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Implementation and evaluation of a "works-in-progress" session to promote scholarship in an academic hospitalist group.

ABSTRACT: Hospitalists frequently work on diverse projects, but often do not have the training and experience necessary to translate projects into peer-reviewed publications and grants.Describe implementation and effect of a works-in-progress (WIP) series on progress and training in scholarly work.Cross-sectional survey.Urban academic medical center.A weekly WIP session, named Incubator, serving as a forum where researchers, clinicians, and educators meet to review and provide feedback on projects underway across the Division of Hospital Medicine.We surveyed presenters at Incubator to evaluate the impact of Incubator on scholarly activities. Responses were based on Kirkpatrick's 4-level training hierarchy: (1) Reaction: participants' satisfaction; (2) Learning: knowledge acquisition; (3) Behavior: application of skills; and (4) Results of projects. We compared responses between researchers and nonresearchers using ?2 tests.Of 51 surveys completed (response rate 70%), 35 (69%) projects were nonresearcher led. Reaction, behavior change, and results were all positive, with >90% respondents reporting a positive outcome in each category, a high rate of publication/funding, and 35% reporting learning as a result of Incubator. Comparison of researchers and nonresearchers revealed no significant differences, except nonresearchers reported significantly more favorable results in behavior and mentoring (P < 0.05).A regularly scheduled, researcher-led WIP session within a largely clinically oriented hospital medicine division can provide a venue for feedback that may promote progress and practical training in scholarly projects. In addition to robust career mentorship programs and protected time, a WIP can be an adjunct to improve scholarly output among academic hospitalists. Journal of Hospital Medicine 2016;11:719-723. © 2016 Society of Hospital Medicine.

SUBMITTER: Patel H

PROVIDER: S-EPMC5446209 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

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Implementation and evaluation of a "works-in-progress" session to promote scholarship in an academic hospitalist group.

Patel Hemali H Fang Margaret C MC Harrison James D JD Auerbach Andy A Kangelaris Kirsten Neudoerffer KN

Journal of hospital medicine 20160613 10

<h4>Background</h4>Hospitalists frequently work on diverse projects, but often do not have the training and experience necessary to translate projects into peer-reviewed publications and grants.<h4>Objective</h4>Describe implementation and effect of a works-in-progress (WIP) series on progress and training in scholarly work.<h4>Design</h4>Cross-sectional survey.<h4>Setting</h4>Urban academic medical center.<h4>Intervention</h4>A weekly WIP session, named Incubator, serving as a forum where resea ...[more]

PMID: 27294477

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Project description:BackgroundGender inequities are documented in academic medicine. Within General Internal Medicine (GIM), there are fewer female division directors and first and last authors on publications. With gender parity in US medical school graduates and with Academic Hospital (AH) medicine being a relatively newer discipline, one might postulate that AH would have less gender inequity.DesignA national survey of AH programs was developed via literature review and expert recommendations. Domains included program and faculty information. Gender of the leader was determined via website or telephone call.ParticipantsLeaders of AH programs associated with the American Association of Medical Colleges (AAMC). Programs without a primary teaching hospital or hospitalist program and those not staffed by university-affiliated physicians were excluded.Main measuresDescription and characteristics of leaders and programs including a multivariable analysis of gender of hospitalist leaders and the portion of female faculty.Key results59% response rate (80 of 135); there were no differences between responders/non-responders in NIH funding (p = 0.12), type of institution (p = 0.09), geographic region (p = 0.15), or year established (p = 0.86). Reported number of female and male faculty were approximately equal. 80% of hospitalist leaders were male; 37% of male hospitalist leaders were professors, no female leaders were professors. In univariate and multivariate analysis only the number of hospitals staffed was a significant predictor of having a female hospitalist leader. There were no significant predictors of having fewer female faculty.ConclusionThis study demonstrated gender inequality in academic hospital medicine regarding leadership and rank. Though there was equal gender distribution of faculty, among leaders most were men and all "full professors" were men. As diversity benefits the tripartite mission research on methods, initiatives and programs that achieve gender equity in leadership are needed.

Project description:Early childhood development (ECD) parenting interventions can improve child developmental outcomes in low-resource settings, but information about their implementation lags far behind evidence of their effectiveness, hindering their generalizability. This study presents results from an implementation evaluation of Msingi Bora ("Good Foundation" in Swahili), a group-based responsive stimulation and nutrition education intervention recently tested in a cluster randomized controlled trial across 60 villages in rural western Kenya. Msingi Bora successfully improved child cognitive, receptive language, and socioemotional outcomes, as well as parenting practices. We conducted a mixed methods implementation evaluation of the Msingi Bora trial between April 2018 and November 2019 following the Consolidated Advice for Reporting ECD implementation research (CARE) guidelines. We collected qualitative and quantitative data on program inputs, outputs, and outcomes, with a view to examining how aspects of the program's implementation, such as program acceptance and delivery fidelity, related to observed program impacts on parents and children. We found that study areas had initially very low levels of familiarity or knowledge of ECD among parents, community delivery agents, and even supervisory staff from our partner non-governmental organization (NGO). We increased training and supervision in response, and provided a structured manual to enable local delivery agents to successfully lead the sessions. There was a high level of parental compliance, with median attendance of 13 out of 16 fortnightly sessions over 8 months. For delivery agents, all measures of delivery performance and fidelity increased with program experience. Older, more knowledable delivery agents were associated with larger impacts on parental stimulation and child outcomes, and delivery agents with higher fidelity scores were also related to improved parenting practices. We conclude that a group-based parenting intervention delivered by local delivery agents can improve multiple child and parent outcomes. An upfront investment in training local trainers and delivery agents, and regular supervision of delivery of a manualized program, appear key to our documented success. Our results represent a promising avenue for scaling similar interventions in low-resource rural settings to serve families in need of ECD programming. This trial is registered at ClinicalTrials.gov, NCT03548558, June 7, 2018. https://clinicaltrials.gov/ct2/show/NCT03548558.

Project description:Education scholarship continues to grow within emergency medicine (EM) and in academic medicine in general. Despite a growing interest, would-be education scholars often struggle to find adequate mentorship, research training, funding, and protected time to produce rigorous scholarship. The ways in which individual academic EM departments can support this mission remains an area in need of description.ObjectivesWe sought to describe academic EM department chairs' perceptions of education scholarship and facilitators and barriers to producing high-quality education scholarship.MethodsWe conducted a qualitative study using a grounded theory-derived approach. Participants were solicited directly, and semistructured interviews were conducted via telephone. Interviews were transcribed verbatim and were analyzed by three study investigators using a coding matrix. Discrepancies in coding were resolved via in depth discussion.ResultsWe interviewed seven EM chairs from academic departments throughout North America (six in geographically diverse regions of the United States and one in western Canada). Chairs described education scholarship as lacking clearly defined and measurable outcomes, as well as methodologic rigor. They identified that education faculty within their departments need training and incentives to pursue scholarly work in a system that primarily expects teaching from educators. Chairs acknowledged a lack of access to education research expertise and mentorship within their own departments, but identified potential resources within their local medical schools and universities. They also voiced willingness to support career development opportunities and scholarly work among faculty seeking to perform education research.ConclusionsAcademic EM chairs endorse a need for methodologic training, mentorship, and access to expertise specific to education scholarship. While such resources are often rare within academic EM departments, they may exist within local universities and schools of medicine. Academic EM chairs described themselves as willing and able to support faculty who wish to pursue this type of work.

Project description:BackgroundTeledermatology (TD) is an evidence-based practice that may increase access to dermatologic care. We sought to use the Exploration, Preparation, Implementation, and Sustainment (EPIS) and the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) frameworks to evaluate implementation of TD at Duke.MethodsThe EPIS and RE-AIM frameworks were deployed to design and implement a TD program that leveraged the strengths of the Duke University Health System and addressed previously reported barriers to implementation of store-and-forward and synchronous TD models. In the resultant hybrid TD model, trained primary care providers (PCPs) sent e-comm referrals with clinical and dermatoscopic images to dermatology. These e-consults were reviewed asynchronously and patients were scheduled for a synchronous video visit with dermatology within days. Dermatologists managed the patient plan. This hybrid TD model was piloted at four primary care clinics. Pertinent outcomes from a TD-adapted RE-AIM framework were tracked using electronic health record data. Patient satisfaction was assessed using a post-video visit survey (n = 18). Implementation barriers and facilitators were also collected through provider surveys (n = 24 PCPs, n = 10 dermatologists, n = 10 dermatology residents).ResultsAt four PCP clinics throughout 9/1/2021-4/30/2022, there were 218 TD referrals. Video visits occurred on average 7.5 ± 0.5 days after referral and 18/18 patients completing the post-visit survey were satisfied. Adoption varied between clinics, with one placing 22% of all dermatology referrals as TD and another placing 2%. The primary PCP barriers to TD were time burdens, lack of fit in clinic flow, and discomfort with image taking. Top-endorsed potential facilitating interventions included allowing for rash referrals without dermoscopy and assurance for clinical evaluation within 3 days.ConclusionsThe use of implementation science frameworks allowed for identification of system and contextual strengths which informed the hybrid TD pilot. Barriers and facilitating interventions will provide guidance for expansion and ongoing maintenance of TD.

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Implementation and evaluation of a "works-in-progress" session to promote scholarship in an academic hospitalist group.

Publications

Implementation and evaluation of a "works-in-progress" session to promote scholarship in an academic hospitalist group.

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