scholarly journals P.133 ‘Building Your Neurology Acumen’: a flipped classroom approach to strengthen Internal Medicine residents’ neurological skills

2021 ◽  
Vol 48 (s3) ◽  
pp. S57-S57
Author(s):  
Z Zaeem ◽  
P Smyth ◽  
V Daniels
Keyword(s):  
Internal Medicine ◽  
Mixed Methods ◽  
Curriculum Development ◽  
Focus Groups ◽  
Needs Assessment ◽  
Royal College ◽  
Flipped Classroom ◽  
Mixed Methods Design ◽  
Internal Medicine Residents ◽  
Convenience Sampling

Background: Rotating internal medicine (IM) residents do not feel adequately prepared to approach patients with neurologic issues. The purpose of this project was to conduct a needs assessment to determine the optimal components and delivery of a neurology curriculum for internal medicine residents. Methods: We utilized a mixed-methods design and recruited participants through a combination of purposive and convenience sampling. We conducted interviews with IM residents (n=12) and focus groups with neurology residents (n=7) and neurology staff (n=8). IM residents completed entry- and post-call surveys while on a neurology rotation. Results: Themes according to Kern’s framework for curriculum development: 1. Problem: Discomfort and perception of under-preparedness amongst IM trainees 2. Needs Assessment: What the learners (stakeholders) think they need to know vs. what their teachers want them to know vs external requirements (Royal College) 3. Goals/objectives: What content is relevant for clinical requirements vs assessments? 4. Methods and setting: Didactic vs bedside vs virtual 5. Implementation of the curriculum 6. Evaluation and feedback Conclusions: Our findings illustrate a possible mismatch between internal medicine residents’ needs and neurologist teachers’ expectations in teaching neurology. Addressing learners’ needs could enhance neurology knowledge and sense of preparedness when encountering patients with neurologic issues.

scholarly journals Training Toward a Movement: Career Development Insights From the First 7 Years of a Global Health Equity Residency

2018 ◽  
Vol 10 (5) ◽  
pp. 509-516 ◽  
Author(s):  
Daniel Palazuelos ◽  
Ranu Dhillon ◽  
Adrianne Katrina Nelson ◽  
Kevin P. Savage ◽  
Rosabelle Conover ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Mixed Methods ◽  
Global Health ◽  
Health Equity ◽  
Structured Interview ◽  
Career Pathways ◽  
Structural Barriers ◽  
Mixed Methods Design ◽  
Life Challenges ◽  
Global Health Equity

ABSTRACT Background  The Doris and Howard Hiatt Residency in Global Health Equity and Internal Medicine at Brigham and Women's Hospital provides global health training during residency, but little is known about its effect on participants' selection of a global health career. Objective  We assessed the perceptions of residency graduates from the first 7 classes to better understand the outcomes of this education program, and the challenges faced by participants. Methods  We interviewed 27 of 31 physicians (87%) who graduated from the program between 2003 and 2013 using a convergent mixed-methods design and a structured interview tool that included both open-ended and forced-choice questions. We independently coded and analyzed qualitative data using a case study design, and then wove together the qualitative and quantitative data at the interpretation phase using a parallel convergent mixed-methods design. Results  Entering a career focused on social justice was cited as the most common motivator for selecting to train in global health. Most respondents (83%, 20 of 24) reported they were able to achieve this goal despite structural barriers, such as lower salaries compared with peers, a lack of mentors in the field, poorly structured and undersupported career pathways at their institutions, and unique work-life challenges. Conclusions  A majority of graduates from 1 dedicated residency program in global health and internal medicine reported they were able to continue to engage in global health activities after graduation and, despite identified challenges, reported that they planned long-term careers in global health.

scholarly journals Promoting Quality Care for Recently Resettled Populations: Curriculum Development for Internal Medicine Residents

2014 ◽  
Vol 6 (2) ◽  
pp. 310-314 ◽  
Author(s):  
Marina MacNamara ◽  
April Wilhelm ◽  
Geolani Dy ◽  
Sarah Andiman ◽  
Carol Landau ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Focus Groups ◽  
Medical Training ◽  
Quality Care ◽  
Hospital Staff ◽  
Online Information ◽  
Preliminary Assessment ◽  
Internal Medicine Residents ◽  
Adequate Education ◽  
Survey Results

Abstract Background Residents report they lack preparation for caring for an increasingly diverse US population. In response, a variety of curricula have been developed to integrate cultural competency into medical training programs. To date, none of these curricula has specifically addressed members of recently resettled populations. Methods A preliminary assessment was conducted among internal medicine (IM) residents at 1 program (N  =  147). Based on 2 conceptual frameworks and the survey results, a pilot curriculum was developed and integrated into the interns' ambulatory block education within the general IM track (n  =  9). It included (1) online information made available to all hospital staff; (2) 4 interactive didactic sessions; and (3) increased exposure to newly arrived patients. The curriculum was qualitatively evaluated through 2 focus groups. Results The preliminary assessment was completed by 101 of 147 residents (69%), with 61% of respondents indicating they felt that they received less than adequate education in this area. Eight of the 9 interns exposed to the new curriculum participated in the focus groups. Overall, respondents reported they thought patient care had improved for recently resettled populations and across their patient panels after exposure to the curriculum. Conclusions This study demonstrated that an intervention that included didactics and enhanced exposure to a diverse population improved IM interns' perceptions of care for all patients, including recently settled individuals.

scholarly journals Improving access to organ donor registration in general practice: a feasibility study

2020 ◽  
Vol 70 (696) ◽  
pp. e497-e504
Author(s):  
Catrin P Penn-Jones ◽  
Chris Papadopoulos ◽  
Gurch Randhawa ◽  
Zeeshan Asghar
Keyword(s):  
Decision Making ◽  
General Practice ◽  
Mixed Methods ◽  
Focus Groups ◽  
Feasibility Study ◽  
Organ Donor ◽  
Mixed Methods Design ◽  
Waiting Room ◽  
Face To Face ◽  
The Uk

BackgroundOrgan donor registration helps guide decision making for families. UK general practice provides the facility to register on the NHS Organ Donor Register, but only to new patients. An intervention was developed to present a registration opportunity to existing patients in this setting.AimTo assess the feasibility and acceptability of an organ donation intervention implemented in UK general practice.Design and settingThe intervention ran in a large practice in Luton in the UK, for 3 months in 2018. A single practice feasibility study was conducted using an embedded experimental mixed methods design.MethodStaff were trained to ask patients in consultations if they wished to join the register, and leaflets and posters were displayed in the waiting room. Data on feasibility and acceptability were captured using SystmONE questionnaires, surveys, and focus groups.ResultsOver 3 months, in 12.4% of face-to-face consultations, patients were asked if they would like to join the register (812 of 6569), and 244 (30.0%) of these patients joined the register. Common reasons staff did not ask patients were due to telephone consultations, lack of time, and it not being appropriate. Nurses and healthcare assistants performed prompted choice more than doctors (23.4%, 17.1%, and 1.6% respectively). Certain clinic types, such as phlebotomy or routine clinics, facilitated asking compared to those where patients presented with unknown or more serious issues.ConclusionThe intervention was found to be feasible and acceptable by some staff and patients. Feasibility criteria were met; therefore, the intervention can progress to further testing.

scholarly journals Point-of-Care Ultrasound in Internal Medicine

2017 ◽  
Vol 12 (2) ◽  
Author(s):  
Mitch Levine
Keyword(s):  
Internal Medicine ◽  
Needs Assessment ◽  
Point Of Care ◽  
Digital Health ◽  
Pericardial Tamponade ◽  
Point Of Care Ultrasound ◽  
Residency Programs ◽  
Technological Advances ◽  
Internal Medicine Residents ◽  
Similar Survey

Over the past few decades a variety of technological advances have dramatically change the manner in which physicians practice medicine. Both clinically and administratively the practice of medicine is in evolution – for example; stents instead of surgery and digital health records instead of paper charts. For internal medicine physicians one of the biggest transformations with respect to how we will practice medicine is just on the horizon. The routine use of point-of-care ultrasound (PoCUS) will become an essential skill for the practicing internist. The application for PoCUS in the field of internal medicine is immense – accurately assessing the JVP in critically ill patients, performing arterial and venipunctures, diagnosing pericardial tamponade or determining the likelihood of a pulmonary embolus, or the diagnostic and therapeutic removal of body fluids, to name a few.While some of our colleagues have adopted this technology as an adjunct to the clinical examination or as an aid to conducting bedside procedures most have not adopted this as a routine skill set. Some of the barriers include insufficient training and a lack of readily accessible equipment in all clinical settings. But this will change, and the use of PoCUS will eventually become a required skill of all practicing internists.In the current issue of CJGIM Lewis et al have conducted a needs assessment of PoCUS in answering either a clinical question or in guiding a procedure. As the Royal College of Physicians and Surgeons does not yet require all internal medicine residency programs to provide a formal PoCUS curriculum, the objective of their study was to conduct a systematic needs assessment for the introduction of a PoCUS curriculum to an internal medicine program. The results showed that some internal medicine residents were already using PoCUS yet they had never been formal trained in the skill. One is left to wonder what a similar survey would find if conducted amongst practicing internists.While each residency programs will inevitably develop a PoCUS curriculum for their trainees, it will remain a continuing education challenge for internists already in practice. The importance of this skill cannot be under estimated and it will require the leadership in the internal medicine community to ensure that they create the opportunity for all internists to master the use of PoCUS.

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