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Biomedical subjects

S Vivell

Publications and source records attributed to S Vivell.

10 recordsLinked to original sources
PubMed1995

Expert ratings of primary care goals and objectives.

OBJECTIVE: To develop consensus on proficiencies internal medicine residents should master in the area of primary and managed care. DESIGN: A draft compendium of primary care educational objectives including important clinical topics was developed at the Sepulveda Veterans Health Administration Medical Center Pilot Ambulatory Care and Education (PACE) Program as part of a local and regional primary care curricular review. Fifty-one experts, including leaders in the Society of General Internal Medicine, the Association of Program Directors in Internal Medicine, the American College of Physicians, general internal medicine division chiefs, and Veterans Affairs (VA) associate chiefs of staff for ambulatory care rated the compendium. MEASUREMENTS AND MAIN RESULTS: Eleven objectives and nine clinical topics were rated "critically important" (4.7 or above on a five-point scale). General internal medicine chiefs and associate chiefs of staff for ambulatory care judged them to be covered adequately in fewer than half of the 17 VA Western Region-affiliated internal medicine programs. Forty-five objectives and 77 clinical topics were considered at least somewhat important to the education of general internal medicine residents in primary care. The VA raters reported that in the prior academic year, their housestaffs had spent between 21% (postgraduate year I) and 33% (postgraduate year III) of their time in ambulatory care settings. CONCLUSION: With the emphasis on primary and managed care, there is a need for national consensus on educational objectives in primary care general internal medicine. This review provides educators with a benchmark to test the adequacy of their institutions' curricula in primary care internal medicine.

Ambulatory Care↗
PubMed1993

Validating a compendium of goals and objectives for educating CNS students in ambulatory care.

In fall 1990, the Department of Veterans Affairs launched a Pilot Ambulatory Care and Education program that has as its major goal the shift from a traditional inpatient specialty-based focus of patient care and health professional education to a more forward-looking outpatient generalist-based focus of care and education. The generalist and specialist focus of the CNS role has been introduced in this innovative ambulatory care program. Formal and informal educational opportunities for interdisciplinary team members and students abound. This article describes the development and validation of a compendium of goals and objectives for educating CNS students in ambulatory care.

Ambulatory Care↗
PubMed1993

The critical shortage of geriatrics faculty.

To estimate the adequacy of current and future supply of geriatrics faculty, we conducted a national survey to determine the current supply of geriatrics faculty in five specialties and compared these estimates to standards for optimal faculty supply in geriatrics. Finally, we generated a model to project future faculty supply based on both current training capacity and differing assumptions regarding future training capacity. Our findings indicate that the current supply of geriatrics physician faculty is less than half the number needed in each specialty. (Existing numbers range from a high of 909 faculty in internal medicine to a low of 86 in physical medicine.) Moreover, given the current capacity for training, there will be a net loss of such faculty each year in each specialty. We conclude that the number of geriatrics faculty currently available is insufficient to provide an appropriate "core" level of geriatrics training for all undergraduate medical students and residents in relevant residency programs. In addition, the current training capacity for geriatrics faculty cannot even sustain the current level of faculty over the next 10 years. To correct the current and future deficit, substantial increases in both geriatrics fellowship positions and mid-career training positions will be necessary.

Career Mobility↗
PubMed1991

Geriatrics faculty in the United States: who are they and what are they doing?

Despite increases in geriatrics training at all levels of medical education, there is a nationwide shortage of geriatrics faculty. This shortage may be due in part to demands for clinical responsibilities that preclude adequate time for teaching and research. To learn about the professional activities of geriatrics faculty, we conducted a national survey of a 50% sample of all medical schools and their affiliated residency programs that focused on physician and non-physician geriatrics faculty in internal medicine, family practice, psychiatry, neurology, and physical medicine and rehabilitation. Although we found minor differences across specialties, in general, approximately one-third of physician faculty time is spent in teaching, the majority of which is clinical teaching. Less than 15% of physician faculty time is spent in research, and fewer than 10% of physician geriatrics faculty devote over half of their time to research. The percentage of time that non-physician faculty (other than "Research Only" faculty) spend in research is only slightly higher. These findings suggest that efforts to increase geriatrics education at all levels and promote research advances will be limited unless geriatricians devote substantially more of their time to these responsibilities.

Clinical Medicine↗
PubMed1990

Geriatrics in residency programs.

To determine how well geriatrics has been integrated into residency training, the authors surveyed a random 33% sample of all the 378 family practice (n = 126) and 420 internal medicine (n = 140) training programs in the United States in 1988. All the programs responded. On average, the internal medicine programs had more geriatrics faculty than did the family practice faculty, but these numbers were insufficient to meet current or future needs. Fewer than half of the residencies had geriatrics inpatient or ambulatory-care evaluation units, geriatrics consult services, geropsychiatry wards, or geriatrics clinics available as training sites. In contrast, nursing homes were available for 93% of the family practice programs and 58% of the internal medicine programs. A total of 80% of the family practice programs but only 36% of the internal medicine programs had geriatrics curricula in place. The authors conclude that integration of geriatrics content into residency training is far from universal, largely because of a shortage of faculty and clinical training sites.

Curriculum↗
PubMed1982

A study of geriatric training programs in the United States.

Training physicians in geriatrics is essential to improving health care for the elderly. The study reported here provides a detailed analysis of geriatric education at the undergraduate, graduate, and fellowship levels. The number of programs for medical students and residents has increased but is still relatively few; most are elective, and they are of variable quality. Both the number of fellowship programs (36) and positions (87) and the current number of yearly graduates (40) are quite small. Few of these programs have been thoroughly evaluated. Data are presented on the type of training sites, educational activities, and clinical interaction at different levels of training. Overall, the nursing home is most frequently used as a training site, and trainees have contact with many care providers. Information of this kind may be of value to those planning or conducting geriatric programs. The results suggest that there is a persistent need for high quality programs at all levels of educational continuum and that such efforts should be evaluated to ensure and improve quality.

Aged↗
PubMed1982

Studies in geriatric education: II. educational materials and programs.

There has recently been an increase in educational programs and materials in geriatrics, but their quality and content have not been adequately assessed. This study concerns important objectives and core contents in geriatric education, with a review of training programs, books, and audiovisual materials. Specific areas of need for printed and audiovisual materials are identified. Medical student and graduate level programs were found to address relatively few objectives. Geriatric fellowship programs, although having more extensive coverage, had some notable deficiencies. This information may be of use to those conducting training programs or preparing educational material in geriatrics.

Aged↗
PubMed1982

Studies in geriatric education: I Developing educational objectives.

This study reports on the development of a comprehensive set of objectives for the education of undergraduates, graduates, and fellows in geriatric medicine. The objectives were derived from reviews of available educational materials and programs, and their significance was validated through consensus techniques that included over 100 workers with special expertise in geriatrics and gerontology from the United States. Canada, and the United Kingdom. A related and supplementary investigation, which also used consensus methods, uncovered ten general and disease-specific objectives considered to be essential outcomes of the education of geriatric fellows. Academic departments and specialty and subspecialty organizations should find the total set of objectives useful for planning and evaluating educational programs in geriatrics.

Canada↗