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PubMed2002

An Assessment of Athletic Training Students' Clinical-Placement Hours.

OBJECTIVE: To establish a time profile to determine how athletic training students use their time in clinical placements and to determine the effects of academic standing, sex, sport type, and risk of injury associated with a sport during athletic training students' clinical placements on instructional, clinical, unengaged, managerial, and active learning time. DESIGN AND SETTING: Subjects were enrolled in clinical placements within National Collegiate Athletic Association Division I athletics, intramural sports, and a local high school. Students were individually videotaped for approximately 4 hours. SUBJECTS: A total of 20 undergraduate athletic training students (17 women, 3 men) from a Committee on Accreditation of Allied Health Education Programs (CAAHEP)-accredited athletic training education program. MEASUREMENTS: We created a conceptual behavioral time framework to examine athletic training students' use of clinical-placement time with the performance domains associated with the 1999 National Athletic Trainers' Association Board of Certification Role Delineation Study. Students' use of time was analyzed with the Behavior Evaluation Strategies and Taxonomies software. RESULTS: Students spent 7% of their overall clinical-placement time in instructional activities, 23% in clinical activities, 10% in managerial activities, and 59% in unengaged activities. Using multiple 3 x 3 factorial analyses of variance, we found that advanced students were engaged in significantly more active learning and clinical time compared with novice and intermediate students. Students assigned to sports in which injuries predominately occur in the upper extremities (upper extremity sports) spent significantly more clinical-placement time unengaged compared with students assigned to sports in which injuries predominantly occur in the lower extremities (lower extremity sports) or in both upper and lower extremities (mixed extremity sports). CONCLUSIONS: In this exploratory study, we examined only the clinical-placement component of 1 athletic training program; therefore, it may not be accurate to generalize the results for all CAAHEP-accredited programs. However, these results can be used by athletic training educators to examine the amount of time students are actually engaged in specific domains of athletic training, to determine the domains in which skills are most commonly being performed, to identify the relationships between the students and clinical instructors or supervisors, and to develop clinical placements in which students learn and practice clinical and educational competencies.

Journal Article↗
PubMed2002

Residency training in emergency ultrasound: fulfilling the mandate.

Although bedside ultrasound is listed in the Model of the Clinical Practice of Emergency Medicine as an integral diagnostic procedure, the manner in which the didactic, hands-on, and experiential components of emergency ultrasound are taught is not specifically prescribed by the Residency Review Committee for Emergency Medicine (RRC-EM) or any single sponsoring group. Seven professional organizations [the American Board of Emergency Medicine (ABEM), the American College of Emergency Medicine (ACEP), the Council of Emergency Medicine Residency Directors (CORD), the Emergency Medicine Residents Association (EMRA), the National Association of EMS Physicians (NAEMSP), the RRC-EM, and the Society for Academic Emergency Medicine (SAEM)] developed the Scope of Training Task Force, with the goal of identifying emerging areas of clinical importance to the specialty of emergency medicine, including emergency department (ED) ultrasound. The Task Force then identified a group of recognized authorities to thoughtfully address the issue of ED ultrasound training. This report represents a consensus of these identified experts on how emergency ultrasound training should be incorporated into emergency medicine residency programs.

Curriculum↗
PubMed1986

Medical oncology manpower training: a position statement of the American Society of Clinical Oncology.

The evolution of Medical Oncology is facing its first major crisis, that of oversupply of trained oncologists. The tabulated number of certified medical oncologists does not constitute all of the physicians practicing Medical Oncology in the United States. Because of the adequate supply of medical oncologists in clinical practice, but a deficiency of academic oncologists dedicated to research careers, a reduction in training programs should emphasize those programs that lack research opportunities. These recommendations are in keeping with the report of the Long-Range Planning Committee of the American Society of Clinical Oncology of March 21, 1984. Plans to expedite these goals are being established.

Medical Oncology↗
PubMed1989

Health promotion and prevention.

Techniques of promotive and preventive health care include: The use of proactive skills in the consultation; and the co-ordinated use of posters and pamphlets with media campaigns. An efficient medical record and patient recall system; and a doctor initiated health check programme with selected patients. A cost effective method of informing practitioners includes: Ensuring access to continuing medical education by supporting FMP and post-graduate medical institutes. The provision of educational material for both the patient and doctor combined with media publicity campaigns. Supporting RACGP CHECKUP and library services for isolated practitioners. Suggested changes to undergraduate medical education are: Promotive and preventive health care delivery needs to be an inbuilt part of the curriculum. Promotive and preventive health care needs to be taught by both academic and private general practitioners who have received tutor training. It should be presented in tutorial form and during student attachment at surgeries. It needs to be followed up by continuing education by postgraduate institutes, the RACGP and FMP. Government input required includes: The provision of increased academic resources and continued funding of FMP. Remuneration for general practitioners who are involved in undergraduate teaching. Alteration of the fee structure to reward quality of care. Allowing Medicare rebate for promotive and preventive health care delivery.

Health Promotion↗
PubMed2005

Trends in ureteropelvic junction obstruction management among urologists in the United States.

OBJECTIVES: To determine current practice patterns in the surgical treatment of ureteropelvic junction obstruction (UPJO) among urologists in the United States. METHODS: Using the American Urological Association directory, an electronic mail survey regarding the surgical management of UPJO was sent to 1040 urologists in the United States with an electronic mail address listed in the roster. RESULTS: The response rate was 37.6%. Of the respondents, 67.4% were in community practice and 32.6% in academic practice. Nearly 53% of the respondents would perform a workup for a crossing vessel before definitive therapy; if no crossing vessel was found, 43.5% would consider Acucise endopyelotomy as the first-line procedure. However, if a crossing vessel was found, 57.4% would perform open pyeloplasty and 34.3% would choose laparoscopic pyeloplasty as their first-line procedure. If pyeloplasty was chosen, community urologists preferred open pyeloplasty (77.6%), and academic urologists preferred laparoscopic pyeloplasty (66.9%). The surgeon's training and experience was the most influential factor in choosing between laparoscopic and open pyeloplasty. If the patient had a failed endopyelotomy in the past, most respondents (90.8%) would perform pyeloplasty for definitive treatment of the UPJO. CONCLUSIONS: Demonstration of a crossing vessel remains an important factor in determining the course of management of a UPJO. During the past 5 years, a growing number of urologists in both academic and nonacademic practices have been performing laparoscopic pyeloplasty for the management of UPJO in adults. Several factors, especially the surgeon's training, have an impact on the choice of procedure. Open pyeloplasty is still performed by a significant number of urologists. These data may be useful in designing physician education programs and/or future investigations to help define standard treatment practices for UPJO.

Adult↗
PubMed2004

Consumers as tutors - legitimate teachers?

BACKGROUND: The aim of this study was to research the feasibility of training mental health consumers as tutors for 4th year medical students in psychiatry. METHODS: A partnership between a consumer network and an academic unit in Psychological Medicine was formed to jointly develop a training package for consumer tutors and a curriculum in interviewing skills for medical students. Student attitudes to mental health consumers were measured pre and post the program. All tutorial evaluation data was analysed using univariate statistics. Both tutors and students evaluated the teaching program using a 4 point rating scale. The mean scores for teaching and content for both students and tutors were compared using an independent samples t-test. RESULTS: Consumer tutors were successfully trained and accredited as tutors and able to sustain delivery of tutorials over a 4 year period. The study found that whilst the medical students started with positive attitudes towards consumers prior to the program, there was a general trend towards improved attitude across all measures. Other outcomes for tutors and students (both positive and negative) are described. CONCLUSIONS: Consumer tutors along with professional tutors have a place in the education of medical students, are an untapped resource and deliver largely positive outcomes for students and themselves. Further possible developments are described.

Attitude of Health Personnel↗
PubMed2005

EUS training and practice patterns among gastroenterologists completing training since 1993.

BACKGROUND: EUS training and practice patterns vary widely. The aim of this study was to assess EUS training methods, volumes, and practice patterns, and to obtain subjective assessment of endoscopic competence from endosonographers. METHODS: A survey was sent to over 1400 U.S. and international gastroenterologists who completed training since 1993. We assessed demographics, whether EUS is performed, how EUS training was obtained, and volume and type of EUS procedures performed in training and at present. Subjective assessment of adequacy of training was also obtained. RESULTS: A total of 157 physicians responded, including 76 EUS performers, of whom 67% completed advanced endoscopy fellowship, 14% were EUS trained during GI fellowship, and 19% learned via other means. EUS performers were subgrouped into those who had and had not completed advanced endoscopy fellowship, and those within and outside of an academic practice. There were significant associations between the number of upper EUS, pancreaticobiliary, and EUS-guided FNAs performed during training (p < 0.001 for all 3 groups) and completion of advanced endoscopy fellowship. Physicians in academic practice performed more EUS and FNAs per month than physicians in other types of practice (p values <0.001 and 0.001, respectively); 93.3% of respondents felt they received adequate instruction in diagnostic EUS, regardless of type of training; 88.9% of EUS performers felt they received adequate instruction in performing FNA. CONCLUSIONS: Most EUS performers are in academic practice. Those with advanced training obtained higher training volumes and perform higher volumes of EUS. The majority of respondents felt well trained regardless of training type and the number of procedures performed during training. This is the first analysis to assess these aspects of EUS training and practice.

Academic Medical Centers↗
PubMed2006

Research careers for American Indian/Alaska Native nurses: pathway to elimination of health disparities.

The health status of American Indians/Alaska Natives lags behind that of the US population. American Indian/Alaska Native (AIAN) nurses are on the front lines of health services for AIAN people. They have the potential to make scientific contributions as well, but are under-represented among researchers working to understand health disparities. The AIAN MS-to-PhD Nursing Science Bridge, at the University of Minnesota, in partnership with the Universities of North Dakota and Oklahoma, provides support for AIAN nurses during the critical training transition from masters of science to doctoral programs. Partner schools collaborate with AIAN elders, medicine people/spiritual leaders, and academic consultants to (1) foster academic success and strengthen the AIAN identity of students during their research training and (2) bring about institutional change to optimize student experiences. Future research programs developed by this cadre of AIAN nurse scientists will contribute scientifically sound, culturally acceptable knowledge to effectively improve the health of AIAN people.

Career Choice↗
PubMed2003

Positioning women's health curricula in US medical schools.

PURPOSE: This survey was undertaken to evaluate the status of women's health curricula at US medical schools. METHODS: The Society for Women's Health Research surveyed 125 US medical schools to gather information on the existence of and institutional funding and support for women's health curricula. RESULTS: After a minimum of 2 reminder emails, 68 schools returned completed surveys for a positive response rate of 54.4%. Thirty (44%) schools responded that they currently offered a women's health curriculum; 12 (18%) schools stated that they had plans to develop one. Of the 42 schools that either offered a women's health curriculum or were planning one, two thirds (n = 28) reported having a designated office responsible for overseeing the curriculum; the Associate Dean of Medicine/Associate Dean of the Medical School was most frequently the person responsible for this office. Overall, more than half of the responding schools reported receiving funding for this office either through general medical school funds (15/28) or from a Dean's fund (9/28). CONCLUSIONS: Our findings suggest that while US medical schools have made great strides in training medical students in women's health, schools can do more to ensure that women's health has an "academic home" within their institutions. Further, efforts to secure adequate funding and train a cross-section of faculty in women's health should be increased.

Curriculum↗
PubMed1993

Determinants of academic survival: survey of AACAP poster authors.

OBJECTIVE: To assess personal and institutional factors that may influence the development and retention of child psychiatry researchers and to estimate academic survival rates of full-time child psychiatry researchers. METHOD: One hundred forty-seven (79%) of 187 physician-first authors of research posters presented at the annual meetings (1984 to 1990) of the American Academy of Child and Adolescent Psychiatrists were surveyed for demographic data, current academic status, level of research involvement, career path from 1984 to 1991, and factors facilitating or hindering research career success. RESULTS: Survival analysis of strictly defined full-time researchers (N = 46) revealed a 67% 7-year survival rate. Significantly higher survival rates were obtained for investigators with more than 2 years of research training or with affiliation with major child psychiatric research institutions when beginning a full-time research position. Both these factors were significant and independent predictors of academic survival. CONCLUSIONS: Research training and affiliation with a major child psychiatric research institution are associated with longer academic survival for full-time researchers.

Adolescent Psychiatry↗
PubMed1994

Preparing generalist physicians: the organizational and policy context.

A combination of financial, regulatory, and professional factors have led to a gradual but pronounced decline in generalist training and practice in the United States. This trend is likely to undergo dramatic reversal, however, as reflected by the diverse range of health care reform proposals incorporating incentives to promote generalist education and primary care practice. Considerable consensus has been reached by a number of professional organizations and public policy groups regarding the broad details of reform of generalist physician training, but key areas of controversy remain with important implications for academic medical centers. In addition, the generalist professional organizations, particularly those of family practice, general internal medicine, and general pediatrics, are being challenged to reconcile historic differences in the definitions and training of generalist competence. In this, the cell for "retraining subspecialists" with both offer an opportunity and entail a risk. Finally, academic medical centers will need new organizational structures that can combine the distinctive intellectual traditions and the expertise of the generalist medical disciplines to develop new approaches to the education and practice of primary care.

Academic Medical Centers↗
PubMed2002

[Should residents operate?].

Surgical training requires that residents have the opportunity to operate. This tradition has now become complicated for teaching surgeons due to work surcharge, to the objective of reducing health costs, and to medical lawsuits. We support the necessity for residents to operate because academic hospitals have a moral and legal obligation to train future surgeons. This objective should be achieved without impairing the quality of care provided, and this must be explained to patients. More widely, the management of surgical training for residents should be rethought to maintain efficiency.

Humans↗
PubMed1986

Social reinforcement: a treatment component in verbal self-instructional training.

This study investigated the effects of noncontingent social reinforcement on social and academic behaviors in grade school children. Twenty-four children in the second through fifth grades were selected on the basis of teacher ratings of disruptive behavior. Subjects were divided into a high social reinforcement verbal self-instructional (VSI) training group, a low social reinforcement VSI group, and a no-contact control group. Children in VSI groups were removed from their classrooms during four 40-minute periods and given VSI training. Significant between-groups differences on measures of social reinforcement were found indicating its successful manipulation. While none of the dependent measures indicated significant differences between experimental groups, a consistent pattern of difference scores emerged giving limited support to the hypothesis that noncontingent social reinforcement contributed to behavioral gains. Results are discussed in terms of the need for future research on the effects of rapport on treatment outcome.

Behavior Therapy↗
PubMed2006

Training welfare caseworkers in service excellence: increasing children's Medicaid coverage.

Many low-income children who are eligible for public sector health insurance remain uninsured. There are many barriers to enrolling these children, but one key issue is parents' reluctance to use the services of the local enrollment agency, which is usually the welfare office. The Eastside Access Partnership, a community-academic coalition on the Eastside of Detroit, addressed the problem of uninsured-but-eligible children through a variety of interventions focused on (1) enhancing community members' understanding of the enrollment process and (2) reducing institutional barriers to enrollment. One of these interventions addressed the institutional barriers by developing a customer service excellence training program for welfare caseworkers. The training program curriculum, which was developed following the principles of community-based participatory research, included extensive input from community residents, welfare agency staff, and academic researchers. The training sessions received positive evaluations from participants and agency executives. A more thorough evaluation of the project is under way.

Child↗
PubMed2002

eLearning: Is There a Place in Athletic Training Education?

OBJECTIVE: To provide an overview of current issue and research literature that discusses the use of eLearning in an academic curriculum. We address several components to be examined before eLearning is incorporated into athletic training education. DATA SOURCES: We searched MEDLINE and Educational Resources Information Center (ERIC) from 2000 through 2002 using the key words distance education, online learning, and the individual research studies referenced in this article. DATA SYNTHESIS: Educational research studies have confirmed that multiple methods in instruction delivery exist. Within the changing culture of higher education, the use of effective communication tools has been shown to increase student knowledge and skills. Through eLearning, methods of instruction design are designed to be student centered and allow the educator to become a facilitator. CONCLUSIONS/RECOMMENDATIONS: Even though the use of eLearning faces many challenges in athletic training education, the research literature does support this method of instructional delivery in selected courses in athletic training education.

Journal Article↗
PubMed1998

Strategies for improving teaching practices: a comprehensive approach to faculty development.

Medical school faculty members are being asked to assume new academic duties for which they have received no formal training. These include time-efficient ambulatory care teaching, case-based tutorials, and new computer-based instructional programs. In order to succeed at these new teaching tasks, faculty development is essential. It is a tool for improving the educational vitality of academic institutions through attention to the competencies needed by individual teachers, and to the institutional policies required to promote academic excellence. Over the past three decades, strategies to improve teaching have been influenced by the prevailing theories of learning and research on instruction, which are described. Research on these strategies suggests that workshops and students' ratings of instruction, coupled with consultation and intensive fellowships, are effective strategies for changing teachers' actions. A comprehensive faculty development program should be built upon (1) professional development (new faculty members should be oriented to the university and to their various faculty roles); (2) instructional development (all faculty members should have access to teaching-improvement workshops, peer coaching, mentoring, and/or consultations); (3) leadership development (academic programs depend upon effective leaders and well-designed curricula; these leaders should develop the skills of scholarship to effectively evaluate and advance medical education); (4) organizational development (empowering faculty members to excel in their roles as educators requires organizational policies and procedures that encourage and reward teaching and continual learning). Comprehensive faculty development, which is more important today than ever before, empowers faculty members to excel as educators and to create vibrant academic communities that value teaching and learning.

Ambulatory Care↗
PubMed1978

Ambulatory neurology in residency training programs: a perspective.

Inpatient care and teaching have been the central theme in academic medicine, including neurology, for the last several decades. However, pressures from within and outside of medicine are building to create a renewed commitment to ambulatory care and education. Most neurology training programs have not yet made that commitment. They should do so for the benefit of both the patients and residents served by the programs. Effective outpatient clinic training programs should include full-time staff devoted to ambulatory care, teaching, and research. The practicing clinical neurology staff could be used more effectively. Regular chart review, case management conferences, and other teaching strategies, and the reorganization of the clinic to include private patients, as well as group practice and interdisciplinary team concepts, could improve both the patient care and resident training in the neurology clinic.

Ambulatory Care↗
PubMed1998

Management training in critical care medicine.

Critical care medicine is the only specialty fellowship which requires formal training in administrative and management skills by its certifying organisation. The rationale for this is the fact that critical care is responsible for some 1% of gross national product, 10% of hospital beds and 30% of acute hospital costs in the USA. The curriculum required during the fellowship training has been defined. In order for critical care medicine to continue to grow as an academic as well as a successful institutional clinical service, it is important that quality training be provided in this non-clinical part of the fellowship curriculum as well as the clinical aspects.

Administrative Personnel↗