The smartphone: How it is transforming medical education, patient care, and professional collaboration

Abstract Background Morning report is accepted as an essential component of residency education throughout different parts of the world. Objective To review the evidence of the educational value, purpose, methods, and outcomes of morning report. Methods A literature search of PubMed, Ovid, and the Cochrane Library for English-language studies published between January 1, 1966, and October 31, 2011, was performed. We searched for keywords and Medical Subject Heading terms related to medical education, methods, attitudes, and outcomes in regard to “morning report.” Title and abstract review, followed by a full-text review by 3 authors, was performed to identify all pertinent articles. Results We identified 71 citations; 40 articles were original studies and 31 were commentaries, editorials, or review articles; 56 studies (79%) originated from internal medicine residency programs; 6 studies (8%) focused on ambulatory morning report; and 63 (89%) originated from the United States. Identified studies varied in objectives, methods, and outcome measures, and were not suitable for meta-analysis. Main outcome measures were resident satisfaction, faculty satisfaction, preparation for professional examinations, use of evidence-based medicine, clinical effects on patient care, adverse event detection, and utilization of a curriculum in case selection. Conclusions Morning report has heterogeneous purposes, methods, and settings. As an educational tool, morning report is challenging to define, its outcome is difficult to measure, and this precludes firm conclusions about its contribution to resident education or patient care. Residency programs should tailor morning report to meet their own unique educational objectives and needs.

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Practicing Anthropology in an Academic Community Hospital: Lessons from the Field

Practicing Anthropology ◽

10.17730/praa.32.4.d653683741q14764 ◽

2010 ◽

Vol 32 (4) ◽

pp. 19-23 ◽

Cited By ~ 1

Author(s):

Lynn Deitrick ◽

Terry Capuano ◽

Debbie Salas-Lopez

Keyword(s):

Medical Education ◽

Organizational Culture ◽

Patient Care ◽

Community Hospital ◽

Continuum Of Care ◽

Academic Community ◽

Hospital Culture ◽

Doctor's Office ◽

Vantage Points

Practicing anthropology at an academic community hospital involves collaborations across the full continuum of care, from hospital, to doctor's office, to the medical education classroom and into the community. Through these collaborations, the anthropologist learns about hospital culture through many different lenses and is, in turn, able to provide valuable insights into organizational culture and patient care from a variety of vantage points.

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The Mandate Project: Institutionalizing a System of Patient Care Quality Assurance

PEDIATRICS ◽

10.1542/peds.57.5.775 ◽

1976 ◽

Vol 57 (5) ◽

pp. 775-782

Author(s):

Daniel S. Fleisher ◽

Clement R. Brown ◽

Carter Zeleznik ◽

Gerald H. Escovitz ◽

Charles Omdal

Keyword(s):

Medical Education ◽

Quality Assurance ◽

Patient Care ◽

Psychosocial Factors ◽

Continuing Medical Education ◽

Care Quality ◽

Quality Assurance Program ◽

Patient Care Quality

In 1970, prior to present-day requirements for quality assurance programs, a project was undertaken to institute such a program voluntarily in ten hospitals. Five hospitals succeeded in fully implementing the program which was based on the "Bi-Cycle Process" and each documented improvements in desired patient care behaviors. Two hospitals partially implemented the process and demonstrated no significant changes in desired patient care behaviors. Two hospitals failed to provide the data upon which assessments could be made and one hospital never got beyond preliminary efforts at instituting the process. The project demonstrates that a voluntary quality assurance program is feasible and has important implications for PSROs and continuing medical education. It also provides evidence that attention to psychosocial factors is essential in the institutionalization of programs designed to produce desired changes in patient care behaviors.

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IS PATIENT SAFETY AT THE HEART OF MEDICAL EDUCATION IN INDONESIA? REFLECTION ON THE IMPACT OF THE NATIONAL EXAMINATION

Jurnal Pendidikan Kedokteran Indonesia The Indonesian Journal of Medical Education ◽

10.22146/jpki.48759 ◽

2019 ◽

Vol 8 (3) ◽

pp. 153

Author(s):

Rachmadya Nur Hidayah

Keyword(s):

Medical Education ◽

Quality Assurance ◽

Patient Safety ◽

Focus Groups ◽

Patient Care ◽

Medical Schools ◽

Theory Approach ◽

High Stakes ◽

Teachers And Students ◽

The Impact

ABSTRACT Background: National examinations in Indonesia (UKMPPD) has been implemented since 2007 as a quality assurance method for medical graduates and medical schools. The impact of UKMPPD has been studied since then, where one of the consequences were related to how it affected medical education and curricula. This study explored the consequences of UKMPPD, focusing on how the students, teachers, and medical schools’ leaders relate the examination with patient care. This study aimed to explore the impact of UKMPPD on medical education, which focusing on the issue of patient safety. Methods: This study was part of a doctoral project, using a qualitative method with a modified grounded theory approach. The perspectives of multiple stakeholders on the impact of the UKMPPD were explored using interview and focus groups. Interviews were conducted with medical schools’ representatives (vice deans/ programme directors), while focus groups were conducted with teachers and students. A sampling framework was used by considering the characteristics of Indonesian medical schools based on region, accreditation status, and ownership (public/ private). Data was analysed using open coding and thematic framework as part of the iterative process. Results: The UKMPPD affected how the stakeholders viewed this high-stakes examination and the education delivered in their medical schools. One of the consequences revealed how stakeholders viewed the UKMPPD and its impact on patient care. Participants viewed the UKMPPD as a method of preparation for graduates’ real clinical practice. The lack of reference for patient safety as the impact of the UKMPPD in this study showed that there were missing links in how stakeholders perceived the examination as part of quality assurance in health care. Conclusion: The UKMPPD as a high-stakes examination has a powerful impact in changing educational policy and programmes in Indonesia. However, in Indonesia, the examination brought in the reflection on how the “patient” element was lacking from medical education. This research offers an insight on the concept of patient safety in Indonesia and how the stakeholders could approach the issue. Keywords: UKMPPD, national licensing examination, impact, competence, patient safety, curriculum

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Two Student Perspectives on Clinical Medical Education During the COVID19 Pandemic

International Journal of Medical Students ◽

10.5195/ijms.2021.909 ◽

2021 ◽

Author(s):

Anne P. George ◽

Elise E. Ewens

Keyword(s):

Medical Education ◽

Medical Students ◽

Patient Care ◽

Direct Patient Care ◽

Rural And Urban ◽

Hands On ◽

Hands On Learning ◽

Ultimate Question ◽

To Come ◽

The U.S

In the age of COVID19, the ultimate question in healthcare became who was essential and who was not. Basically, who could be cut from the roster in patient care? Unfortunately, as medical students, many of us did not make that cut, and as rotations were continually evolving and changing, students from even the same institution had varying experiences. Third-year clerkships are defined by the direct patient care and hands-on learning students get, but in the age of COVID19, “hands-on learning” has been a bit hard to come by. Hence, COVID has caused many changes in the way medicine is being taught and practiced. This article will detail the experiences of two medical students from the same institution, working in different locations for their third-year clerkships. We contrast our rural and urban experiences as students in the time of COVID and display the varying experiences students are having during this time. We touch on the potential ramifications for these wide varieties of experiences from students across the U.S. and how this will affect sub-internships and residency applications.

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Professional Development Track to Prepare Future Academic Clinicians

Medical Science Educator ◽

10.1007/s40670-020-01118-5 ◽

2020 ◽

Author(s):

K. Marie Traylor ◽

Jorge L. Cervantes ◽

Cynthia N. Perry

Keyword(s):

Professional Development ◽

Medical Education ◽

Student Achievement ◽

Education Research ◽

Medical Student ◽

Patient Care ◽

Academic Medicine ◽

Student Feedback ◽

Residency Programs ◽

School Of Medicine

Abstract Professional development is instrumental in the success of professionals and trainees in academic medicine. In response to medical student feedback requesting additional professional development opportunities, the Foster School of Medicine developed a distinction program, the Pathway for Preparing Academic Clinicians (PPAC), designed to deliver sought-after skill development and foundational knowledge in the three primary activities of academic medicine: medical education, research, and patient care. This distinction program addresses a curricular gap as identified by students and common to many UME curricula and also provides an opportunity for residency programs to identify student achievement within a pass/fail program.

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Toward a New Paradigm in Graduate Medical Education in the United States: Elimination of the 24-Hour Call

Journal of Graduate Medical Education ◽

10.4300/jgme-d-09-00061.1 ◽

2009 ◽

Vol 1 (2) ◽

pp. 188-194 ◽

Cited By ~ 5

Author(s):

Susan G. Mautone

Keyword(s):

Medical Education ◽

Patient Care ◽

Graduate Medical Education ◽

Motor Vehicle ◽

Motor Vehicle Accidents ◽

Near Misses ◽

Scheduling System ◽

Duty Hours ◽

Graduate Medical ◽

Vehicle Accidents

Abstract Background Sleep deprivation negatively affects resident performance, education, and safety. Concerns over these effects have prompted efforts to reduce resident hours. This article describes the design and implementation of a scheduling system with no continuous 24-hour calls. Aims included meeting Accreditation Council for Graduate Medical Education work hour requirements without increasing resident complement, maximizing continuity of learning and patient care, maintaining patient care quality, and acceptance by residents, faculty, and administration. Methods Various coverage options were formulated and discussed. The final schedule was the product of consensus. After re-engineering the master rotation schedule, service-specific conversion of on-call schedules was initiated in July 2003 and completed in July 2004. Annual in-training and certifying examination performance, length of stay, patient mortalities, resident motor vehicle accidents/near misses, and resident satisfaction with the new scheduling system were tracked. Results Continuous 24-hour call has been eliminated from the program since July 2004, with the longest assigned shift being 14 hours. Residents have at least 1 free weekend per month, a 10-hour break between consecutive assigned duty hours, and a mandatory 4-hour “nap” break if assigned a night shift immediately following a day shift. Program-wide, duty hours average 66 hours per week for first-year residents, 63 hours per week for second-year residents, and 60 hours per week for third-year residents. Self-reported motor vehicle accidents and/or near misses of accidents significantly decreased (P < .001) and resident satisfaction increased (P = .42). The change was accomplished at no additional cost to the institution and with no adverse patient care or educational outcomes. Conclusions Pediatric residency training with restriction to 14 consecutive duty hours is effective and well accepted by stakeholders. Five years later, the re-engineered schedule has become the new “normal” for our program.

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The Role of Humanities in Medical Education

Advances in Medical Education, Research, and Ethics - Handbook of Research on the Efficacy of Training Programs and Systems in Medical Education ◽

10.4018/978-1-7998-1468-9.ch008 ◽

2020 ◽

pp. 148-155

Author(s):

Arthur L. Frank

Keyword(s):

United States ◽

Medical Education ◽

Patient Care ◽

The United States ◽

Physician Communication ◽

Ethical Behaviors ◽

The Subject ◽

Improving Patient Care

This chapter considers the role and value of the study of the humanities in medical education. Most authors on this subject believe the study of the humanities results in a better physician. However, few papers document this almost universally accepted idea. This chapter cites the available literature on the subject and also considers how the study of the humanities has become more common in countries beyond the United States. The study of the humanities is thought to improve physician communication and to influence ethical behaviors, ultimately improving patient care.

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Educational Experiences Residents Perceive As Most Helpful for the Acquisition of the ACGME Competencies

Journal of Graduate Medical Education ◽

10.4300/jgme-d-11-00058.1 ◽

2012 ◽

Vol 4 (2) ◽

pp. 176-183 ◽

Cited By ~ 7

Author(s):

Lourdes R. Guerrero ◽

Susan Baillie ◽

Paul Wimmers ◽

Neil Parker

Keyword(s):

Medical Education ◽

Los Angeles ◽

Patient Care ◽

Graduate Medical Education ◽

Role Models ◽

Monitoring And Evaluation ◽

Learning Activities ◽

Web Based ◽

Residency Programs ◽

Graduate Medical

Abstract Background The Accreditation Council for Graduate Medical Education (ACGME) requires physicians in training to be educated in 6 competencies considered important for independent medical practice. There is little information about the experiences that residents feel contribute most to the acquisition of the competencies. Objective To understand how residents perceive their learning of the ACGME competencies and to determine which educational activities were most helpful in acquiring these competencies. Method A web-based survey created by the graduate medical education office for institutional program monitoring and evaluation was sent to all residents in ACGME-accredited programs at the David Geffen School of Medicine, University of California-Los Angeles, from 2007 to 2010. Residents responded to questions about the adequacy of their learning for each of the 6 competencies and which learning activities were most helpful in competency acquisition. Results We analyzed 1378 responses collected from postgraduate year-1 (PGY-1) to PGY-3 residents in 12 different residency programs, surveyed between 2007 and 2010. The overall response rate varied by year (66%–82%). Most residents (80%–97%) stated that their learning of the 6 ACGME competencies was “adequate.” Patient care activities and observation of attending physicians and peers were listed as the 2 most helpful learning activities for acquiring the 6 competencies. Conclusion Our findings reinforce the importance of learning from role models during patient care activities and the heterogeneity of learning activities needed for acquiring all 6 competencies.

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Faculty development in the age of competency-based medical education: A needs assessment of Canadian emergency medicine faculty and senior trainees

CJEM ◽

10.1017/cem.2019.343 ◽

2019 ◽

Vol 21 (4) ◽

pp. 527-534 ◽

Cited By ~ 6

Author(s):

Alexandra Stefan ◽

Justin N. Hall ◽

Jonathan Sherbino ◽

Teresa M. Chan

Keyword(s):

Emergency Medicine ◽

Medical Education ◽

Faculty Development ◽

Patient Care ◽

Needs Assessment ◽

Direct Observation ◽

Senior Resident ◽

Cross Sectional ◽

Competency Based Medical Education ◽

Competency Based

ABSTRACTObjectivesThe Royal College of Physicians and Surgeons of Canada (RCPSC) emergency medicine (EM) programs transitioned to the Competence by Design training framework in July 2018. Prior to this transition, a nation-wide survey was conducted to gain a better understanding of EM faculty and senior resident attitudes towards the implementation of this new program of assessment.MethodsA multi-site, cross-sectional needs assessment survey was conducted. We aimed to document perceptions about competency-based medical education, attitudes towards implementation, perceived/prompted/unperceived faculty development needs. EM faculty and senior residents were nominated by program directors across RCPSC EM programs. Simple descriptive statistics were used to analyse the data.ResultsBetween February and April 2018, 47 participants completed the survey (58.8% response rate). Most respondents (89.4%) thought learners should receive feedback during every shift; 55.3% felt that they provided adequate feedback. Many respondents (78.7%) felt that the ED would allow for direct observation, and most (91.5%) participants were confident that they could incorporate workplace-based assessments (WBAs). Although a fair number of respondents (44.7%) felt that Competence by Design would not impact patient care, some (17.0%) were worried that it may negatively impact it. Perceived faculty development priorities included feedback delivery, completing WBAs, and resident promotion decisions.ConclusionsRCPSC EM faculty have positive attitudes towards competency-based medical education-relevant concepts such as feedback and opportunities for direct observation via WBAs. Perceived threats to Competence by Design implementation included concerns that patient care and trainee education might be negatively impacted. Faculty development should concentrate on further developing supervisors’ teaching skills, focusing on feedback using WBAs.

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