scholarly journals The TeleHealth OSCE: Preparing Trainees to Use Telemedicine as a Tool for Transitions of Care

2020 ◽  
Vol 12 (6) ◽  
pp. 764-768
Author(s):  
Daniel J. Sartori ◽  
Rachael W. Hayes ◽  
Margaret Horlick ◽  
Jennifer G. Adams ◽  
Sondra R. Zabar
Keyword(s):  
Assessment Tool ◽  
Relationship Development ◽  
Transitions Of Care ◽  
Transition Of Care ◽  
Post Discharge ◽  
Specific Knowledge ◽  
Domain Specific ◽  
Internal Medicine Residents ◽  
Specific Skill ◽  
Outpatient Settings

ABSTRACT Background Telemedicine holds promise to bridge the transition of care between inpatient and outpatient settings. Despite this, the unique communication and technical skills required for virtual encounters are not routinely taught or practiced in graduate medical education (GME) programs. Objective To develop an objective structured clinical examination (OSCE) case to assess residents' telemedicine-specific skills and identify potential gaps in our residency program's curriculum. Methods As part of a multi-station OSCE in 2019, we developed a case simulating a remote encounter between a resident and a recently discharged standardized patient. We developed an assessment tool comprising specific behaviors anchored to “not done,” “partly done,” and “well done” descriptors to evaluate core communication and telemedicine-specific skills. Results Seventy-eight NYU internal medicine residents participated in the case. Evaluations from 100% of participants were obtained. Residents performed well in Information Gathering and Relationship Development domains. A mean 95% (SD 3.3%) and 91% (SD 4.9%) of residents received “well done” evaluations across these domains. A mean 78% (SD 14%) received “well done” within Education/Counseling domain. However, only 46% (SD 45%) received “well done” evaluations within the Telemedicine domain; specific weak areas included performing a virtual physical examination (18% well done) and leveraging video to augment history gathering (17% well done). There were no differences in telemedicine-specific skill evaluations when stratified by training track or postgraduate year. Conclusions We simulate a post-discharge virtual encounter and present a novel assessment tool that uncovers telemedicine-specific knowledge gaps in GME trainees.

‘I’m an expert in me and I know what I can cope with’: Patient expertise in rheumatoid arthritis

2014 ◽  
Vol 10 (3) ◽  
pp. 249-261 ◽  
Author(s):  
Tessa Sanderson ◽  
Jo Angouri
Keyword(s):  
Rheumatoid Arthritis ◽  
Meta Analysis ◽  
Healthcare Systems ◽  
Specific Knowledge ◽  
Active Involvement ◽  
Domain Specific ◽  
Access To Health ◽  
Patient Expertise ◽  
Domain Specific Knowledge ◽  
The Uk

The active involvement of patients in decision-making and the focus on patient expertise in managing chronic illness constitutes a priority in many healthcare systems including the NHS in the UK. With easier access to health information, patients are almost expected to be (or present self) as an ‘expert patient’ (Ziebland 2004). This paper draws on the meta-analysis of interview data collected for identifying treatment outcomes important to patients with rheumatoid arthritis (RA). Taking a discourse approach to identity, the discussion focuses on the resources used in the negotiation and co-construction of expert identities, including domain-specific knowledge, access to institutional resources, and ability to self-manage. The analysis shows that expertise is both projected (institutionally sanctioned) and claimed by the patient (self-defined). We close the paper by highlighting the limitations of our pilot study and suggest avenues for further research.

scholarly journals Impact of pharmacist-conducted anticoagulation patient education and telephone follow-up on transitions of care: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lamis R. Karaoui ◽  
Elsy Ramia ◽  
Hanine Mansour ◽  
Nisrine Haddad ◽  
Nibal Chamoun
Keyword(s):  
Tertiary Care ◽  
Intervention Group ◽  
Bleeding Event ◽  
Transitions Of Care ◽  
Control Group ◽  
Published Data ◽  
Post Discharge ◽  
Readmission Rates ◽  
The Impact

Abstract Background There is limited published data in Lebanon evaluating the impact of supplemental education for anticoagulants use, especially DOACs, on clinical outcomes such as bleeding. The study aims to assess the impact of pharmacist-conducted anticoagulation education and follow-up on bleeding and readmission rates. Methods This study was a randomized, non-blinded interventional study conducted between August 2017 and July 2019 in a tertiary care teaching Lebanese hospital. Participants were inpatients ≥18 years discharged on an oral anticoagulant for treatment. Block randomization was used. The control group received the standard nursing counseling while the intervention group additionally received pharmacy counseling. Phone call follow-ups were done on day 3 and 30 post-discharge. Primary outcomes included readmission rates and any bleeding event at day 3 and 30 post-discharge. Secondary outcomes included documented elements of education in the medical records and reported mortality upon day 30 post-discharge. Results Two hundred patients were recruited in the study (100 patients in each study arm) with a mean age of 73.9 years. In the pharmacist-counseled group, more patients contacted their physician within 3 days (14% versus 4%; p = 0.010), received explicit elements of education (p < 0.001) and documentation in the chart was better (p < 0.05). In the standard of care group, patients were more aware of their next physician appointment date (52% versus 31%, p < 0.001). No difference in bleeding rates at day 3 and 30 post-discharge was observed between the groups. Conclusions Although pharmacist-conducted anticoagulation education did not appear to reduce bleeding or readmission rates at day 30, pharmacist education significantly increased patient communication with their providers in the early days post-discharge. Trial registration Lebanon Clinical Trial Registry LBCTR2020033424. Retrospectively registered. Date of registration: 06/03/2020.

Impact of community pharmacist–performed post-discharge medication reviews in transitions of care

2018 ◽  
Vol 58 (6) ◽  
pp. 659-666 ◽  
Author(s):  
Christa E. Tetuan ◽  
Kendall D. Guthrie ◽  
Steven C. Stoner ◽  
Justin R. May ◽  
D. Matthew Hartwig ◽  
...  
Keyword(s):  
Community Pharmacist ◽  
Transitions Of Care ◽  
Post Discharge ◽  
Discharge Medication ◽  
Medication Reviews

scholarly journals Pharmacist-Led Transition of Care Interventions Identify and Reduce Medication Errors in Heart Failure Patients Post-Discharge

2016 ◽  
Vol 22 (8) ◽  
pp. S134-S135
Author(s):  
Michelle Fine ◽  
R. Kannan Mutharasan ◽  
Preeti Kansal ◽  
Hannah Alphs Jackson ◽  
Corrine Benacka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Medication Errors ◽  
Transition Of Care ◽  
Post Discharge ◽  
Heart Failure Patients

Heart Failure Transitions of Care: A Pharmacist-Led Post-Discharge Pilot Experience

2017 ◽  
Vol 60 (2) ◽  
pp. 249-258 ◽  
Author(s):  
Sherry K. Milfred-LaForest ◽  
Julie A. Gee ◽  
Adam M. Pugacz ◽  
Ileana L. Piña ◽  
Danielle M. Hoover ◽  
...  
Keyword(s):  
Heart Failure ◽  
Transitions Of Care ◽  
Post Discharge ◽  
Pilot Experience

Domain-Specific Knowledge Systems in the Brain: The Animate-Inanimate Distinction

1998 ◽  
Vol 10 (1) ◽  
pp. 1-34 ◽  
Author(s):  
Alfonso Caramazza ◽  
Jennifer R. Shelton
Keyword(s):  
Knowledge Systems ◽  
Neural Mechanisms ◽  
Specific Knowledge ◽  
Knowledge Framework ◽  
Semantic Categories ◽  
Domain Specific ◽  
Domain Specific Knowledge ◽  
Cognitive Neuropsychological ◽  
The Brain ◽  
Selective Impairment

We claim that the animate and inanimate conceptual categories represent evolutionarily adapted domain-specific knowledge systems that are subserved by distinct neural mechanisms, thereby allowing for their selective impairment in conditions of brain damage. On this view, (some of) the category-specific deficits that have recently been reported in the cognitive neuropsychological literature—for example, the selective damage or sparing of knowledge about animals—are truly categorical effects. Here, we articulate and defend this thesis against the dominant, reductionist theory of category-specific deficits, which holds that the categorical nature of the deficits is the result of selective damage to noncategorically organized visual or functional semantic subsystems. On the latter view, the sensory/functional dimension provides the fundamental organizing principle of the semantic system. Since, according to the latter theory, sensory and functional properties are differentially important in determining the meaning of the members of different semantic categories, selective damage to the visual or the functional semantic subsystem will result in a category-like deficit. A review of the literature and the results of a new case of category-specific deficit will show that the domain-specific knowledge framework provides a better account of category-specific deficits than the sensory/functional dichotomy theory.

scholarly journals Toward Knowledge Management for Smart Manufacturing

2017 ◽  
Vol 17 (3) ◽  
Author(s):  
Shaw C. Feng ◽  
William Z. Bernstein ◽  
Thomas Hedberg ◽  
Allison Barnard Feeney
Keyword(s):  
Knowledge Management ◽  
Design Process ◽  
Process Planning ◽  
Smart Manufacturing ◽  
Specific Knowledge ◽  
Domain Specific ◽  
Domain Specific Knowledge ◽  
Knowledge Objects ◽  
Planning Production

The need for capturing knowledge in the digital form in design, process planning, production, and inspection has increasingly become an issue in manufacturing industries as the variety and complexity of product lifecycle applications increase. Both knowledge and data need to be well managed for quality assurance, lifecycle impact assessment, and design improvement. Some technical barriers exist today that inhibit industry from fully utilizing design, planning, processing, and inspection knowledge. The primary barrier is a lack of a well-accepted mechanism that enables users to integrate data and knowledge. This paper prescribes knowledge management to address a lack of mechanisms for integrating, sharing, and updating domain-specific knowledge in smart manufacturing (SM). Aspects of the knowledge constructs include conceptual design, detailed design, process planning, material property, production, and inspection. The main contribution of this paper is to provide a methodology on what knowledge manufacturing organizations access, update, and archive in the context of SM. The case study in this paper provides some example knowledge objects to enable SM.

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