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At least 19 recordsLinked to original sources
PubMed2004

Teaching the basics of clinical pharmaceutical care: innovative pharmacy workshops at the University of Wisconsin and the University of Nebraska.

BACKGROUND: Safe and effective prescription writing, using drug formularies, and managing pharmaceutical care are skills medical students need to acquire. Spurred by the Undergraduate Medical Education for the 21st Century (UME-21) grants, the University of Wisconsin and the University of Nebraska independently developed educational workshops to address these competencies. METHODS: The University of Wisconsin's workshop is presented to medical students at the start of their third year. They receive information from pharmacists on medication errors, prescription writing, and drug formularies. A "learners guide" summary is discussed by a physician, which brings into focus the clinical application of the didactic session. A small-group session follows with hands-on experience in writing prescriptions and using formularies for three patient case scenarios. The workshop at the University of Nebraska consists of three sessions during the third-year internal medicine clerkship. In the first session, pharmacists discuss formularies, the Pharmacy and Therapeutics (PT) committee, and the preparation of a drug monograph. During the second session, students develop an evidence-based drug monograph on a product or herbal. In the final session, the class functions as a mock PT committee, and after listening to the drug monographs, determines whether the product should be added to the formulary. We evaluated students' satisfaction with the workshops using Likert scales and assessed students' ability to correctly fill out a prescription form. RESULTS: Both workshops were well received. The mean rating at University of Wisconsin was 1.7 on a scale of 1 (satisfied) to 7 (dissatisfied), and at University of Nebraska it was 3.8 with 5 (outstanding) to 1 (unacceptable). At the University of Wisconsin, on a year-end skills assessment involving 148 students, 100% of the students properly filled out a prescription. Ninety-four percent received an excellent grade, 6% a pass, and no marginal or failing grades were given out. CONCLUSIONS: The workshop on pharmaceutical prescribing was rated favorably by students. After participating in the workshop, students acquired skills in prescription writing.

Clinical Clerkship↗
PubMed1998

Integrated clinical experience: University of Nebraska Medical Center.

The Integrated Clinical Experience (ICE) at the University of Nebraska College of Medicine is a required, two-year course of study for first- and second-year students. It provides early clinical experiences in primary care settings in metropolitan and rural areas, and related instruction in the social, behavioral, and ethical foundations of medicine. The authors describe the course goals, teaching format, topics, and evaluation of students and faculty. ICE is based on the assumptions that medicine is an applied behavioral science as well as an applied biological science, that critical reflection is important in professional education, and that early exposure to primary care will promote interest in primary care careers. The authors also describe some of the challenges associated with the implementation of this new course of study. These include student dissatisfaction with behavioral and ethical topics, resistance to critical reflection about their personal attitudes and values, and discomfort with "subjective" grading. ICE has also been controversial with some basic science faculty who feel they have had to sacrifice curriculum time to make room for this new program. Also, recruiting the large number of faculty, particularly physicians, needed to run the program has been difficult. Finally, the organization of the curriculum, with basic sciences in the morning and the ICE in the afternoon, may inadvertently reinforce the conceptual split between the biomedical and psychosocial dimensions of medicine. Efforts are under way to address this problem by exploring ways to intergrate the curriculum better.

Attitude of Health Personnel↗
PubMed2006

A historical perspective on the University of Nebraska Medical Center's College of Dentistry Class of 1961.

We conducted a retrospective analysis of the University of Nebraska Medical Center (UNMC) College of Dentistry (COD) Class of 1961 to glean information that might be useful in the design of dental education programs in Nebraska and elsewhere. We scanned annual class newsletters, demographic statistics for students entering the UNMC dental program for each decade from 1961 to 2001, and UNMC COD alumni data for patterns and themes among thirty-two dental professionals. Eighty-four percent of those contacted provided responses to a survey. We found that, like current dental cohorts nationwide, the UNMC COD Class of 1961 is mostly of European ancestry (non-Hispanic) and male. But in contrast to current dental college graduates, the UNMC Class of '61 were able to rely upon self-employment and spousal and/or military support (GI Bill) to cover the costs of their dental education. They also were more likely to enter dental school before completion of an undergraduate degree and have a substantial work history before entering the UNMC dental program. Although the most common reason for attending dental school related to independence and financial security, "time with family" and "family vacations" were the next most important reasons cited for becoming dental professionals. Among '61 graduates, the average number of years spent in the dental profession is thirty-seven years. Despite the notable changes in dental technology and the continual need for updating knowledge and skill, eight members of the UNMC COD Class of 1961 continue to practice dentistry. Most maintain contact with other class members, providing support to former classmates and maintaining an identity with their alma mater, the University of Nebraska.

Cohort Studies↗
PubMed2001

The Interdisciplinary Generalist Project at the University of Nebraska Medical Center.

The Interdisciplinary Generalist Curriculum (IGC) Project at the University of Nebraska College of Medicine (Nebraska) had three goals: (1) to increase first- and second-year students' exposure to primary care practice in the community; (2) to develop specific educational programs introducing these students to the principles and practices of primary care medicine; and (3) to establish a generalist coordinating council to provide leadership and to nurture generalist educational initiatives in the College of MEDICINE: Students at Nebraska were already required to spend three half-days a semester in a longitudinal clinical experience (LCE) and to complete a three-week primary care block experience in the summer between the first and second years. IGC Project funds were used increase the number of required LCE visits to five a semester and to develop curricular enhancements that would maximize the educational potential of community-based clinical experiences for first- and second-year students. Curricular elements developed included a focus on faculty development for preceptors and development of the Primary Care Introduction to Medicine Curriculum, an eight-week, interdisciplinary module scheduled late in the first year to help prepare students for intensive summer rotations. Other developments were the implementation of a pediatric physical examination experience for first-year students and the implementation of instruction in community-oriented primary care in the second year. Lessons learned are related to: (1) the value and power of early clinical experiences; and (2) the enhancing effect of a holistic, longitudinal view of the curriculum on the planning of early clinical experiences.

Curriculum↗
PubMed1992

The impact of transplantation on the clinical laboratory. Experience at the University of Nebraska with bone marrow and liver transplantation.

The number of both bone marrow and solid organ transplantation programs has increased significantly during the past several years. The implementation of these programs and their growth have had a significant impact on the clinical laboratories that are involved in the support of these programs. Between 1983 and 1985, two major organ transplantation programs were implemented at the University of Nebraska Medical Center, Omaha. The clinical laboratories at the University of Nebraska Medical Center have seen a 217% increase in procedure volume and a 165% increase in full-time equivalents during an 8-year period from 1983 to 1991 as a result of these programs. The laboratory procedures that are performed on patients who are undergoing transplantation currently generate approximately $9 million in charges per year. In the present article, I discuss the effect of bone marrow and liver transplantation programs on the entire laboratory and individual laboratory sections.

Academic Medical Centers↗
PubMed1992

Liver transplantation at the University of Nebraska Medical Center from 1985 to 1992.

Based on our 7 and one-half-year experience with liver transplantation at the University of Nebraska Medical Center: 1. Success and growth of the program has been, in part, the result of close interaction and support of the various specialists involved. 2. We have demonstrated that outstanding patient and graft survival rates can be obtained with cyclosporine/prednisone immunosuppression. 3. Few, if any, technical contraindications exist to liver transplantation. 4. Surgical advances have allowed allografts to be salvaged which would otherwise require replacement. 5. Routine donor-liver biopsy prior to implantation has reduced the rate of primary nonfunction. 6. New strategies to improve survival for patients with hepatitis-B-related liver disease and hepatic malignancies undergoing liver transplantation need to be developed. 7. The management of patients with fulminant hepatic failure is evolving and now includes innovative approaches such as the use of ECLS and auxiliary transplants.

Academic Medical Centers↗
PubMed2006

A partnership between the University of Nebraska College of Medicine and the community.

Over the last 20 years, older people have served as teachers for students as part of the formal curriculum in geriatrics at the University of Nebraska Medical Center. In recent years, we have supported a more in-depth, longitudinal experience that connects medical students with elders in the community. The program was initiated as a special project of our Aging Interest Group and is called the Senior Companionship Program (SCP). Although the SCP is optional, when combined with the required experiences for medical students, it triples the contact time that students have with older adults in community settings. The student-run SCP is fostering positive attitudes towards older adults. Comments from participating students indicate that the SCP is a valuable experience, and well worth their time commitment. We describe the program structure, changes to the program based upon the input of participants, as well as the program's strengths, limitations, and prospects.

Adult↗
PubMed1992

Merging the departments of psychiatry of a private and state university: the Nebraska experience.

Medical colleges throughout the nation are being pressured to decrease the costs of medical education. In some of our smaller cities, the duplication of faculty expertise and costly technological resources at distinct but neighboring campuses has led to training costs far beyond what can be comfortably supported by either the institutions or their students. While the trend toward collaboration or mergers between identical medical departments on adjacent campuses is gaining ground, the methods required to achieve success in these ventures remain relatively uncharted. This paper provides an overview of the creation of successful merger between the departments of Psychiatry of Creighton University School of Medicine and the University of Nebraska College of Medicine. The development of the merger from conception to completion, along with the lessons learned along the way, are offered in the hope that other medical departments may benefit.

Academic Medical Centers↗
PubMed1999

Costs of care associated with high-dose therapy and autologous transplantation for non-Hodgkin's lymphoma: results from the University of Nebraska Medical Center 1989 to 1995.

The purpose of this paper was to (1) comprehensively analyze transplant-related costs for predicted temporal cost shifting and (2) to evaluate whether previous findings of decreasing costs of care persisted using a cost analysis of 353 NHL patients who received autologous stem cell transplantation (SCT) at the University of Nebraska Medical Center. All transplant-related costs between the patient's initial consult and program dismissal were obtained and inflated to constant 1995 dollars. Homogeneous resources were categorized into six cost-drivers and subdivided into outpatient, transplant, and additional inpatient time periods in order to evaluate resource utilization and cost shifting patterns. Between 1989 and 1991 both the average length of stay and comprehensive costs decreased 4.9 days and 14%, respectively. By 1995 additional decreases of 25.7 days and 51% led to an overall 7 year cost decline of 65%. Percent contributions of the six cost-drivers remained similar demonstrating uniformed suppression in transplant-related resource consumption. In contrast, the timing of resource utilization changed dramatically, with transplant hospitalization costs accounting for 83% of the overall costs in 1989, 71% by 1992, and only 45% in 1995, while total outpatient's contribution was 14%, 26% and 49%. Before 1991 ebbing costs were likely related to the development of new technologies such as hematopoietic growth factors and peripheral SCT, while the three-fold larger improvement in costs reported by 1995 are presumably associated with learning curve effects such as organizational changes, increased use of coordinated outpatient facilities, and the more cost-effective use of laboratory tests and pharmaceuticals.

Adolescent↗
PubMed1992

Hepatic retransplantation: University of Nebraska Medical Center experience.

The lack of an artificial liver makes liver retransplantation a unique, life-saving procedure when all the other alternatives to save a failed graft have been exhausted. On the other hand, the shortage of donors in line with the increasing number of end-stage liver disease patients who are waiting in long recipient lists represents a dilemma and raises the question of most appropriate recipient selection. In this report, we retrospectively analyzed the results of 350 primary, 48 secondary, and 5 tertiary hepatic transplants performed between July 1985 and January 1990 at University of Nebraska Medical Center. The same immunosuppression protocol was used in each case and the maintenance immunosuppressive therapy consisted of a cyclosporine (CyA) and steroids. The overall survival rate of 80.5% at 1 year which was achieved in the primary grafting group was significantly better than the secondary grafting group (63.0%, p less than 0.05). However, this difference was not significant in pediatric patients and their rates were 73.8% and 71.6% in primary and secondary grafting groups, respectively. When the retransplanted patients were considered as deaths unless secondary grafting was performed, the overall patient survival rate of 69.7% in primary grafting group at 1 yr increased to 77.8% in the retransplanted group and this difference was significant (p less than 0.05). Blood loss and operating time were found to be lower in the retransplanted group. Furthermore, the decrease of the operating time in the retransplanted pediatric patients reached statistical significance (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗