Residents’ use of mobile technologies: three challenges for graduate medical education

IntroductionThe practice of medicine involves, among other things, managing ambiguity, interpreting context and making decisions in the face of uncertainty. These uncertainties, amplified for learners, can be negotiated in a variety of ways; however, the promise, efficiency and availability of mobile technologies and clinical decision supports make these tools an appealing way to manage ambiguity.Mobile technologies are becoming increasingly prevalent in medical education and in the practice of medicine. Because of this, we explored how the use of mobile technologies is influencing residents’ experiences of graduate medical education.MethodsWe conducted an 18-month qualitative investigation to explore this issue. Our research was conceptually and theoretically framed in sociomaterial studies of professional learning. Specifically, our methods included logging of technology use and related reflexive writing by residents (n=10), interviews with residents (n=12) and interviews with faculty (n=6).ResultsWe identified three challenges for graduate medical education related to mobile technology use: (1) efficiency versus critical thinking; (2) patient context versus evidence-based medicine and (3) home/work-life balance.DiscussionIn this digital age, decontextualised knowledge is readily available. Our data indicate that rather than access to accurate knowledge, the more pressing challenge for medical educators is managing how, when and why learners choose to access that information.

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A Framework for Mobile Health, Smartphone/Device and App Competencies for Psychiatry and Medicine (Preprint)

10.2196/preprints.12229 ◽

2018 ◽

Author(s):

Donald Technology In Medical Education For Psychiatry ◽

Steven Chan ◽

John Torous ◽

John Luo ◽

Robert Boland ◽

...

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Mobile Health ◽

Technology Use ◽

New Technologies ◽

Quality Care ◽

Medical Knowledge ◽

Clinical Decision ◽

Learning Context ◽

Graduate Medical

BACKGROUND Technology use is ubiquitous in the digital age, especially in the X, Millennial/Y and Z generations. To ensure quality care, clinicians need skills, knowledge and attitudes that can be measured. This paper proposes mobile health, smartphone/device and app competencies based on a literature review, expert consensus and recommendations of the Institute of Medicine’s Health Professions Educational Summit. OBJECTIVE Outline competencies for mH, SP/D and apps using the Accreditation Council of Graduate Medical Education (ACGME) framework. METHODS Literature is integrated on patient-, learner-, competency- and outcome-based themes from the fields of technology, healthcare, pedagogy and business. Mobile health, smartphone/device and app competencies may be situated within the graduate medical education domains of patient care, medical knowledge, practice based learning and improvement, systems based practice, professionalism, and interpersonal skills and communication. Teaching methods are suggested to align competency outcomes, learning context and evaluation. RESULTS Health care via mobile health (mH), smartphone/device (SP/D) and apps have enough similarities to in-person and telepsychiatric care that competencies can be placed in milestone domains. Additional competencies are needed since mH includes clinical decision support, device/technology assessment/selection and information flow management across an e-platform. Since care with mH may have asynchronous components – like social media – competencies for trainees and clinicians may help them shift traditional learning, teaching, supervisory and evaluation practices to achieve targeted outcomes. Clinicians have to best assess, triage and treat patients using technology in a much broader context, while maintaining the therapeutic relationship. Curricula with interactive case-, problem- and system-based teaching are suggested for faculty, along with clinical exposure to new technologies and adaptation of systems-based practice. Health systems need to manage change and create a positive e-culture. CONCLUSIONS Research is needed on implementing and evaluating mH competencies, organization change with technology and how a paradigm shift like mobile health re-contextualizes digital healthcare CLINICALTRIAL Not applicable.

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Graduate Medical Education in Otolaryngology: Making Dollars and Sense of Reform

Otolaryngology ◽

10.1177/01945998211004263 ◽

2021 ◽

pp. 019459982110042

Author(s):

Jenny X. Chen ◽

Shivani A. Shah ◽

Vinay K. Rathi ◽

Mark A. Varvares ◽

Stacey T. Gray

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Resident Training ◽

Short Term ◽

Graduate Medical ◽

Departmental Leadership ◽

Key Stakeholders ◽

The Face ◽

Funding Cuts

Graduate medical education (GME) is funded by the Centers for Medicare and Medicaid Services through both direct and indirect payments. In recent years, stakeholders have raised concerns about the growth of spending on GME and distribution of payment among hospitals. Key stakeholders have proposed reforms to reduce GME funding such as adjustments to statutory payment formulas and absolute caps on annual payments per resident. Otolaryngology departmental leadership should understand the potential effects of proposed reforms, which could have significant implications for the short-term financial performance and the long-term specialty workforce. Although some hospitals and departments may elect to reduce resident salaries or eliminate positions in the face of GME funding cuts, this approach overlooks the substantial Medicare revenue contributed by resident care and high cost of alternative labor sources. Commitment to resident training is necessary to align both the margin and mission of otolaryngology departments and their sponsoring hospitals.

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Development of a Competency-based Training in Obstetrics and Gynecology Ultrasound for Undergraduate and Graduate Medical Education

Donald School Journal of Ultrasound in Obstetrics & Gynecology ◽

10.5005/jp-journals-10009-1339 ◽

2014 ◽

Vol 8 (1) ◽

pp. 83-86

Author(s):

Hoi Ho ◽

Jorge Sarmiento ◽

Dolgor Baatar ◽

Jesus Peinado

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Obstetrics And Gynecology ◽

Residency Programs ◽

Graduate Medical ◽

Practice Of Medicine ◽

Competency Based ◽

Medical Educators ◽

And Training ◽

The Continuum

ABSTRACT Advances in technology have made ultrasonography a rapidly evolving concept in the practice of medicine and a valuable component of the competency-based education. American Medical Association (AMA) recently affirms that ‘ultrasound imaging is a safe, effective and efficient tool when utilized by, or under the direction of appropriately trained physicians.’ AMA also supports the educational efforts and widespread integration of ultrasound throughout the continuum of medical education. Training in ultrasonography is rapidly expanding to numerous residency programs of graduate medical education but discrepancies in ultrasound curriculum and criteria for proficiency exist among programs within the same discipline, despite clearly defined objectives recommended by the governing bodies. There is a trend to integrate ultrasonography into the curriculum of undergraduate medical education. However, funding, availability of ultrasound-trained faculty and student time are barriers to the implementation. Ultrasonography is a natural fit for competency-based training and should be introduced early in medical education. We expect that the LCME will soon mandate the integration of ultrasound into the 4-year curriculum. The imminent question that medical educators ask is not when ultrasound will become a required component of the curriculum but how to effectively integrate the teaching and training of ultrasound into the continuum of medical education. How to cite this article Baatar D, Peinado J, Sarmiento J, Ho H. Development of a Competency-based Training in Obstetrics and Gynecology Ultrasound for Undergraduate and Graduate Medical Education. Donald School J Ultrasound Obstet Gynecol 2014;8(1):83-86.

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