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At least 1,351 records · Page 75Linked to original sources
PubMed1997

Quality improvement in neurology residency programs. Report of the Quality Improvement Committee of the Association of University Professors of Neurology.

The neurology residency programs in the United States are facing a crisis of quality. The Association of University Professors of Neurology (AUPN) approved the Quality Improvement Committee to examine this situation and make recommendations, which have been accepted by the AUPN. The recommendations are (1) that the educational goals of neurology residency training be dissociated from patient-care needs in academic medical centers and (2) that minimum levels of quality be applied to residents in neurology residency programs and to these programs themselves. These minimum criteria should include minimum educational criteria for entry into the program, minimum criteria for advancement from one year to the next in the program, and minimum criteria for performance of the graduates of neurology residency programs for program accreditation. The implementation of these recommendations will require a shift of funding of the care of indigent patients from the graduate medical education budget to direct patient-care sources. These recommendations will significantly improve the quality of neurologists and neurologic care in the United States.

Academic Medical Centers↗
PubMed2002

Using the picture exchange communication system (PECS) with children with autism: assessment of PECS acquisition, speech, social-communicative behavior, and problem behavior.

The picture exchange communication system (PECS) is an augmentative communication system frequently used with children with autism (Bondy & Frost, 1994; Siegel, 2000; Yamall, 2000). Despite its common clinical use, no well-controlled empirical investigations have been conducted to test the effectiveness of PECS. Using a multiple baseline design, the present study examined the acquisition of PECS with 3 children with autism. In addition, the study examined the effects of PECS training on the emergence of speech in play and academic settings. Ancillary measures of social-communicative behaviors and problem behaviors were recorded. Results indicated that all 3 children met the learning criterion for PECS and showed concomitant increases in verbal speech. Ancillary gains were associated with increases in social-communicative behaviors and decreases in problem behaviors. The results are discussed in terms of the provision of empirical support for PECS as well as the concomitant positive side effects of its use.

Autistic Disorder↗
PubMed2005

Quality of life and stress factors for veterinary medical students.

Psychological distress has been shown to affect the academic success, health, emotional well-being, and dropout rates of medical students. Although it can be assumed that stress has similar effects on veterinary students, there is a paucity of research pertaining to the psychological stressors and coping strategies of this group. This article focuses on selected non-academic areas (as identified through a survey of currently enrolled students) that can create significant stressors for veterinary students. Also assessed and discussed here are poor coping strategies (e.g., substance abuse) and gender differences in perceived stressors and coping strategies that emerged from the survey. Results suggest the need for veterinary programs to integrate academic and professional skills instruction with personal life balance training and access to psychological services.

Adult↗
PubMed1995

Will the Opacich fieldwork model work?

One of the dilemmas for occupational therapy fieldwork education is how to maintain and promote a holistic approach when our traditional model is a separatist one. Traditionally and historically, most Level II fieldwork education has been offered in 2- or 3-month experiences, with one affiliation being in a physical disabilities setting, another in a mental health setting, and a third, if chosen, in a pediatrics or specialty setting, although this arrangement has never been prescribed by AOTA. The shortage of psychosocial fieldwork sites and the increasing demands for efficacy have forced us to examine not only how we will meet the unrelenting need for sites but also how we will fulfill the expectations for effective and meaningful applied education for our students. Although health care delivery, and even health care reform, are reimbursement driven, we cannot abandon the humanistic and holistic values on which our profession was built. Reflection on our roots leads us to the importance of the inclusion of psychosocial considerations for every client. One way to accomplish this is to have sites that function within a medical model, where the primary focus is biological, include psychosocial issues in their treatment planning more overtly, just as sites whose primary focus is psychosocial need to become more overt about addressing clients' biological needs. A collaborative approach between academic and fieldwork educators would be necessary to provide training and support for affecting these changes. The fieldwork reconceptualization offered by Opacich is intriguing.(ABSTRACT TRUNCATED AT 250 WORDS)

Holistic Health↗
PubMed1992

Assessing housestaff diagnostic skills using a cardiology patient simulator.

OBJECTIVE: To assess the cardiovascular physical examination skills of internal medicine housestaff. DESIGN: Cross-sectional assessment of housestaff performance on three valvular abnormality simulations conducted on the cardiology patient simulator, "Harvey." Evaluations were done at the beginning (session I) and end (session II) of the academic year. SETTING: Duke University Medical Center internal medicine training program. SUBJECTS: Sixty-three (59%) of 107 eligible internal medicine housestaff (postgraduate years 1 through 3) agreed to participate and completed session I; 60 (95%) completed session II. MEASUREMENTS: All volunteers were tested on three preprogrammed simulations (mitral regurgitation, mitral stenosis, and aortic regurgitation). RESULTS: The overall correct response rates for all housestaff were 52% for mitral regurgitation, 37% for mitral stenosis, and 54% for aortic regurgitation. No difference was noted in correct response rates between sessions I and II. For mitral regurgitation, correct assessment of the contour of the holosystolic murmur predicted a correct diagnosis (P = 0.002). For mitral stenosis, identification of an opening snap and proper characterization of the mitral area diastolic murmur predicted a correct diagnosis (P < 0.0001). No individual observations were noted for the aortic regurgitation simulation, whose identification by the housestaff was associated with a correct diagnosis. CONCLUSIONS: Housestaff had difficulty establishing a correct diagnosis for simulations of three common valvular heart diseases. Accurate recognition of a few "key" observations was associated with a correct diagnosis in two of the three diseases. Teaching housestaff to elicit and interpret a few critical signs accurately may improve their physical diagnosis abilities.

Cardiology↗
PubMed1995

Apples & oranges: a look at cultural diversity.

Both assimilating into another culture and developing an understanding of our own culture require a process of several stages. With the goal of assisting in the cultural awareness training of home care staff, the author offers some academic theories concerning cultural transitions.

Acculturation↗
PubMedDate not supplied

The university and the needs of the society: what professional models?

An overview of the complex Italian situation and the consequences of the European integration, which puts an emphasis on the role of research and education involving the universities and the specific faculties, is given. Attention is then focused on the characteristics of the evolution of the medical activity and health services as for prevention, health education, more extensive knowledge and the need for continuing education. Different problems are tackled and pertinent suggestions are offered. The cultural and professional perspectives of the doctor should be considered within a new psychosocial approach to the illness, super- and hyper-specialization, collaboration and skills in non traditional fields. Medical education should be based on tutorial teaching and student-centered rather than on the traditional teacher centered-academic teaching. For better health care medical education and training should be updated with respect to the doctor-patient relationship as well as to the technological advances and team-work in medicine. The ethical aspects of the medical profession should be evidenced to be able to tackle the involved problems. The main features of the doctor of the future are the need and the difficulty of updating and life-long learning.

Education, Medical↗
PubMed2003

The specialty of colon and rectal surgery: its impact on patient care and role in academic medicine.

The specialty of colon and rectal surgery, a specialty of general surgery, has evolved from the field of proctology. Clinical care has demonstrated decreased number of patients requiring intestinal stomas, improved quality of life in patients with benign anorectal disorders, and more favorable results in patients afflicted with primary and recurrent colorectal cancer. Basic science investigations have spawned from clinical questions such as the molecular biology of colorectal cancer, use of cyclooxygenase inhibitors and polyp regression, and novel cytokine antagonists in inflammatory bowel disease. Medical students are exposed to surgeons with expertise in anorectal anatomy and physiology, mechanisms of carcinogenesis and the importance of screening for detection of colorectal cancer, and novel therapies for inflammatory bowel disease. Surgical residents benefit by having a colorectal surgeon on the faculty by repetitive exposure to anorectal surgery, low pelvic anastomoses, stoma creation and closure, and surgery involving the small intestine. Senior colorectal surgeons will develop critical pathways for the healthcare delivery of patients afflicted with colorectal disease. The specialty of colorectal surgery will continue to translate into improved patient care and positively impact in academic medicine by providing expertise into student and resident training and generate highly sophisticated clinical and basic science investigations.

Colon↗
PubMed1990

Medical education for alcohol and other drug abuse in the United States.

Initiatives by individuals, private foundations and government have led to improvements in the United States in medical education dealing with alcohol and drug-related problems. Progress has been made, particularly in the past 5 years, in developing new medical school curricula and in faculty development. Greater activity by national professional organizations has helped raise the priority of training in alcohol- and drug-related areas for undergraduate and postgraduate medical education. As an example, Project ADEPT (Alcohol and Drug Education for Physician Training in primary care) at Brown University in Providence, Rhode Island, is described. The importance of positive and motivated faculty role models and of skills training is emphasized.

Academic Medical Centers↗
PubMed1983

Developing concepts and patterns of primary care.

Kupat Holim, the Health Insurance Institution of the General Federation of Labor in Israel, provides prepaid health insurance and comprehensive, nationwide health services for approximately 80% of the population of Israel. New concepts and patterns of care developed and implemented by Kupat Holim over recent years include an extended team with new kinds of primary care providers, health education activities, prevention, increased home care, and changes in the schedules and in the planning of clinics. These changes have required new concepts of training and education with close cooperation between services and academic institutions.

Community Health Centers↗
PubMedDate not supplied

Components of effective faculty orientation.

A number of factors make effective faculty orientation even more important for family medicine. Surveys indicate that the small number of available new faculty tends to be young and relatively inexperienced in academic medicine and that many go directly from residency training into faculty positions. Once in these roles, new faculty may find few senior colleagues to serve as experienced guides. Reports show that many department chairs plan to step down soon and may not be available as role models. The components of effective orientation are explained, along with their relationship to professional success. Recommendations are made for family medicine programs.

Faculty, Medical↗
PubMed1995

The development of family medicine in Israel.

Israeli family medicine provides an example of the accelerated development of a new discipline. This development occurred in a highly dynamic and rapidly growing society against a background of conflicting cultural traditions within the health care field. The developmental stages included: 1) the preponderance of specialists over generalists, 2) the introduction of family medicine teaching into the undergraduate medical curriculum, 3) the achievement of family medicine's independence from the status of a branch of internal medicine or community medicine, 4) the development of the residency training programs, and 5) the establishment of a national academic infrastructure. This paper analyzes the unsolved problem of gaining significant numbers of university academic appointments. Also, two major challenges for the future are examined: 1) the integration of preventive care into family practice, and 2) the exposure of primary care to competition from hospital-based specialists in an atmosphere of increasing commercialism. The Israeli experience forms a basis for comparison for family medicine in other countries.

Cross-Cultural Comparison↗
PubMed1997

[The School of Medicine of the Universidad de La Frontera].

The School of Medicine of Universidad de La Frontera is the result of a tight relationship between teaching and patient care. Its recent development is based on the strengthening of international bonds. Curricular innovation is an important accomplishment, mandated by the strategic setting up of its academic corps. The aim of undergraduate teaching is to train health professionals able to successfully face prevalent health problems, with health team management capabilities, that work in close relationship with the community, with continuous educational, research, communicational and learning skills and with a solid ethical and humanitarian education. Student based education using priority health problems as models, small group tutorials and community training are the bases of medical training for the next century.

Chile↗
PubMed2006

Academic health centers and public health departments: partnership matters.

BACKGROUND: The Institute of Medicine has called for increased population-based training for healthcare professions students, and particularly medical students. For this to be effective, students should receive such training in the locations where population-based approaches to care take place, such as public health departments (HDs). However, little is known about currently existing relationships between academic health centers (AHCs) and HDs. METHODS: During the spring and summer of 2003, e-mail surveys on this topic were sent to the 104 members of the Association of Academic Health Centers, and 500 members of the National Association of City and County Health Officers and the Association of State and Territorial Health Officers. Results were received from 50 AHCs and 201 HDs. RESULTS: Survey results suggest that large numbers of healthcare professions students--residents, medical students, and others--are currently being trained in many HDs nationwide. The web of relationships between AHCs and HDs extends beyond education into research, service, and other purposes. CONCLUSIONS: These preliminary results require verification. Nevertheless, they raise questions about the types and quality of the education being offered in health departments, the impact of AHC/HD relationships on both parties, and how existing relationships may be enhanced to meet current and future national needs.

Academic Medical Centers↗
PubMed2000

Confidence of academic general internists and family physicians to teach ambulatory procedures.

OBJECTIVE: To evaluate and compare the readiness of academic general internal medicine physicians and academic family medicine physicians to perform and teach 13 common ambulatory procedures. DESIGN: Mailed survey. SETTING: Internal medicine and family medicine residency training programs associated with 35 medical schools in 9 eastern states. PARTICIPANTS: Convenience sample of full-time teaching faculty. MEASUREMENTS AND MAIN RESULTS: A total of 331 general internists and 271 family physicians returned completed questionnaires, with response rates of 57% and 65%, respectively. Academic generalists ranked most of the ambulatory procedures as important for primary care physicians to perform; however, they infrequently performed or taught many of the procedures. Overall, compared with family physicians, general internists performed and taught fewer procedures, received less training, and were less confident in their ability to teach these procedures. Physicians' confidence to teach a procedure was strongly associated with training to perform the procedure and performing or precepting a procedure at least 10 times per year. CONCLUSIONS: Many academic general internists do not perform or precept common adult ambulatory procedures. To ensure that residents have the opportunity to learn routine ambulatory procedures, training programs may need to recruit qualified faculty, train current faculty, or arrange for academic specialists or community physicians to teach these skills.

Adult↗
PubMed2005

Laparoscopic Roux-en-Y gastric bypass: differences in outcome between attendings and assistants of different training backgrounds.

BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is associated with a significant learning curve. We hypothesize that differences in surgeon and assistant training backgrounds may significantly impact outcomes during the learning curve. METHODS: Retrospective analysis was performed on patients undergoing LRYGBP at an academic medical center between January 1998 and August 2003. Operations were performed by surgeons with different training backgrounds: without formal laparoscopic fellowship (S1, n=95); immediately following laparoscopic fellowship (S2, n=100); and with extensive laparoscopic experience post fellowship (S3, n=88). First assistants were attendings, fellows, or residents. The variables analyzed included demographics, operative times, estimated blood loss (EBL), rate of conversion, length of stay (LOS), ICU stay, re-operation/re-admission rate, and complications. Results were analyzed by ANOVA and Fisher's exact test. RESULTS: There were significant differences among surgeons of different training backgrounds in EBL, LOS, rate of ICU admission, and intraoperative and late complications rates. Among assistants of different training levels, there were significant differences in operative time, EBL, intraoperative complication rates and re-admission rates. CONCLUSIONS: Differences in training background of the surgeons resulted in significant differences in outcome, including EBL, LOS, ICU admission and intraoperative and late complication rates. Lower assistant training levels significantly impacted efficiency through lengthened operative times and increased EBL, as well as increased intraoperative complication rates and re-admission rates. Our results suggested that participating in a laparoscopic fellowship and operating with a more experienced assistant may improve outcomes during the learning curve.

Adult↗
PubMed1997

Critical thinking in undergraduate athletic training education.

OBJECTIVE: The purposes of this study were (a) to determine whether or not undergraduate athletic training educators are writing learning objectives that foster critical thinking (CT) skills, and (b) to determine if their written assignments and written examinations are measuring the extent to which students have developed CT skills. DESIGN AND SETTING: Thirty institutions seeking accreditation for their athletic training programs from the Commission on Accreditation of Allied Health Educational Programs in the 1994-95 academic year were asked to provide their curriculum materials (course syllabus, two to three examinations, or both from each athletic training-specific course). SUBJECTS: Thirteen curriculum directors (43%) provided materials. MEASUREMENTS: Each learning objective, examination question, and written assignment was classified as either CT or non-critical thinking (NCT) using Bloom's taxonomy. RESULTS: From 64 usable syllabi, a total of 678 learning objectives were classified as either CT (52%) or NCT (48%). From 81 written examinations, 3215 questions were classified as either CT (14%) or NCT (86%). In addition, a total of 143 written assignments were all classified as CT. CONCLUSIONS: The results of this study indicate that educators fostered more CT in their learning objectives and written assignments than in their written exams. Valid educational instruments (eg, Bloom's taxonomy) may help educators design learning objectives, assignments, and examinations.

Journal Article↗
PubMed1987

Pediatric rheumatology: fellowship training requirements and survey of specialty needs.

This article documents the growth of pediatric rheumatology in the decade since Park City I as an emerging academic pediatric subspecialty. Current staffing patterns are surveyed for our medical schools and estimates of future requirements for fellowship training are provided. Impediments to the necessary growth of this subspecialty for the needs of clinical practice and research are outlined and criteria for certification are reviewed.

Child↗