Direct Observation Medical Trainees

2013 ◽  
Vol 03 (01) ◽  
Author(s):  
Joseph Gigante
Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 223
Author(s):  
Ryuichi Ohta ◽  
Yoshinori Ryu ◽  
Chiaki Sano

Rural community-based medical education (CBME) enriches undergraduate and postgraduate students’ learning but has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. We identified the challenges faced by stakeholders as well as the relevant solutions to provide recommendations for sustainable CBME in community hospitals during the COVID-19 pandemic. A total of 31 pages of field and reflection notes were collated through direct observation and used for analysis. Five physicians, eight nurses, one clerk, fourteen medical trainees, and three rural citizens were interviewed between 1 April and 30 September 2020. The interviews were recorded and their contents were transcribed verbatim and analyzed using thematic analysis. Three themes emerged: uncertainty surrounding COVID-19, an overwhelming sense of social fear and pressure within and outside communities, and motivation and determination to continue providing CBME. Rural CBME was impacted by not only the fear of infection but also social fear and pressure within and outside communities. Constant assessment of the risks associated with the pandemic and the implications for CMBE is essential to ensure the sustainability of CBME in rural settings, not only for medical educators and students but also stakeholders who administrate rural CBME.


JAMA ◽  
2009 ◽  
Vol 302 (12) ◽  
pp. 1316 ◽  
Author(s):  
Jennifer R. Kogan ◽  
Eric S. Holmboe ◽  
Karen E. Hauer

Author(s):  
Brian Garibaldi ◽  
Timothy Niessen ◽  
Yi Zhen Lee ◽  
Bennett Clark ◽  
Sanjay Desai

2015 ◽  
Vol 7 (2) ◽  
pp. 253-255 ◽  
Author(s):  
Sarah Pitts ◽  
Joshua Borus ◽  
Adrianne Goncalves ◽  
Holly Gooding

Abstract Background Direct clinical observation is an essential component of medical trainee assessment, particularly in the era of milestone-based competencies. However, the adolescent patient's perspective on this practice is missing from the literature. Quality health care is patient centered, yet we did not know if our educational practices align with this clinical goal. Objective We sought to better understand our adolescent/young adult patients' perspectives of the direct observation of our medical trainees in the outpatient clinical setting. Methods As a quality improvement initiative, we surveyed adolescent/young adult patients, medical trainees, and physician observers in our outpatient clinical practice regarding their experience following a direct observation encounter. We performed descriptive analyses of the data. Results During a 1-year period, responses were received from 23 adolescent/young adult patients, 8 family members, 14 trainees, and 6 faculty observers. Nearly all adolescent/young adult patients (n = 22) and all surveyed family members (n = 8) expressed comfort with direct observation, and all respondents felt the care they received was the same or better. All patient/family respondents preferred direct observation to the idea of remote observation, and most, but not all, trainees and faculty observers expressed similar opinions. Conclusions Adolescent/young adult patients and their family members found direct observation of their trainee providers to be comfortable and beneficial. Despite adolescent and young adults' facility and comfort with modern technologies, there was an expressed preference for direct versus remote observation.


Author(s):  
R. W. Anderson ◽  
D. L. Senecal

A problem was presented to observe the packing densities of deposits of sub-micron corrosion product particles. The deposits were 5-100 mils thick and had formed on the inside surfaces of 3/8 inch diameter Zircaloy-2 heat exchanger tubes. The particles were iron oxides deposited from flowing water and consequently were only weakly bonded. Particular care was required during handling to preserve the original formations of the deposits. The specimen preparation method described below allowed direct observation of cross sections of the deposit layers by transmission electron microscopy.The specimens were short sections of the tubes (about 3 inches long) that were carefully cut from the systems. The insides of the tube sections were first coated with a thin layer of a fluid epoxy resin by dipping. This coating served to impregnate the deposit layer as well as to protect the layer if subsequent handling were required.


Author(s):  
John M. Wehrung ◽  
Richard J. Harniman

Water tables in aquifer regions of the southwest United States are dropping off at a rate which is greater than can be replaced by natural means. It is estimated that by 1985 wells will run dry in this region unless adequate artificial recharging can be accomplished. Recharging with surface water is limited by the plugging of permeable rock formations underground by clay particles and organic debris.A controlled study was initiated in which sand grains were used as the rock formation and water with known clay concentrations as the recharge media. The plugging mechanism was investigated by direct observation in the SEM of frozen hydrated sand samples from selected depths.


Author(s):  
N. E. Paton ◽  
D. de Fontaine ◽  
J. C. Williams

The electron microscope has been used to study the diffusionless β → β + ω transformation occurring in certain titanium alloys at low temperatures. Evidence for such a transformation was obtained by Cometto et al by means of x-ray diffraction and resistivity measurements on a Ti-Nb alloy. The present work shows that this type of transformation can occur in several Ti alloys of suitable composition, and some of the details of the transformation are elucidated by means of direct observation in the electron microscope.Thin foils were examined in a Philips EM-300 electron microscope equipped with a uniaxial tilt, liquid nitrogen cooled, cold stage and a high resolution dark field device. Selected area electron diffraction was used to identify the phases present and the ω-phase was imaged in dark field by using a (101)ω reflection. Alloys were water quenched from 950°C, thinned, and mounted between copper grids to minimize temperature gradients in the foil.


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