Protocols and Set-Ups

2021 ◽  
pp. 210-240
Author(s):  
Neha Madhiwalla
Keyword(s):  
Medical Education ◽  
Medical Practice ◽  
Significant Proportion ◽  
Knowledge System ◽  
Evidence Based ◽  
Cultural Resources ◽  
Scientific Medicine ◽  
Self Assessment ◽  
Government Services ◽  
Production Of Knowledge

Within the larger context of commodified medical practice and compromised standards in under-resourced government services, premier government medical colleges are reputed to be the enclaves where ‘scientific medicine’ is practised. In the past decade, these have begun to admit a significant proportion of less socially privileged students. This chapter examines the contribution to the production of knowledge of obstetricians graduating from two such institutions who have returned to the ‘periphery’. These students approach medical education without the cultural resources to engage with medicine as a knowledge system. The focus is on instilling discipline and imparting skill in technique, which students imbibe as protocols, without acquiring a broader understanding of the field, an affinity for research, or an exposure to evidence-based practice. Unable to visualize their practice as a conscious engagement with their context, they define their adaptations as violations of the ‘protocolic practice’, undermining their self-assessment as practitioners of science.

Digital Platform for Evidence-Based Medicine in Hematology (non-malignant and malignant conditions) in a Developing Country

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 31-31
Author(s):  
Juliana Rocha ◽  
Renata L Stanzione ◽  
Gabriela Fernandes Aranha ◽  
Dida Capobianco ◽  
Jose Claudio Cyrineu Terra ◽  
...  
Keyword(s):  
Medical Education ◽  
Developing Country ◽  
Medical Practice ◽  
Evidence Based Medicine ◽  
Continuous Process ◽  
Digital Transformation ◽  
Evidence Based ◽  
Access To Information ◽  
Digital Platform ◽  
Based Medicine

Introduction: The SARS-COV2 pandemic has transformed several aspects of our daily lives, we have already experienced profound changes in our society and behavior, and it was only possible to keep part of the gear of life functioning thanks to technology. But it is not possible to talk about technology without talking about digital transformation. The technology applied to medicine provides health professionals with greater access to information and tools that convey evidence-based medicine are essential. Among them we can mention databases such as Medline, PubMed, Embase, Cochrane and UpToDate platform. The COVID 19 pandemic has further accelerated this digital transformation process, instituting changes that are here to stay. Objectives: Today in Brazil, we have an average of 7,000 oncologists and 3,000 hematologists. We know that access to information in a foreign language, even English, is still a problem. The excess of information, and the difficulty of reading scientific publications critically, are another obstacle in medical education in a developing country. The objective of this project is to expand access to information, in continues medical education model, to improve public and private health in the area of hematology. Methods: The hematology team at Hospital Israelita Albert Einstein (HIAE), associated with the HIAE digital transformation laboratory, developed a healthtech platform, called hematolog.app, aiming to make available several updated technical content in different formats: podcasts, videos , discussion of clinical cases, analysis of scientific articles in the form of visual abstracts, reviews of relevant topics in text format. The initiative is supported by the most important national hematology Societies. Discussion: We know that healthtech platforms have transformed medical practice. An online survey of clinicians at the Massachusetts General Hospital and Brigham and Women's Hospital described the following effects among UpToDate users: 95% reported that UpToDate was integral for making decisions, 94% reported that they had changed diagnosis, 95% reported that UpToDate led to a change in patient management, 97% said UpToDate helps them provide the best care for their patients, 90% reported that UpToDate makes them a better doctor, 96% reported made them more comfortable with their decisions. PubMed makes it possible to identify references and summaries of articles from the Medline database, maintained by the National Library of Medicine. PubMed provides several tools to make the search more efficient, unknown to most doctors. Conclusion: The development of hematolog.app aims to create a digital platform that integrates specialists in the area, creating a continuous process of education, and integrating professionals in a developing country, seeking to standardize medical practice in different regions and health services in Brazil, creating an interconnected social network and practicing evidence-based medicine. Disclosures No relevant conflicts of interest to declare.

52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Training Program ◽  
Correlation Coefficient ◽  
Training Programs ◽  
Self Assessment ◽  
Procedural Skills ◽  
Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

AFRICAN LITERATURE AND INDIGENOUS RELIGION: A STUDY OF WOLE SOYINKA’S DEATH AND THE KING’S HORSEMAN AND D.O. FAGUNWA’S ADIITU OLODUMARE

Imbizo ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 4-20
Author(s):  
Femi Abodunrin
Keyword(s):  
21St Century ◽  
African Literature ◽  
Knowledge System ◽  
Religious Knowledge ◽  
Indigenous Religion ◽  
Vast Array ◽  
Production Of Knowledge ◽  
World Today ◽  
Metaphysical Presupposition ◽  
Performance Poetry

Religious bigotry pervades our world today. As the 21st century oscillates between what Ramin Jahanbegloo (2015) has described as the politicisation of religion and its accompanying ideologisation, this study examines the vast array of literary creativity and indigenous religion/knowledge from an ecocritical viewpoint. By indigenous, it is meant those systems of knowledge and production of knowledge that are sometimes perceived as antithetical to the Western empirical systems. Encapsulated in myths and mythical wisdom, these indigenous values have at the centre of their philosophical presuppositions a symbiotic strategy that seeks to integrate man with nature. The study examines Wole Soyinka’s Death and the King’s Horseman and D.O. Fagunwa’s Adiitu Olodumare [The Mysteries of God, Olu Obafemi (trans)], in particular, and the indigenous religious/knowledge system that they reiterate, in general, as distinct from the Western monotheistic system in ontological and metaphysical terms. Also, largely because the metaphysical presupposition of Yoruba religion is essentially performance poetry in motion, a carnivalesque perspective is employed to account for the folkloric and other elements of carnival often described as ‘the feast of time, the feast of becoming, change and renewal’.

Generating publicly available progress notes of authentic quality: A crowdsourcing-based approach (Preprint)

2020 ◽  
Author(s):  
Rina Kagawa ◽  
Yukino Baba ◽  
Hideo Tsurushima
Keyword(s):  
Social Capital ◽  
Medical Education ◽  
Medical Practice ◽  
Patient Privacy ◽  
Patient Anxiety ◽  
Physical Status ◽  
High Quality ◽  
Privacy Concerns ◽  
Progress Notes ◽  
Research And Education

BACKGROUND Sharing progress notes as a common social capital is essential in research and education, but the content of progress notes is sensitive and needs to be kept confidential. Publishing actual progress notes are difficult due to privacy concerns. OBJECTIVE This study aims to generate a large repository of pseudo-progress notes of authentic quality. We focused on two requirements for authentic quality: the validity and consistency of the data, from the perspective of medical practice, and the empirical and semantic characteristics of progress notes, such as shorthand styles used for reporting changes in a patient's physical status, long narrative sentences detailing patient anxiety, and interprofessional communications. METHODS We proposed a practical framework that consists of a simulation of the notes and evaluation of the simulated notes. The framework utilized two human cognitive traits: (1) the ability to use imitation to simulate objects with diverse characteristics without background knowledge and (2) the use of comparison as a strategy for deep thinking. This enabled crowd workers to generate a large number of progress notes. Our framework involved three steps. In step 1, crowd workers imitated actual progress notes decomposed into subject data (S), object data (O), and assessment and plan (A/P). These imitated texts were then shuffled and recomposed in S, O, and A/P in order to create simulated progress notes. In step 2, crowd workers identified the characteristics of actual progress notes based on comparisons between actual and dummy progress notes. These characteristics were clustered based on their similarities. Each cluster exhibited the empirical and semantic characteristics of the actual progress notes. Finally, in step 3, the texts from step 1 that exhibited the identified characteristics from step 2 were evaluated as quality-guaranteed progress notes that met the two requirements. All data were preprocessed to protect patient privacy. RESULTS Step 1: By recomposing the 700 imitated texts, 9,856 simulated progress notes were generated. Step 2: 3,938 differences between actual progress notes and dummy progress notes were identified. After clustering, 166 characteristics were evaluated to be appropriate as empirical and semantic characteristics of the actual progress notes. Step 3: 500 crowd workers demonstrated that 83.0% of the simulated progress notes satisfied at least one of the characteristics obtained in step 2. The crowd workers' artificially-reproduced progress notes were evaluated to determine the most realistic, based on four metrics: disease, morpheme, readability, and reality. CONCLUSIONS Our results demonstrated that crowd workers could generate and evaluate highly professional documents. We have made our large repository of high-quality crowdsourced progress notes publicly available, and we encourage their use in the development of medical education and research.

Introduction

2018 ◽  
Author(s):  
Jacob Stegenga
Keyword(s):  
Medical Practice ◽  
Evidence Based Medicine ◽  
Inductive Inference ◽  
Formal Theory ◽  
Practice Research ◽  
Evidence Based ◽  
Master Argument ◽  
Medical Interventions ◽  
Concepts Of Disease ◽  
Based Medicine

This chapter introduces the book, describes the key arguments of each chapter, and summarizes the master argument for medical nihilism. It offers a brief survey of prominent articulations of medical nihilism throughout history, and describes the contemporary evidence-based medicine movement, to set the stage for the skeptical arguments. The main arguments are based on an analysis of the concepts of disease and effectiveness, the malleability of methods in medical research, and widespread empirical findings which suggest that many medical interventions are barely effective. The chapter-level arguments are unified by our best formal theory of inductive inference in what is called the master argument for medical nihilism. The book closes by considering what medical nihilism entails for medical practice, research, and regulation.

scholarly journals Evidence-Based Alignment of Pathology Residency With Practice II: Findings and Implications

2021 ◽  
Vol 8 ◽  
pp. 237428952110028
Author(s):  
W. Stephen Black-Schaffer ◽  
Stanley J. Robboy ◽  
David J. Gross ◽  
James M. Crawford ◽  
Kristen Johnson ◽  
...  
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Evidence Based ◽  
Donor Center ◽  
Laboratory Management ◽  
Banking Services ◽  
Graduate Medical ◽  
Pathology Informatics ◽  
Billing And Coding ◽  
Future Practice

This article presents findings from a 4-year series of surveys of new-in-practice pathologists, and a survey of physician employers of new pathologists, assessing how pathology graduate medical education prepares its graduates for practice. Using the methodology described in our previous study, we develop evidence for the importance of residency training for various practice areas, comparing findings over different practice settings, sizes, and lengths of time in practice. The principal findings are (1) while new-in-practice pathologists and their employers report residency generally prepared them well for practice, some areas—billing and coding, laboratory management, molecular pathology, and pathology informatics—consistently were identified as being important in practice but inadequately prepared for in residency; (2) other areas—autopsy pathology, and subspecialized apheresis and blood donor center blood banking services—consistently were identified as relatively unimportant in practice and excessively prepared for in residency; (3) the notion of a single comprehensive model for categorical training in residency is challenged by the disparity between broad general practice in some settings and narrower subspecialty practice in others; and (4) the need for preparation in some areas evolves during practice, raising questions about the appropriate mode and circumstance for training in these areas. The implications of these findings range from rebalancing the emphasis among practice areas in residency, to reconsidering the structure of graduate medical education in pathology to meet present and evolving future practice needs.

scholarly journals Time for evidence based medical education

BMJ ◽  
1999 ◽  
Vol 318 (7193) ◽  
pp. 1223-1224 ◽  
Author(s):  
S. Petersen
Keyword(s):  
Medical Education ◽  
Evidence Based

scholarly journals Self-Assessment of Problem Solving Disposition in Medical Students

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Silvia Lizett Olivares-Olivares ◽  
Mildred Vanessa López-Cabrera
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Medical Students ◽  
Problem Solving ◽  
Medical Schools ◽  
Self Assessment ◽  
Competency Based Education ◽  
Competency Based ◽  
Future Demands ◽  
Disposition Model

Medical schools are committed to both students and society to develop capabilities required to succeed in health care environments. Present diagnosis and treatment methods become obsolete faster, demanding that medical schools incorporate competency-based education to keep pace with future demands. This study was conducted to assess the problem solving disposition of medical students. A three-subcategory model of the skill is proposed. The instrument was validated on content by a group of 17 experts in medical education and applied to 135 registered students on the sixth year of the M.D. Physician Surgeon program at a private medical school. Cronbach’s alpha indicated an internal consistency of 0.751. The findings suggest that selected items have both homogeneity and validity. The factor analysis resulted in components that were associated with three problem-solving subcategories. The students’ perceptions are higher in the pattern recognition and application of general strategies for problem solving subcategories of the Problem solving disposition model.

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