Medicine and Health Sciences Commons^™

Incorporating Home Visits In A Primary Care Residency Clinic: The Patient And Physician Experience, Mary Caitlin St. Clair, Jessica J. F. Kram, Glenda Sundberg

Aurora Family Medicine Residents

Purpose: Home visits, once a popular but now uncommon form of health care delivery, are on the rise. Few studies have focused on the value the experience brings to resident physicians and their patients.

Methods: A 6-month pilot was conducted with 11 residents who participated in 32 home visits with 11 patients. Patient and resident experiences were captured through a survey following the home visits.

Results: In all, 100% of patients and a majority of residents were very interested in being a part of and incorporating future home visits, respectively. Every patient in the survey said that the visits resulted …

Incorporating Home Visits In A Primary Care Residency Clinic: The Patient And Physician Experience, Mary Caitlin St. Clair, Jessica J. F. Kram, Glenda Sundberg

Glenda Sundberg, FNP-CS, APNP

Purpose: Home visits, once a popular but now uncommon form of health care delivery, are on the rise. Few studies have focused on the value the experience brings to resident physicians and their patients.

Methods: A 6-month pilot was conducted with 11 residents who participated in 32 home visits with 11 patients. Patient and resident experiences were captured through a survey following the home visits.

Results: In all, 100% of patients and a majority of residents were very interested in being a part of and incorporating future home visits, respectively. Every patient in the survey said that the visits resulted …

Incorporating Home Visits In A Primary Care Residency Clinic: The Patient And Physician Experience, Mary Caitlin St. Clair, Jessica J. F. Kram, Glenda Sundberg

Jessica Kram, MPH

Purpose: Home visits, once a popular but now uncommon form of health care delivery, are on the rise. Few studies have focused on the value the experience brings to resident physicians and their patients.

Methods: A 6-month pilot was conducted with 11 residents who participated in 32 home visits with 11 patients. Patient and resident experiences were captured through a survey following the home visits.

Results: In all, 100% of patients and a majority of residents were very interested in being a part of and incorporating future home visits, respectively. Every patient in the survey said that the visits resulted …

Assessment In The Interpersonal Domain: Experiences From Empathy Assessment In Medical Education, Neville Chiavaroli

Neville Chiavaroli

Frameworks for the teaching and assessment of 21st-century skills commonly recognise the importance of learning and skill development in the interpersonal domain. They also usually acknowledge the challenge of reliably and validly assessing students in this domain. In the field of medical education and in selecting students for medical courses, the concept of empathy has become central to representing the particular interpersonal understandings and skills expected of students and practising doctors. Attempts to assess these attributes during medical training are just as challenging as in school contexts. This presentation draws on several years’ experience of working with medical educators to …

Survey Of Osteopathic Medical Students Regarding Physician Shadowing Experiences Before And During Medical School Training., Erik E. Langenau, Sarah B Frank, Sarah J Calardo, Michael B. Roberts

Erik E. Langenau

Introduction: Shadowing a physician is an observational experience which includes a student observing a licensed healthcare provider caring for patients. Shadowing is commonly done by students before and during medical school, but little is known about the nature or extent of these extra-curricular observational experiences.

Objective: We hypothesized that shadowing experiences were common yet variable. We investigated the prevalence, nature, and perceived value of medical student experiences with shadowing physicians (both before and during medical school).

Methods: This survey-based study was non-experimental with a cross-sectional convenience sample of osteopathic medical students about their shadowing experiences before and during medical school. …

Body And Disease 2008: An Integrated Course Teaching Pathology, Pharmacology, Immunology And Microbiology, Janil Puthucheary, Doyle Graham, Charles A. Gullo Phd, Hwang Nina Chih, Lynette Oon, Tan Soo Yong, Sandy Cook

Charles Gullo

The Duke-NUS Graduate Medical School Singapore (Duke-NUS) Body and Disease course is a 20-week, integrated course occurring at the end of the first year. The course covers four basic science topics: Pathology, Pharmacology, Immunology, and Microbiology and is modelled after the same course from the Duke University School of Medicine (DSOM) in Durham, North Carolina, USA. The structure of the course, as delivered by DSOM, was adapted to meet the needs and structure of the Duke-NUS programme. In addition, the course was adapted significantly to incorporate the Team-Based Learning methodology. In this paper, we detail how we approached these unique …

Roadmap For Creating An Accelerated Three-Year Medical Education Program, Shou Ling Leong, Joan Cangiarella, Tonya Fancher, Lisa Dodson, Colleen Grochowski, Vicky Harnik, Carol Hustedde, Betsy Jones, Christina Kelly, Allison Macerollo, Annette C. Reboli, Melvin Rosenfeld, Kristen Rundell, Tina Thompson, Robert Whyte, Martin Pusic

Annette C. Reboli

Medical education is undergoing significant transformation. Many medical schools are moving away from the concept of seat time to competency-based education and introducing flexibility in the curriculum that allows individualization. In response to rising student debt and the anticipated physician shortage, 35% of US medical schools are considering the development of accelerated pathways. The roadmap described in this paper is grounded in the experiences of the Consortium of Accelerated Medical Pathway Programs (CAMPP) members in the development, implementation, and evaluation of one type of accelerated pathway: the three-year MD program. Strategies include developing a mission that guides curricular development – …

Developing A Global Health Assessment Collaboration: Ancillary Report, Daniel Edwards, Jacob Pearce, David Wilkinson

Dr Daniel Edwards

This document reports on a project designed to develop an assessment collaboration between medical schools in both Australia and the United Kingdom. The project was funded by the Office for Learning and Teaching (OLT), utilising surplus funding from a broader assessment collaboration project – the Australian Medical Assessment Collaboration (OLT ID12-2482). The Global Health Assessment Collaboration (GHAC) involved five universities in Australia and the United Kingdom (UK). It developed an assessment framework and item specifications, undertook assessment item drafting workshops, built in a process of review and resulted in the development of a focused suite of assessment items. This report …

An Update Of Oral Health Curricula In Us Family Medicine Residency Programs, Hugh Silk, Judith A. Savageau, Kate Sullivan, Gail Sawosik, Min Wang

Judith A. Savageau

BACKGROUND AND OBJECTIVES: National initiatives have encouraged oral health training for family physicians and other nondental providers for almost 2 decades. Our national survey assesses progress of family medicine residency programs on this important health topic since our last survey in 2011.

METHODS: Family medicine residency program directors (PDs) completed an online survey covering various themes including number of hours of oral health (OH) teaching, topics covered, barriers, evaluation, positive influences, and program demographics.

RESULTS: Compared to 2011, more PDs feel OH should be addressed by physicians (86% in 2017 vs 79% in 2011), yet fewer programs are teaching OH …

Is Engagement Alone Sufficient To Ensure “Active Learning”?, Reed Krause, Amy C. Hayton Md, Jeff Wonoprabowo, Lawrence Loo

Amy Hayton, MD

“Active Learning” is commonly defined as any instructional method that engages students in the learning process. However, active learning encompasses a broad range of educational methods and its impact on learning outcomes has been variable. In 2015, our IM clerkship redesigned its half-day learning sessions from a largely passive didactic style of lecturing to more active learning approaches. We further revised the curriculum in 2016 to further convert the sessions to primarily case based learning led by a faculty or resident. The goal of our intervention was to increase the Self-Reported Engagement Measure (STOBE) of each didactic session and improve …

Does Ecg And Arrhythmia Simulation Training In Adjunct To Didactics Improve Medical Students’ Clinical Skills Compared To Didactics Alone?, Reed Krause, Amy C. Hayton Md

Amy Hayton, MD

Medical Schools continue to face the challenge of bridging the gap between classroom education and its application in the clinical environment. Several studies have shown utility of incorporating simulation training into a variety of healthcare related topics. We hypothesize that incorporating ECG and arrhythmia simulation training in adjunction to ECG and arrhythmia didactics; it would improve Year-3 medical students’ preparedness for managing arrhythmias in the clinical setting.

Community Health, Advocacy, And Managing Populations (Champ) Longitudinal Residency Education And Evaluation, Kjersti E. Knox, Will Lehmann, Joseph Vogelgesang, Deborah Simpson

Deborah Simpson, PhD

Purpose: Longitudinal education initiatives designed to prepare residents to address health disparities and social determinants of health (SDH) are needed. This report addresses this gap by describing a family medicine residency’s Community Health, Advocacy, and Managing Populations (CHAMP) curriculum and its evaluation by learners, faculty, and community partners. The CHAMP longitudinal curriculum is explicitly designed to prepare residents to address health disparities and SDH. We report early outcomes, including community partner feedback, of this innovative curriculum.

Methods: Data were obtained through standardized rotation evaluations, thematic analysis of structured group and individual interviews, and aggregated competency milestone data. Kirkpatrick’s four-level model …

Community Health, Advocacy, And Managing Populations (Champ) Longitudinal Residency Education And Evaluation, Kjersti E. Knox, Will Lehmann, Joseph Vogelgesang, Deborah Simpson

Will Lehmann, MD

Purpose: Longitudinal education initiatives designed to prepare residents to address health disparities and social determinants of health (SDH) are needed. This report addresses this gap by describing a family medicine residency’s Community Health, Advocacy, and Managing Populations (CHAMP) curriculum and its evaluation by learners, faculty, and community partners. The CHAMP longitudinal curriculum is explicitly designed to prepare residents to address health disparities and SDH. We report early outcomes, including community partner feedback, of this innovative curriculum.

Methods: Data were obtained through standardized rotation evaluations, thematic analysis of structured group and individual interviews, and aggregated competency milestone data. Kirkpatrick’s four-level model …

Push For Progress Inspired Improved Outcomes, Jacob L. Bidwell

Jacob Bidwell, MD

The author and issue editor describes the changing faces of health care as well as movements undertaken by U.S. health systems over the last two decades to improve the treatment and documented outcomes of minority or impoverished patients and to understand the impact of cultural differences on patient care. While much progress has been made, achieving health equity will require the continued efforts of many working toward this goal.

Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone

Aurora Geriatrics Fellows

Background: We noted a low reported prevalence of delirium (3%) in hospitalized older patients at a community teaching hospital in north central Wisconsin. Purpose: This was a quality improvement project to report recognition of delirium by nurses before and after an educational intervention. Methods: This project was performed on one medical unit in our hospital. Quality improvement data was collected at baseline and after the educational intervention. Data collected included observation by a geriatrician attending weekly interdisciplinary rounds to note any mention by nurses of delirium or confusion. The patient’s electronic health record (EHR) was reviewed to note delirium assessment …

Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone

Jodi Punke

Background: We noted a low reported prevalence of delirium (3%) in hospitalized older patients at a community teaching hospital in north central Wisconsin.

Purpose: This was a quality improvement project to report recognition of delirium by nurses before and after an educational intervention.

Methods: This project was performed on one medical unit in our hospital. Quality improvement data was collected at baseline and after the educational intervention. Data collected included observation by a geriatrician attending weekly interdisciplinary rounds to note any mention by nurses of delirium or confusion. The patient’s electronic health record (EHR) was reviewed to note delirium assessment …

Wise-Family Medicine: A Statewide Faculty Development Collaborative, Deborah Simpson, Kjersti Knox, Anne Getzin, John R. Brill, Melissa M. Stiles, Jeffrey A. Morzinski

Kjersti Knox, MD

Background: In many states, family medicine residencies and medical schools compete clinically for patients, educationally for trainees and, more recently, for community preceptors (CPs). As Wisconsin’s medical schools and health care systems have expanded their geographic footprints, our CPs now teach trainees from competing institutions. Yet residency and medical student accrediting bodies require faculty and preceptor development.

Purpose: To evaluate the impact of a statewide collaborative of family medicine educators on meeting faculty development needs of our CPs and collaborative members.

Methods: Faculty development leaders representing the three largest family medicine residency training sponsors in the state created the Wisconsin …

Wise-Family Medicine: A Statewide Faculty Development Collaborative, Deborah Simpson, Kjersti Knox, Anne Getzin, John R. Brill, Melissa M. Stiles, Jeffrey A. Morzinski

Deborah Simpson, PhD

Background: In many states, family medicine residencies and medical schools compete clinically for patients, educationally for trainees and, more recently, for community preceptors (CPs). As Wisconsin’s medical schools and health care systems have expanded their geographic footprints, our CPs now teach trainees from competing institutions. Yet residency and medical student accrediting bodies require faculty and preceptor development.

Purpose: To evaluate the impact of a statewide collaborative of family medicine educators on meeting faculty development needs of our CPs and collaborative members.

Methods: Faculty development leaders representing the three largest family medicine residency training sponsors in the state created the Wisconsin …

Wise-Family Medicine: A Statewide Faculty Development Collaborative, Deborah Simpson, Kjersti Knox, Anne Getzin, John R. Brill, Melissa M. Stiles, Jeffrey A. Morzinski

Anne Getzin, MD

Background: In many states, family medicine residencies and medical schools compete clinically for patients, educationally for trainees and, more recently, for community preceptors (CPs). As Wisconsin’s medical schools and health care systems have expanded their geographic footprints, our CPs now teach trainees from competing institutions. Yet residency and medical student accrediting bodies require faculty and preceptor development.

Purpose: To evaluate the impact of a statewide collaborative of family medicine educators on meeting faculty development needs of our CPs and collaborative members.

Methods: Faculty development leaders representing the three largest family medicine residency training sponsors in the state created the Wisconsin …

Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone

Ariba Khan, MD, MPH

Background: We noted a low reported prevalence of delirium (3%) in hospitalized older patients at a community teaching hospital in north central Wisconsin.

Purpose: This was a quality improvement project to report recognition of delirium by nurses before and after an educational intervention.

Methods: This project was performed on one medical unit in our hospital. Quality improvement data was collected at baseline and after the educational intervention. Data collected included observation by a geriatrician attending weekly interdisciplinary rounds to note any mention by nurses of delirium or confusion. The patient’s electronic health record (EHR) was reviewed to note delirium assessment …

Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone

Michael Malone, MD

Background: We noted a low reported prevalence of delirium (3%) in hospitalized older patients at a community teaching hospital in north central Wisconsin.

Purpose: This was a quality improvement project to report recognition of delirium by nurses before and after an educational intervention.

Methods: This project was performed on one medical unit in our hospital. Quality improvement data was collected at baseline and after the educational intervention. Data collected included observation by a geriatrician attending weekly interdisciplinary rounds to note any mention by nurses of delirium or confusion. The patient’s electronic health record (EHR) was reviewed to note delirium assessment …

Triple Aim For Clinical Teachers (Tact): Faculty Physician Perceptions On Their Ability To Balance Clinical Quality, Trainee Learning, And Teaching Efficiency, Minuja Muralidharan, Anne Getzin, Kjersti E. Knox, Bonnie L. Bobot, Marie M. Forgie, Nicole P. Salvo, Deborah Simpson

Nicole P. Salvo, MD

Background: A common challenge facing teaching physicians is balancing high-quality student and resident teaching with efficient, high-quality care and patient service. Publicly accessible clinic performance reports increasingly affect where patients seek care and demand that teaching clinics rise to consumer expectations while training future physicians to function in the modern health care workplace. Limited information is available to guide physicians to achieve the triple aim for clinical teachers (TACT): clinical quality/patient experience, trainee learning, and teaching efficiency.

Purpose: To understand clinical teachers’ TACT-related experiences, perceptions and preferences for how to learn TACT-associated skill sets to improve their competence as teachers. …

Triple Aim For Clinical Teachers (Tact): Faculty Physician Perceptions On Their Ability To Balance Clinical Quality, Trainee Learning, And Teaching Efficiency, Minuja Muralidharan, Anne Getzin, Kjersti E. Knox, Bonnie L. Bobot, Marie M. Forgie, Nicole P. Salvo, Deborah Simpson

Kjersti Knox, MD

Background: A common challenge facing teaching physicians is balancing high-quality student and resident teaching with efficient, high-quality care and patient service. Publicly accessible clinic performance reports increasingly affect where patients seek care and demand that teaching clinics rise to consumer expectations while training future physicians to function in the modern health care workplace. Limited information is available to guide physicians to achieve the triple aim for clinical teachers (TACT): clinical quality/patient experience, trainee learning, and teaching efficiency.

Purpose: To understand clinical teachers’ TACT-related experiences, perceptions and preferences for how to learn TACT-associated skill sets to improve their competence as teachers. …

Triple Aim For Clinical Teachers (Tact): Faculty Physician Perceptions On Their Ability To Balance Clinical Quality, Trainee Learning, And Teaching Efficiency, Minuja Muralidharan, Anne Getzin, Kjersti E. Knox, Bonnie L. Bobot, Marie M. Forgie, Nicole P. Salvo, Deborah Simpson

Deborah Simpson, PhD

Background: A common challenge facing teaching physicians is balancing high-quality student and resident teaching with efficient, high-quality care and patient service. Publicly accessible clinic performance reports increasingly affect where patients seek care and demand that teaching clinics rise to consumer expectations while training future physicians to function in the modern health care workplace. Limited information is available to guide physicians to achieve the triple aim for clinical teachers (TACT): clinical quality/patient experience, trainee learning, and teaching efficiency.

Purpose: To understand clinical teachers’ TACT-related experiences, perceptions and preferences for how to learn TACT-associated skill sets to improve their competence as teachers. …

Assessment Of Medical Students’ Learning Outcomes In Australia : Current Practice, Future Possibilities, David Wilkinson, Benedict Canny, Jacob Pearce, Hamish Coates, Daniel Edwards

Dr Jacob Pearce

All 19 medical schools in Australia examine and assess the performance of their students, but do so largely in isolation from each other. That is, most schools design, develop and deliver their own exams, against their own curriculum and standards, and students pass, fail and are graded with little external moderation or comparison. Accreditation of schools by the Australian Medical Council (AMC) provides some reassurance that assessment practices are appropriate in medical schools. However, very limited data are available for benchmarking performance against any national standard, or between medical schools in Australia. The Australian Medical Assessment Collaboration has been designed …

Determining The Quality Of Assessment Items In Collaborations: Aspects To Discuss To Reach Agreement Developed By The Australian Medical Assessment Collaboration, Lambert Schuwirth, Jacob Pearce

Dr Jacob Pearce

The Australian Medical Assessment Collaboration (AMAC) project, funded by the Office of Learning and Teaching, seeks to provide an infrastructure and a road map to support collaboration between Australian medical schools in matters of assessment. This may not seem very new perhaps, because there are already several collaborations taking place in Australia, and, typically, they relate to joint item banks, (such as the IDEAL consortium), or joint test administration, (such as the International Foundation of Medicine tests). The AMAC project seeks to build on these existing collaborations in two ways: first, by tying these initiatives together and thus bundling the …

Improving The Quality Of Medical Education, Daniel Edwards

Dr Daniel Edwards

An ongoing collaboration is developing tools and processes to help prove and improve the quality of medical education in Australia through quality comparison, the sharing of expertise and high-quality assessment, as Dan Edwards explains.

Australian Medical Assessment Collaboration: From Proof Of Concept To Proof Of Sustainability: Final Report 2014, Daniel Edwards, David Wilkinson

Dr Daniel Edwards

This is the final report for AMAC-2, entitled Australian Medical Assessment Collaboration: from proof of concept to proof of sustainability (OLT project ID12-2482). This project advanced previous work funded by the ALTC and was undertaken from early 2013 to mid 2014. AMAC-2 took the proof of concept achieved through the initial AMAC project with the aim of building an ongoing, sustainable and successful collaboration between medical schools in Australia and New Zealand.

Implementing Common Assessment: Lessons And Models From Amac Developed By The Australian Medical Assessment Collaboration, Daniel Edwards

Dr Daniel Edwards

The aim of this document is to provide insight into the implementation of common assessments in higher education in order to assist in future work on conducting these kinds of projects. The discussion here draws heavily on the AMAC experience, attempting to broaden the learning from this project for use in future collaborations. The focus of this project has been on medical education, and as such, much of the detail is related to this field. However, it is hoped that the general ideas discussed here can be seen as informative for other fields and disciplines in higher education and at …

Student Safety And Patient Violence: The Basic Facts, Kevin J. Black

Kevin J. Black, MD