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PubMed2004

Assessment of competencies in physicians-in-training through the delivery of a community-based health curriculum using distance learning.

Academic physicians must master the elements of curriculum development and evaluation specific to defined competencies in postgraduate medical education. Six fellows in primary care medicine, working as a peer group with a faculty mentor, designed and evaluated a distance-learning project that included resident physicians. Professionalism, interpersonal skills and systems-based medical practice skills were measured with original instruments designed by the peer group. By the process of evaluation and revision in a peer-group setting and with mentorship from program faculty, experiential learning enhanced the training of future academic physicians. This paper describes the background, process and statistical results of their work.

Academic Medical Centers↗
PubMed1980

Analysis of nurses' knowledge of behavioral methods applied to chronic and acute pain patients.

Thirty-seven nurses with no formal training in behavioral methods were assessed on their knowledge of basic behavioral principles and terminology, the application of behavioral methods with chronic and acute pain patients to decrease negative and increase positive behaviors, and when and with which patients such methods should be applied. Results showed that nurses failed to exhibit adequate understanding of behavioral methods except for their application to decrease negative behavior. Findings are discussed in terms of documenting the need for formal training in behavioral methods as part of nurses' academic curriculum and targeting specific areas that should be emphasized as part of such training.

Acute Disease↗
PubMed2002

Minimally invasive surgery training in Canada: a survey of general surgery.

BACKGROUND: The purpose of this study was to assess the state of surgical training in minimally invasive surgery (MIS) within Canadian academic surgical departments. METHODS: A pretested questionnaire was distributed to the general surgery residents of participating Canadian academic surgical departments. RESULTS: Fourteen of 16 residency programs participated and 235 of 388 residents (60%) responded to the survey. Residents expect to perform both basic (217/235 [92%]) and advanced (123/234 [53%]) MIS procedures on completion of their residency. However, only 41 of 233 (18%) believed that their advanced MIS training would be adequate. On a Likert scale, the most important factors influencing their training included limited advanced case volume (median, 5), limited opportunity in the operating room (OR) (median, 5), lack of attending surgeon interest (median, 4), limited OR time (median, 4), and a lack of surgical department support (median, 4). Residents were concerned about their ability to acquire these skills once they finished their training (median, 4), and 231 of 234 (99%) thought that there was an important role for a MIS surgeon within the academic setting (median, 5). CONCLUSION: The rapid development of MIS has generated complex issues for resident training within the present Canadian academic surgical environment.

Adult↗
PubMed2006

The academic lineage of Sir John Carew Eccles (1903-1997).

This report reviews the academic lineage of Sir John Eccles; who trained him, whom he then trained and with whom he collaborated, and the subsequent impact of his trainees and collaborators on neuroscience and other areas. In a post-training career at five institutions in four countries (Great Britain, Australia, New Zealand, back to Australia, USA) and during retirement in Switzerland, Eccles trained and collaborated with over 180 people (mostly neuroscientists) from 21 countries. Most of them have had stellar research and training records that span the cellular-behavioral-philosophical spectrum of neuroscience, with a focus from peripheral neuromuscular issues to the forebrain. Some have been equally distinguished in other areas of biomedical science. Eccles' academic contributions and lineage are a valuable colloquium topic in a neuroscience training program. His experimental work spanned much of the 20th C before the recent emphasis on the application of the techniques of molecular biology. He continually sought to integrate information from the cellular to the systems and behavioral levels of analysis and synthesis. He also devoted a substantial amount of his intellectual effort to the mind-brain and other philosophical issues. Eccles' prodigious working hours and enthusiasm for his projects were a role model for such trainees. Hard-working trainees often ask how can they retain their all-round interests, and indeed their humanity and citizenry, as they focus more and more on their necessarily narrowly focused neuroscience research. Again, Eccles' writings and overall behavior show that it can indeed be done, but only by the application of extraordinary effort and dedication.

Academic Medical Centers↗
PubMed1998

A comparison of family medicine clerkship student performance across multiple teaching sites.

BACKGROUND AND OBJECTIVES: Family medicine clerkships are frequently conducted in decentralized settings. Concerns have been raised regarding the educational consistency of such rotations. In this study, we assess learning across multiple training sites, as reflected by measures of student performance. METHODS: The study population was 77 students assigned to six clusters of family medicine clerkship training sites during the 1993-1994 academic year. Learning, as measured by faculty evaluations, objective structured clinical examination (OSCE) performance, and Society of Teachers of Family Medicine (STFM) predoctoral examination performance, was compared for student cohorts assigned to each of the teaching site clusters using analysis of variance. RESULTS: No differences in OSCE or STFM examination performance were found across the teaching site clusters. Greater variation in faculty evaluation across sites was apparent, and when the academic and private practice teaching sites were compared with the HMO and community clinics teaching sites, this variation achieved statistical significance. CONCLUSIONS: As measured by OSCE and STFM examination performance, student learning did not vary across multiple training sites. However, greater variability was found in faculty evaluations of student performance. Sources of this variation might include differing levels of student-faculty interactions across sites or subjectivity inherent to the faculty evaluation process.

California↗
PubMed1986

Relationship between expected indebtedness and career choice of medical students.

In this study the authors explored the relationship between medical students' expected indebtedness and their career choice. Based on responses by University of Rochester medical students to a questionnaire, the authors found that total indebtedness, which included family loans and academic loans, was positively related to expected future salary, post-training work mode (that is, private or government practice or academic), and anticipated career choice (general, specialty, or subspecialty). Reported academic indebtedness, however, was not by itself significantly related to these variables. The authors concluded that anticipated high levels of total indebtedness were related to the anticipation of high future income, an intention to enter subspecialty practice, and the expectation of practicing full-time. Implications of these relationships for the field of medicine are outlined.

Career Choice↗
PubMed2006

The administration of music therapy training clinics: a descriptive study.

A two-part study was conducted to describe issues and administrative practices related to university and college affiliated music therapy training clinics. First, all 72 AMTA academic directors were surveyed in order to discover (a) which programs had a clinic, and (b) the reasons why other directors did not operate a clinic. Second, 12 survey respondents, who reported that they were involved with a training clinic, participated in in-depth interviews discussing: (a) their motivations for establishing a clinic, (b) the possible effects of a clinic on the community, (c) the individuals and groups involved in clinic operations, d) clinic space and equipment, (e) policy and procedure topics, (f) specific administrative practices related to clients and students, (g) finances, (h) research (i) quality assurance, (j) dual roles, and (k) liability issues. The administrative practices described by the interviewees varied greatly across clinics and provided a wealth of information that could be considered both useful and thought provoking for those interested in operating a music therapy clinic.

Administrative Personnel↗
PubMed2005

[Teaching and training in geriatric medicine in the European Union].

In 1993 about 20% of the population in the 15 'old' member countries of the European Union (EU) was over 60 years of age and this percentage will increase to more than 25% in 2020. These developments play a key role for the investments in education and training to meet societies needs for health care services. In 2002 about 25% of the medical students in the 'old' EU did not receive any education in geriatric medicine. A question is who will provide the services for older people in related areas, like social care, community care, acute care in the hospitals, long-term care, permanent care and care for psychiatric patients? Geriatric medicine has been recognized as an independent specialty in 8 of the 15 member countries of the 'old' EU. In all EU member states the governments are autonomous regarding all aspects of health care services, including the recognition of specialties and specialist training programmes. A two years training in internal medicine has been recommended in the EU, followed by another four years of training in geriatric medicine. The specialist training has a hospital oriented character, however, it includes also community care and other institutionalised care like nursing homes. The curriculum should contain: biological, social, psychological and medical aspects of common diseases and disturbances in older people. A problem in many EU countries is the shortage of well trained researchers and leading persons for academic positions for geriatric medicine. In a number of countries chairs at the universities remain vacant for long periods of time or even disappear. Good services in the health care for older people need a high quality curriculum and training programme.

Aged↗
PubMed1999

The impact of genetics on medical education and training.

This paper explores, mainly from the UK perspective, some of the issues relating to the current, and potential, impact of advances in genetics and molecular biology on the education and research training of healthcare professionals. We start by describing some of the expectations for progress in the use of genomic technologies and genetic data in healthcare delivery and the need for policy development to ensure timely translation of advances in science and technology into improved patient care. We review briefly the likely evolution of clinical genetics service provision to build the requisite scientific basis in primary care and explore how user needs could be addressed. Strategic issues for the future medical curriculum are introduced and linked with the concerns about the current status of clinical academic research. The issues for research training, career progression, nurturing of research 'at the bedside', definition of the research agenda and weaknesses in both academic infrastructure and support costs are reviewed in the context of the urgent imperative for medicine to harness the accelerating pace of progress in genomics.

Curriculum↗
PubMedDate not supplied

A survey of chairpersons of departments of medicine about the current and future roles of clinical genetics in internal medicine.

PURPOSE: The response of academic Departments of Medicine (DOM), who train the bulk of future US internists, to the increasing importance of clinical genetics is not known. METHODS: A survey was distributed to 153 DOM chairpersons assessing the current and future roles of clinical genetics as related to internal medicine. RESULTS: Eighty-five (56%) surveys with complete data were returned. A minority of DOM currently employ geneticists; most genetics education and services are provided by nongeneticists; the general competency of internists to deliver genetic services is unclear. CONCLUSIONS: Academic DOM have limited faculty expertise in clinical genetics; this may impact the ability to integrate genetics into internal medicine practice and training.

Data Collection↗
PubMed1988

Struggle for identity: the turbulent 1960s.

I. STRUGGLE FOR IDENTITY. The controversy about the name of the Academy surfaced again soon after the 3rd International Congress in Washington in 1960. Watkins reemphasized the need to pronounce it "phys-i-a'trist" and suggested that we be called the American Academy of Physiatrics. Krusen responded by suggesting that the name, American Academy of Physical Medicine & Rehabilitation should be retained since the rest of the world wouldn't recognize us. He pointed out that he had just surveyed 40 countries in the developing phase of physical medicine and rehabilitation, and would not want to confuse the issue. Clearly the field of PM&R will be defined by those who practice the specialty. II. LEGISLATION. The legislation initiating Medicare was extraordinarily influential in redefining the specialty. The legislation creating the Office of Vocational Rehabilitation and the subsequent funding of rehabilitation research and training centers engendered an increased awareness in the academic community of the need for rehabilitation medicine. III. CHANGES IN EDUCATION. The Academy gradually increased in number of members, and began to influence the training of residents with the development of a Resident Guide. Many of the senior members of the Academy re-emphasized the need for research to expand new knowledge and all generated a plea for more academic physiatrists. The R&T centers did provide a mechanism to increase the residency training. The role of the physiatrist in the medical school was defined and promoted in colleague with other specialties.(ABSTRACT TRUNCATED AT 250 WORDS)

History, 20th Century↗
PubMed2005

Resident efficiency in a pediatric emergency department.

OBJECTIVES: To measure the hourly rate of patients evaluated and treated by resident physicians in an academic pediatric emergency department (PED) and examine differences in the rate by subspecialty and year of training. METHODS: For all residents rotating in an academic, urban children's hospital PED, the rate of patients seen per hour over the course of their rotation was calculated using an electronic tracking system, EmSTAT, for calendar year 2000. Rates are reported as the mean number of patients seen per resident hour worked. Mean differences are reported for resident subspecialties (emergency medicine, pediatrics, and family practice) and postgraduate year (PGY1-PGY3), and subclass comparisons were made with an analysis of variance test with Tukey's post hoc analysis. RESULTS: A total of 153 residents (63.4% pediatric, 18.9% family practice, and 17.7% emergency medicine) saw 24,414 patients during the study period. The makeup of the group by training year was as follows: PGY1, 20.9%; PGY2, 41.2%; and PGY3, 37.9%. For all residents, the mean rate was 1.02 patients seen per hour (pph). Significant differences in the mean number of patients seen per hour by subspecialty existed, with emergency medicine residents seeing a mean of 1.12 pph, pediatrics residents seeing 1.02 pph, and family practice residents seeing 0.93 pph (mean difference, p < 0.05 for all comparisons). Rates increased by year of training, with PGY1 seeing a mean of 0.95 pph, PGY2 seeing 0.99 pph, and PGY3 seeing 1.09 pph (mean difference, p < 0.05 for all comparisons except PGY1 vs. PGY2). CONCLUSIONS: Significant differences in the rate of patients evaluated and treated in the PED exist by resident subspecialty and year of training. Knowing these rates is helpful in evaluation of resident performance, because it allows comparison with peers. Additionally, such information may be useful for residency program evaluators to gauge the amount of patient exposure for residents.

Educational Status↗
PubMed1998

Building nursing informatics courses on the Web.

The Information Technology is rapidly being integrated into Educational Institutions and Health Care Environments. Although the use of computer for education and training is not new to the academic society, further prospects are available through the use of emerging technologies as the Multimedia and the World Wide Web. In today's rapidly changing healthcare environment, the need for high quality, cost effective education for employees, consumers, and students is gaining increased attention. The development of customised computer-based training programs has long been beyond the capabilities or financial resources of most healthcare organisations; however, with recent advancements in technology, this situation is rapidly changing. The Nurses represent the greater part of the Health Care Professionals thus the education of this group is of outmost importance for the health-care environments. The World Wide Web can be used as an educational tool in order to have better-educated Nurses not only by supporting the Academic institutions but also by providing Distance Learning Education covering new aspects of the Nursing Science. The purpose of this paper is to increase the understanding of the ways in which the emerging technologies of Multimedia and the World Wide Web can enhance the learning process, and also provide education at a distance.

Computer Communication Networks↗
PubMed1986

The otolaryngologist's attitude to facial plastic surgery.

Of 453 Canadian otolaryngologist, 226 responded to a questionnaire, indicating significant interest in the state of facial plastic and reconstructive surgery. The majority of these otolaryngologists practised in larger cities and one-quarter received foreign training. Half of the respondents had academic affiliations and three-quarters considered themselves general otolaryngologists. Almost all the otolaryngologists believed that cosmetic and reconstructive surgery should form a major part of their specialty, this being unanimous among current residents. A large majority felt there should be more facial plastic surgical training, this both at the residency and fellowship levels, preferably through increased surgical exposure. With respect to sub-certification, only the resident group was in favor.

Attitude of Health Personnel↗
PubMed1982

The effectiveness of visual information processing training with hispanic children.

The purpose of this study was to determine whether one kind of visual information processing training improves performance on visual tasks and on academic achievement. One hundred fifty-three kindergarten, first- and second-grade Hispanic children who were poor visual processors were randomly assigned to either a training, a contrast, or a control group. The training group received tutoring in visual-information processing for approximately seven weeks while the contrast group was given small group instruction with regular curriculum materials. At the conclusion of the training all Ss were administered several visual tasks and achievement measures. Results indicated that only the tutored children performed significantly better than the other children on the Bender Gestalt test and that the attained visual motor integrative skills were maintained over a period of time. However, training in visual processing skills did not increase performance on academic tasks or on a task of basic concepts.

Achievement↗
PubMed1998

Characteristics of psychiatrists who perform ECT.

OBJECTIVE: Use of ECT is highly variable, and previous study has linked its availability to the geographic concentration of psychiatrists. However, less than 8% of all U.S. psychiatrists provide ECT. The authors analyzed the characteristics of psychiatrists who use ECT to understand more fully the variation in its use and how changes in the psychiatric workforce may affect its availability. METHOD: Data from the 1988-1989 Professional Activities Survey were examined to investigate the influence of demographic, training, clinical practice, and geographic characteristics on whether psychiatrists use ECT. RESULTS: Psychiatrists who provided ECT were more likely to be male, to have graduated from a medical school outside the United States, and to have been trained in the 1960s or 1980s rather than the 1970s. They were more likely to provide medications than psychotherapy, to practice at private rather than state and county public hospitals, to treat patients with affective and organic disorders, and to practice in a county containing an academic medical center. CONCLUSIONS: Demographic and training characteristics significantly influence whether a psychiatrist uses ECT. Opposing trends in the U.S. psychiatric workforce could affect the availability of the procedure. Expanding training opportunities for ECT and making education, training, and testing more consistent nationwide could improve clinicians' consensus about ECT and narrow variation in its use.

Confidence Intervals↗