARTICIPANTS: One hundred nine third-year medical students who participated in the primary care course and completed the pediatric and internal medicine clerkships. Fifty-six students took part in the self-assessment portion of the study. MAIN OUTCOME MEASURES: Student performance scores in the pediatric clerkship and internal medicine clerkship were analyzed for significant differences based on preceptor type. Student self-assessment on pediatric objectives was analyzed for significant differences based on preceptor experience. RESULTS: Students with pediatric preceptors received higher clinical scores in the pediatric clerkship (P = .04) and perceived themselves as more advanced on 18 of the 39 pediatric curriculum pretest self-assessment items. Students with pediatric or internal medicine preceptors received significantly higher scores on the written patient medical history and physical examinations (P = .02). There were no significant differences on the pediatric written examination. There were no significant performance differences in the internal medicine clerkship. All hypothesis testing was conducted at the 95% confidence level. CONCLUSION: Experiences with pediatric preceptors in the early years of medical school may improve a student's performance and confidence in the pediatric clerkship.

Analysis of Variance↗
PubMed1999

The family physician and house calls. A survey of Colorado family physicians.

BACKGROUND: Visiting patients at home has long been one of the activities of the family physician, but the practice of making house calls has diminished significantly during the second half of the 20th century. The goal of this study was to describe physicians' attitudes about house calls and their practice of making them in the rapidly changing health care environment of the United States. METHODS: A 30-item, self-administered questionnaire was designed to obtain demographic information about physicians and their attitudes toward house calls, practice experiences with making house calls, and any additional factors that influence making house calls. It was mailed to all members of the Colorado Academy of Family Physicians, during the summer of 1997. RESULTS: A 66% response rate was obtained from practicing physicians. Overall attitudes toward house calls were positive. Fifty-three percent of the respondents reported making house calls, and 8% reported making more than 2 house calls per month. Male physicians, those older than 40 years, those in rural settings, and those trained in a community-based residency were more likely to make house calls. Patient payer mix and practice setting were also related to whether a physician made house calls. House calls were most frequently made to geriatric patients, cancer patients, trauma patients, and patients with transportation difficulties. Many physicians reported using home health agencies for assessment and treatment of patients needing home care. CONCLUSIONS: Family physicians agree that house calls are good for patients. More than half of the respondents reported that they occasionally make house calls. However, few physicians routinely perform house calls.

Adult↗
PubMed1998

Update on early medical and surgical abortion.

Abortion is one of the most common surgical procedures in the United States. Recent innovations in medicine make early pregnancy termination safe and effective. Our purpose is to review advances in early detection and confirmation of intrauterine pregnancy and discuss medical and surgical techniques for elective termination early in pregnancy. Manual vacuum aspiration is a safe and effective method for pregnancy termination through 10 weeks' gestation. Medical abortion using methotrexate or mifepristone with misoprostol is safe and effective for early pregnancy termination through 7 weeks' gestation.

Abortifacient Agents, Nonsteroidal↗