Pandemics and Innovation: How Medical Education Programs Can Adapt Extraclinical Teaching to Maintain Social Distancing.
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ABSTRACT:
SUBMITTER: Sharif S
PROVIDER: S-EPMC8015769 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundTo provide optimal care, medical students should understand that the social determinants of health (SDH) impact their patients' well-being. Those charged with teaching SDH to future physicians, however, face a paucity of curricular guidance.ObjectiveThis review's objective is to map key characteristics from publications about teaching SDH to students in undergraduate medical education (UME).MethodsIn 2016, the authors searched PubMed, Embase, Web of Science, the Cochrane and ERIC databases, bibliographies, and MedEdPORTAL for articles published between January 2010 and November 2016. Four reviewers screened articles for eligibility then extracted and analyzed data descriptively. Scoping review methodology was used to map key concepts and curricular logistics as well as educator and student characteristics.ResultsThe authors screened 3571 unique articles of which 22 were included in the final review. Many articles focused on community engagement (15). Experiential learning was a common instructional strategy (17) and typically took the form of community or clinic-based learning. Nearly half (10) of the manuscripts described school-wide curricula, of which only three spanned a full year. The majority of assessment was self-reported (20) and often related to affective change. Few studies objectively assessed learner outcomes (2).ConclusionsThe abundance of initial articles screened highlights the growing interest in SDH in medical education. The small number of selected articles with sufficient detail for abstraction demonstrates limited SDH curricular dissemination. A lack of accepted tools or practices that limit development of robust learner or program evaluation was noted. Future research should focus on identifying and evaluating effective instructional and assessment methodologies to address this gap, exploring additional innovative teaching frameworks, and examining the specific contexts and characteristics of marginalized and underserved populations and their coverage in medical education.
| S-EPMC6502919 | biostudies-literature
Project description:BackgroundProfessionalism is a core competency of medical residents in residency programs. Unprofessional behavior has a negative influence on patient safety, quality of care, and interpersonal relationships. The objective of this scoping review is to map the range of teaching methods of professionalism in medical residency programs (in all specialties and in any setting, whether in secondary, primary, or community care settings). For doing so, all articles which are written in English in any country, regardless of their research design and regardless of the residents' gender, year of study, and ethnic group will be reviewed.MethodsThis proposed scoping review will be directed in agreement with the methodology of the Joanna Briggs Institute for scoping reviews. The six steps of Arksey and O'Malley methodological framework for conducting scoping reviews, updated by Levac et al. (Implement. Sci. 5(1): 69, 2010) will be followed. The findings from this study will be merged with those of the previous Best Evidence Medical Education (BEME) systematic review. All published and unpublished studies from 1980 until the end of 2019 will be reviewed, and the previous BEME review will be updated by the findings of the articles from the beginning of 2010 until the end of 2019. All research designs and all credible evidence will be included in this review.ConclusionsConducting this scoping review will map the teaching methods of professionalism and will provide an inclusive evidence base to help the medical teachers in the choosing for proper teaching methods for use in their teaching practice.Systematic review registrationNot registered.
| S-EPMC7719236 | biostudies-literature
Project description:BackgroundNutrition medical education training programs that are focused on home cooking are emerging.ObjectiveThis short communication describes the first synchronous tele-nutrition medical education training program using a novel Culinary Coaching (CC) model.DesignSeven health coaches were trained and each coach delivered CC programs to four patients (28 total). Evaluations included:1) two questionnaires before, immediately after, and six months post training program; and 2) one questionnaire after each patient program.ResultsCC training significantly improved coaches' attitudes about and confidence to deliver CC from pre-program means of 3.61 and 3.65 (out of 5), respectively, to post-program means, 3.77 (p<0.01) and 3.86 (p<0.05), respectively, and remained higher 6 months after the training program (3.93, p<0.01; 3.93, p<0.05). Health coaches described a high usage of CC principles and tools through the patient programs.ConclusionsThis early evidence suggests that the CC model can be successfully expanded to health coaches, thus improving nutritional care.
| S-EPMC6127849 | biostudies-literature
Project description:We develop a model of induced innovation that applies to medical research. Our model yields three empirical predictions. First, initial death rates and subsequent research effort should be positively correlated. Second, research effort should be associated with more rapid mortality declines. Third, as a byproduct of targeting the most common conditions in the population as a whole, induced innovation leads to growth in mortality disparities between minority and majority groups. Using information on infant deaths in the U.S. between 1983 and 1998, we find support for all three empirical predictions.
| S-EPMC4140440 | biostudies-literature
Project description:Educating physicians early and often on how to have conversations with patients about diet to prevent and treat chronic disease is imperative, yet under realized. Some innovative medical schools have begun implementing hands-on cooking (HOC) programs to fill this gap, but how these programs are promoted is unknown. This study assessed the prevalence and innovation characteristics of HOC programs offered to medical students in the USA. Content analysis of webpages was conducted using a Diffusion of Innovation (e.g., relative advantage, compatibility, complexity, trialability, and observability) framework. Themes of relative advantage included increasing students' confidence, improvements in medical and interprofessional education, and translating into a benefit to patients through improved care. Compatibility codes showed only a quarter of webpages referred to the program as "evidence-based." Complexity codes showed most (86%) webpages clearly described the course. About half the webpages described the program as an elective, suggesting trialability of this innovation. Many (43%) of the programs referenced use of a standardized "culinary medicine" curriculum, contributing to the observability of this innovation. Within the sample of schools, 35% provided HOC programs for their students. These findings suggest HOC programs have a strong foothold in healthcare education and provide a framework from which future studies might examine what effects innovative, successful HOC programs have on curriculum development, student experience, and, ultimately, patient outcomes.
| S-EPMC8368565 | biostudies-literature
Project description:BACKGROUND:With the increasing recognition that leadership skills can be acquired, there is a heightened focus on incorporating leadership training as a part of graduate medical education. However, there is considerable lack of agreement regarding how to facilitate acquisition of these skills to resident, chief resident, and fellow physicians. METHODS:Articles were identified through a search of Ovid MEDLINE, EMBASE, CINAHL, ERIC, PsycNet, Cochrane Systemic Reviews, and Cochrane Central Register of Controlled Trials from 1948 to 2019. Additional sources were identified through contacting authors and scanning references. We included articles that described and evaluated leadership training programs in the United States and Canada. Methodological quality was assessed via the MERSQI (Medical Education Research Study Quality Instrument). RESULTS:Fifteen studies, which collectively included 639 residents, chief residents, and fellows, met the eligibility criteria. The format, content, and duration of these programs varied considerably. The majority focused on conflict management, interpersonal skills, and stress management. Twelve were prospective case series and three were retrospective. Seven used pre- and post-test surveys, while seven used course evaluations. Only three had follow-up evaluations after 6 months to 1 year. MERSQI scores ranged from 6 to 9. CONCLUSIONS:Despite interest in incorporating structured leadership training into graduate medical education curricula, there is a lack of methodologically rigorous studies evaluating its effectiveness. High-quality well-designed studies, focusing particularly on the validity of content, internal structure, and relationship to other variables, are required in order to determine if these programs have a lasting effect on the acquisition of leadership skills.
| S-EPMC7268469 | biostudies-literature
Project description:ImportanceOral health care faces ongoing workforce challenges that affect patient access and outcomes. While the Medicare program provides an estimated $14.6 billion annually in graduate medical education (GME) payments to teaching hospitals, including explicit support for dental and podiatry programs, little is known about the level or distribution of this public investment in the oral health and podiatry workforce.ObjectiveTo examine Medicare GME payments to teaching hospitals for dental and podiatry residents from 1998 to 2018, as well as the distribution of federal support among states, territories, and the District of Columbia.Design, setting, and participantsThis cross-sectional study was conducted using data from 1252 US teaching hospitals. Data were analyzed from May through August 2020.ExposuresDental and podiatry residency training.Main outcomes and measuresMedicare dental and podiatry GME payments were examined.ResultsAmong 1252 teaching hospitals, Medicare provided nearly $730 million in dental and podiatry GME payments in 2018. From 1998 to 2018, the number of residents supported more than doubled, increasing from 2340 residents to 4856 residents, for a 2.1-fold increase, while Medicare payments for dental and podiatry GME increased from $279 950 531 to $729 277 090, for a 2.6-fold increase. In 2018, an estimated 3504 of 4856 supported positions (72.2%) were dental. Medicare GME payments varied widely among states, territories, and the District of Columbia, with per capita payments by state, territory, and district population ranging from $0.05 in Puerto Rico to $14.24 in New York, while 6 states received no support for dental or podiatry residency programs.Conclusions and relevanceThese findings suggest that dental and podiatry GME represents a substantial public investment, and deliberate policy decisions are needed to target this nearly $730 million and growing investment to address the nation's priority oral and podiatry health needs.
| S-EPMC8160593 | biostudies-literature
Project description:BackgroundEffective physician communication improves care, and many medical schools and residency programs have adopted communication focused curricula. The COVID-19 pandemic has shifted the doctor-patient communication paradigm with the rapid adoption of video-based medical appointments by the majority of the medical community. The pandemic has also necessitated a sweeping move to online learning, including teaching and facilitating the practice of communication skills remotely. We aimed to identify effective techniques for surgeons to build relationships during a video consult, and to design and pilot a class that increased student skill in communicating during a video consult.MethodsFourth-year medical students matched into a surgical internship attended a 2-hour class virtually. The class provided suggestions for building rapport and earning trust with patients and families by video, role play sessions with a simulated patient, and group debriefing and feedback. A group debriefing generated lessons learned and best practices for telemedicine communication in surgery.ResultsStudents felt the class introduced new skills and reinforced current ones; most reported higher self-confidence in target communication skills following the module. Students were particularly appreciative of opportunity for direct observation of skills and immediate faculty feedback, noting that the intimate setting was unique and valuable. Several elements of virtual communications required increased focus to communicate empathy and concern. Proper lighting and positioning relative to the camera were particularly important and body movement required "narration" to minimize misinterpretation. A patient's distress was more difficult to interpret; asking direct questions was recommended to understand the patient's emotional state.ConclusionsThere is a need to teach video-conference communication skills to enable surgical teams to build rapport in this distinct form of consultation. Our training plan appears effective at engaging learners and improving skills and confidence, and identifies areas of focus when teaching virtual communication skills.
| S-EPMC7373024 | biostudies-literature
Project description:ObjectiveTo study medical students' views about the quality of the teaching they receive during their undergraduate training, especially in terms of the hidden curriculum.DesignSemistructured interviews with individual students.SettingOne medical school in the United Kingdom.Participants36 undergraduate medical students, across all stages of their training, selected by random and quota sampling, stratified by sex and ethnicity, with the whole medical school population as a sampling frame.Main outcome measuresMedical students' experiences and perceptions of the quality of teaching received during their undergraduate training.ResultsStudents reported many examples of positive role models and effective, approachable teachers, with valued characteristics perceived according to traditional gendered stereotypes. They also described a hierarchical and competitive atmosphere in the medical school, in which haphazard instruction and teaching by humiliation occur, especially during the clinical training years.ConclusionsFollowing on from the recent reforms of the manifest curriculum, the hidden curriculum now needs attention to produce the necessary fundamental changes in the culture of undergraduate medical education.
| S-EPMC520997 | biostudies-literature
Project description:BackgroundMentorship models rarely seek generalizability across training programs at the graduate medical education (GME) level.ObjectiveWe examined the sustainability and effectiveness of an intervention to increase the number and usefulness of trainee mentorship.MethodsA 0.20 full-time equivalent GME faculty adviser position (MD, MEd) implemented mentorship programs in residencies and fellowships. In group 1, 6 GME programs implemented the mentorship strategies prior to 2014, which were used to measure whether the number of mentor relationships were longitudinally sustained. In group 2, 10 different GME programs implemented the mentorship strategies in 2016, which were used to measure whether the intervention immediately increased the number of mentor relationships. To measure mentorship usefulness, trainees rated mentors' ability to promote clinical skills and personal and professional development. The remaining programs were the comparison. Responses from the 2014 and 2016 annual institutional trainee survey were analyzed.ResultsThe incidence of group 1 reporting mentor relationships in 2014 compared to the incidence of group 1 in 2016 were 89% (41 of 46) and 95% (42 of 44), respectively, suggesting that the intervention was sustained for 2 years (P = .26). Group 2 showed a higher proportion of trainees reporting mentors in 2016 (88%, 149 of 170) compared to preintervention (66%, 71 of 108; P = .00001). Groups 1 and 2 reported significant increases in mentorship usefulness.ConclusionsA GME initiative to enhance mentoring across specialties in 16 GME training programs was self-sustaining and effective.
| S-EPMC6476078 | biostudies-literature