scholarly journals An Evaluation of a Formative Assessment Process used on Post Take Ward Rounds

2013 ◽  
Vol 12 (4) ◽  
pp. 208-213
Author(s):  
Gordon Caldwell ◽  
Keyword(s):  
Formative Assessment ◽  
Clinical Training ◽  
Clinical Care ◽  
Clinical Excellence ◽  
Assessment Process ◽  
Online Surveys ◽  
Positive Effects ◽  
Acute Medical Unit ◽  
Ward Rounds ◽  
Case Based

The purpose of clinical training is to develop doctors capable of delivering professional, personal, effective, high quality, safe clinical care with Intelligent Kindness. The processes supporting training must promote development towards excellence. In 2004 a formative assessment process for use on medical post take ward rounds was introduced based on a model of a Driving Instructor and Learner Driver. This process has been evaluated in comparison with the Case based Discussion (CbD) and mini-Cex by 140 of 369 trainees, using online surveys. Ten trainees were interviewed in depth. The majority of trainees reported that this process had helped them more in their development as doctors than the CbD or mini-CEX. Trainees were able to describe positive effects in areas such as diagnosis, prescribing and confidence in their work. In the NHS the assessments are meant to be “trainee driven”, however all but one of the trainees stated that they preferred the routine provision of an assessment to having to ask for an assessment. This evaluation of a truly formative assessment process shows that the trainees benefit in their progression towards clinical excellence. Effective formative feedback can be provided on an Acute Medical Unit even within the constraints of busy post take ward rounds. Within a team of Consultants one should be allowed time to develop an extended Clinical Supervisor role.

scholarly journals The importance of maternal pregnancy vitamin D for offspring bone health: learnings from the MAVIDOS trial

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110069
Author(s):  
Rebecca J. Moon ◽  
Elizabeth M. Curtis ◽  
Stephen J. Woolford ◽  
Shanze Ashai ◽  
Cyrus Cooper ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Development ◽  
Controlled Trial ◽  
Clinical Care ◽  
Later Life ◽  
Vitamin D Supplementation ◽  
Public Health Policies ◽  
Positive Effects

Optimisation of skeletal mineralisation in childhood is important to reduce childhood fracture and the long-term risk of osteoporosis and fracture in later life. One approach to achieving this is antenatal vitamin D supplementation. The Maternal Vitamin D Osteoporosis Study is a randomised placebo-controlled trial, the aim of which was to assess the effect of antenatal vitamin D supplementation (1000 IU/day cholecalciferol) on offspring bone mass at birth. The study has since extended the follow up into childhood and diversified to assess demographic, lifestyle and genetic factors that determine the biochemical response to antenatal vitamin D supplementation, and to understand the mechanisms underpinning the effects of vitamin D supplementation on offspring bone development, including epigenetics. The demonstration of positive effects of maternal pregnancy vitamin D supplementation on offspring bone development and the delineation of underlying biological mechanisms inform clinical care and future public-health policies.

scholarly journals ACADEMIA’S ROLE TO DRIVE CHANGE IN THE ORTHOTICS AND PROSTHETICS PROFESSION

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Géza Kogler ◽  
Christopher Hovorka
Keyword(s):  
Technology Use ◽  
Clinical Training ◽  
Clinical Decision Making ◽  
New Technologies ◽  
Clinical Care ◽  
Clinical Decision ◽  
The United States ◽  
Academic Program ◽  
Number Of Patients ◽  
Curricular Emphasis

This position paper outlines the important role of academia in shaping the orthotics and prosthetics (O&P) profession and preparing for its future. In the United States, most healthcare professions including O&P are under intense pressure to provide cost effective treatments and quantifiable health outcomes. Pivotal changes are needed in the way O&P services are provided to remain competitive. This will require the integration of new technologies and data driven processes that have the potential to streamline workflows, reduce errors and inform new methods of clinical care and device manufacturing. Academia can lead this change, starting with a restructuring in academic program curricula that will enable the next generation of professionals to cope with multiple demands such as the provision of services for an increasing number of patients by a relatively small workforce of certified practitioners delivering these services at a reduced cost, with the expectation of significant, meaningful, and measurable value. Key curricular changes will require replacing traditional labor-intensive and inefficient fabrication methods with the integration of newer technologies (i.e., digital shape capture, digital modeling/rectification and additive manufacturing). Improving manufacturing efficiencies will allow greater curricular emphasis on clinical training and education – an area that has traditionally been underemphasized. Providing more curricular emphasis on holistic patient care approaches that utilize systematic and evidence-based methods in patient assessment, treatment planning, dosage of O&P technology use, and measurement of patient outcomes is imminent. Strengthening O&P professionals’ clinical decision-making skills and decreasing labor-intensive technical fabrication aspects of the curriculum will be critical in moving toward a digital and technology-centric practice model that will enable future practitioners to adapt and survive. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36673/28349 How To Cite: Kogler GF, Hovorka CF. Academia’s role to drive change in the orthotics and prosthetics profession. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.21. https://doi.org/10.33137/cpoj.v4i2.36673 Corresponding Author: Géza F. KoglerOrthotics and Prosthetics Unit, Kennesaw State University.E-Mail: [email protected] ID: https://orcid.org/0000-0003-0212-5520

Technology-Assisted Formative Assessment

2015 ◽  
pp. 380-398 ◽  
Author(s):  
Karen E. Irving
Keyword(s):  
Formative Assessment ◽  
Teaching And Learning ◽  
Formative Feedback ◽  
First Century ◽  
Assessment Process ◽  
Just In Time ◽  
Assessment Practices ◽  
Present Information ◽  
Electronic Technologies ◽  
Share Information

Reliable just-in-time assessments are the foundation of informed teaching and learning. Modern electronic technologies assist in the formative assessment process by supporting classroom environments that allow students and teachers to assess learning and providing mechanisms to present information about student learning during instructional sequences. To implement formative assessment practices, students and teachers benefit from rich educational tasks that invite students to share information about their understanding of the lesson while the lesson is occurring in order to nurture productive learning by both teacher and student. Formative feedback is facilitated by technologies such as connected classrooms, videography, online formative quizzes, and manuscript multi-draft editing. Technology-assisted formative assessment represents a powerful option to promote improved classroom communications that support formative assessment practices for teachers in twenty-first century classrooms.

scholarly journals Assessing Diagnostic Reasoning Using a Standardized Case-Based Discussion

2019 ◽  
Vol 6 ◽  
pp. 238212051984941 ◽  
Author(s):  
Ruth M Sutherland ◽  
Katharine J Reid ◽  
Neville G Chiavaroli ◽  
David Smallwood ◽  
Geoffrey J McColl
Keyword(s):  
Medical Students ◽  
Student Performance ◽  
Clinical Training ◽  
Medical Training ◽  
Clinical Information ◽  
Performance Standards ◽  
Diagnostic Reasoning ◽  
First Year ◽  
Oral Assessment ◽  
Case Based

Background: Development of diagnostic reasoning (DR) is fundamental to medical students’ training, but assessing DR is challenging. Several written assessments focus on DR but lack the ability to dynamically assess DR. Oral assessment formats have strengths but have largely lost favour due to concerns about low reliability and lack of standardization. Medical schools and specialist medical colleges value many forms of oral assessment (eg, long case, Objective Structured Clinical Examination [OSCE], viva voce) but are increasingly searching for ways in which to standardize these formats. We sought to develop and trial a Standardized Case-Based Discussion (SCBD), a highly standardized and interactive oral assessment of DR. Methods: Two initial cohorts of medical students (n = 319 and n = 342) participated in the SCBD as part of their assessments. All students watch a video trigger (based on an authentic clinical case) and discuss their DR with an examiner for 15 minutes. Examiners probe students’ DR and assess how students respond to new standardized clinical information. An online examiner training module clearly articulates expected student performance standards. We used student achievement and student and examiner perceptions to gauge the performance of this new assessment form over 2 implementation years. Results: The SCBD was feasible to implement for a large student cohort and was acceptable to students and examiners. Most students and all examiners agreed that the SCBD discussion provided useful information on students’ DR. The assessment had acceptable internal consistency, and the associations with other assessment formats were small and positive, suggesting that the SCBD measures a related, yet novel construct. Conclusions: Rigorous, standardized oral assessments have a place in a programme of assessment in initial medical training because they provide opportunities to explore DR that are limited in other formats. We plan to incorporate an SCBD into our clinical assessments for the first year of clinical training, where teaching and assessing basic DR is emphasized. We will also explore further examiners’ understanding of and approach to assessing DR.

scholarly journals Using the CLER Pathways to Excellence to Evaluate the Learning Environments at a Multi-Site Institution

2018 ◽  
Vol 10 (6) ◽  
pp. 683-687
Author(s):  
Maria Aaron ◽  
Philip Shayne ◽  
Erica Brownfield ◽  
Nathan O. Spell ◽  
Jaffar Khan ◽  
...  
Keyword(s):  
Learning Environment ◽  
Learning Environments ◽  
Clinical Training ◽  
Clinical Care ◽  
Evaluation Process ◽  
Audience Response ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Supportive Culture ◽  
Effective Supervision

ABSTRACT Background The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review (CLER) program visits 1 participating site per sponsoring institution. While valuable, feedback on that site does not necessarily generalize to all learning environments where trainees and faculty provide clinical care, and institutions may be missing significant insight and feedback on other clinical learning sites. Objective We explored how the Emory Learning Environment Evaluation process—modeled after CLER—could be used to improve the learning environments at 5 major clinical training sites. Methods Participants were recruited via e-mail. Sites hosted separate 60-minute sessions for medical students, residents and fellows, and faculty. We used the CLER Pathways to Excellence to develop a combination of fixed choice and opened-ended questions deployed via an audience response system and verbal queries. Data were analyzed primarily through descriptive statistics and graphs. Results Across sites, per session, medical student participants ranged from 9–16, residents and fellows ranged 21–30, and faculty ranged 15–29. Learners agreed that sites: (1) provided a supportive culture for requesting supervision (students 100%; residents and fellows 70%–100%), and (2) provided a supportive culture for reporting patient safety events (students 94%–100%; residents and fellows 91%–95%). Only a minority of residents and fellows and faculty agreed that they were educated on how to provide effective supervision (residents and fellows 21%–52%; faculty 45%–64%). Conclusions Data from this process have helped standardize improvement efforts across multiple clinical learning environments within our sponsoring institution.

scholarly journals Measuring the Effectiveness of Virtuous Pedagogy: A Quantitative Study of the What If Learning Approach in Church of England Schools

2020 ◽  
Vol 10 (11) ◽  
pp. 315
Author(s):  
Sabina Hulbert ◽  
Trevor Cooling ◽  
Robert Bowie
Keyword(s):  
Church Of England ◽  
Learning Approach ◽  
Online Surveys ◽  
Pedagogical Approach ◽  
Positive Effects ◽  
The United Kingdom ◽  
Before And After ◽  
Implicit And Explicit ◽  
Explicit Measures ◽  
Positive Effect

What If Learning is a pedagogical approach that allows teachers to deliver traditional content, as prescribed by national curricula, while at the same time promoting character virtues fundamental to Christian ethos. It encourages teachers to present topics from a different perspective, which shapes understanding through the lenses of cooperation, coaching or hospitality. What If Learning reframes ‘how’ to teach rather than changing ‘what’ to teach. This study tested the effects of a three-months-long What If Learning intervention which reshaped the delivery of lessons to reflect values of hospitality and welcome in twenty schools across five dioceses in the United Kingdom. Four hundred and seventy-four pupils and 198 of their teachers filled in online surveys presenting implicit and explicit measures of intergroup attitudes adapted from the existing literature to reflect our operationalisation of tolerance as the Christian virtue of hospitality or welcome. Data were collected from all participants at three time points: before and after the intervention and then again three months later. Analyses of variance revealed a pattern of answers largely supportive of the positive effect of the proposed pedagogical approach, although not always consistent with the hypotheses. Teachers report overwhelming positive effects of the intervention on several aspects of pupils’ behaviour and flourishing potentials. The discussion focuses on the widespread implications of these findings while acknowledging the need for additional research to strengthen our conclusions and promote the approach even further.

scholarly journals Safe use of the EHR by medical scribes: a qualitative study

2020 ◽  
Author(s):  
Joan S Ash ◽  
Sky Corby ◽  
Vishnu Mohan ◽  
Nicholas Solberg ◽  
James Becton ◽  
...  
Keyword(s):  
Patient Safety ◽  
Best Practices ◽  
Clinical Training ◽  
Rapid Assessment ◽  
Data Gathering ◽  
Assessment Process ◽  
Healthcare Organizations ◽  
Safety Risks ◽  
The Us ◽  
Medical Scribes

Abstract Objective Hiring medical scribes to document in the electronic health record (EHR) on behalf of providers could pose patient safety risks because scribes often have no clinical training. The aim of this study was to investigate the effect of scribes on patient safety. This included identification of best practices to assure that scribe use of the EHR is not a patient safety risk. Materials and Methods Using a sociotechnical framework and the Rapid Assessment Process, we conducted ethnographic data gathering at 5 purposively selected sites. Data were analyzed using a grounded inductive/hermeneutic approach. Results We conducted site visits at 12 clinics and emergency departments within 5 organizations in the US between 2017 and 2019. We did 76 interviews with 81 people and spent 80 person-hours observing scribes working with providers. Interviewees believe and observations indicate that scribes decrease patient safety risks. Analysis of the data yielded 12 themes within a 4-dimension sociotechnical framework. Results about the “technical” dimension indicated that the EHR is not considered overly problematic by either scribes or providers. The “environmental” dimension included the changing scribe industry and need for standards. Within the “personal” dimension, themes included the need for provider diligence and training when using scribes. Finally, the “organizational” dimension highlighted the positive effect scribes have on documentation efficiency, quality, and safety. Conclusion Participants perceived risks related to the EHR can be less with scribes. If healthcare organizations and scribe companies follow best practices and if providers as well as scribes receive training, safety can actually improve.

Acquiring Advanced Technology: Decision-making Strategies at Twelve Medical Centers

1993 ◽  
Vol 9 (4) ◽  
pp. 530-538 ◽  
Author(s):  
Saul N. Weingart
Keyword(s):  
Decision Making ◽  
Technology Assessment ◽  
Ad Hoc ◽  
Clinical Care ◽  
Advanced Technology ◽  
Financial Impact ◽  
Assessment Process ◽  
Medical Centers ◽  
The Impact

AbstractThis study describes decision making regarding the acquisition of technology in 12 major medical centers. The financial impact of a project was the most widely cited criterion of decision, but financial considerations were less important than either the impact of a technology on the quality of clinical care or its contribution to teaching and research. Rarely were criteria set out explicitly or in advance. Although exemplary models exist, the technology assessment process at most institutions is described as “political,” “informal,” or “ad hoc.”

Controversial clinical practices for patients with preeclampsia or HELLP syndrome: a survey

2015 ◽  
Vol 43 (1) ◽  
Author(s):  
Ahmet Basaran ◽  
Mustafa Basaran ◽  
Betul Basaran ◽  
Cihat Sen ◽  
James N. Martin
Keyword(s):  
Hellp Syndrome ◽  
Clinical Care ◽  
Fetal Lung ◽  
Extensive Literature ◽  
Clinical Practices ◽  
Lung Maturation ◽  
Online Surveys ◽  
Considerable Controversy ◽  
Extensive Literature Search ◽  
Fetal Lung Maturation

AbstractConsiderable controversy continues to surround the management of severe preeclampsia and HELLP syndrome. Experts, researchers, and those published in the field were surveyed about their specific practices.An extensive literature search was undertaken to identify the cohort of authors with recent publications on the subjects of preeclampsia (2009–2012) and HELLP syndrome (2005–2012). Online surveys were sent to all authors using the email addresses found in their publications.Surveys were delivered by email to 363 authors of preeclampsia publications and 91 authors of HELLP syndrome publications. Completed surveys were received from 61 (13.4%) of the group. Except for consensus about the indication of corticosteroids for the enhancement of fetal lung maturation, there was considerable variation in corticosteroid practice and anesthesia techniques.A marked diversity in practice characterized the clinical care rendered by experts in the field of preeclampsia and HELLP syndrome. Thus, there is an urgent need for well-designed and executed prospective clinical trials to improve the evidence for best consensus practice in this area of obstetrical medicine.

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