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Independent medical education

Vineet M Arora
With the advent of electronic medical records (EMRs) fueling the rise of big data, the use of predictive analytics, machine learning, and artificial intelligence are touted as transformational tools to improve clinical care. While major investments are being made in using big data to transform health care delivery, little effort has been directed toward exploiting big data to improve graduate medical education (GME). Because our current system relies on faculty observations of competence, it is not unreasonable to ask whether big data in the form of clinical EMRs and other novel data sources can answer questions of importance in GME such as when is a resident ready for independent practice...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Andrés Pomi
BACKGROUND: One of the central challenges of third millennium medicine is the abatement of medical errors. Among the most frequent and hardiest causes of misdiagnosis are cognitive errors produced by faulty medical reasoning. These errors have been analyzed from the perspectives of cognitive psychology and empirical medical studies. We introduce a neurocognitive model of medical diagnosis to address this issue. METHODS: We construct a connectionist model based on the associative nature of human memory to explore the non-analytical, pattern-recognition mode of diagnosis...
November 27, 2017: Diagnosis
Viktor Riklefs, Gulmira Abakassova, Aliya Bukeyeva, Sholpan Kaliyeva, Bakhtiyar Serik, Alma Muratova, Raushan Dosmagambetova
BACKGROUND: Medical education in Kazakhstan has been literally transformed in the past 10 years. Kazakhstan inherited the Soviet-time discipline-based teacher-centered system of education when no decisions could be made independently. The curriculum was mostly governed in a traditional way, with lectures being the core, little use of e-learning tools, and assessment through oral exams and multiple-choice questions. Most of the universities still preserve the subject-based curriculum with elements of integrated learning...
March 11, 2018: Medical Teacher
Anthony Kopatsis, Christine Wagner, Helen Costello, Nicholas Morin, Katherine Elizabeth Kopatsis, Mario Gomez
We sought to determine patterns of injury in our Latino trauma community targeting alcohol (EtOH) intoxication as an influential variable. With the information gained in our culturally specific and culturally sensitive trauma community, we can use the information to fine-tune our trauma preventive medicine programs. Trauma injuries are the third largest contributor to racial disparities in the United States. Alcohol is involved in approximately half of all trauma admissions to trauma centers around the country...
March 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Hye-Sun Shin
BACKGROUND: No studies have reported the association between the number of teeth and hypertensions in the Korean national data. The purpose of this study was to investigate whether the number of teeth is associated with blood pressure and hypertension in a representative sample of the Korean population. METHODS: A cross-sectional study was conducted on 13,561 participants ≥ 19 years of age using the 2012-2014 Korea National Health and Nutrition Examination Survey data...
February 22, 2018: Journal of Periodontology
Kerry Wilbur, Alaa Elmubark, Sara Shabana
INTRODUCTION: The standardized patient (SP) has assumed a fundamental role in undergraduate medical education since first conceived over 50 years ago. While widely used in student training and assessment of communication and clinical examination across health disciplines, little is known how SPs enhance knowledge or skill development among professionals. We conducted a systematic review to determine the effectiveness of SPs in continuing medical education (CME) programs. METHODS: Authors independently searched for studies published between 1966 and 2016, describing CME initiatives using SP encounters as practice for participants compared with those which did not...
January 2018: Journal of Continuing Education in the Health Professions
Gong-Jun Ji, Panpan Hu, Ting-Ting Liu, Ying Li, Xingui Chen, Chunyan Zhu, Yanghua Tian, Xianwen Chen, Kai Wang
Purpose To quantitatively summarize the functional connectivity (FC) feature of the corticobasal ganglia-thalamocortical (CBTC) network in patients with Parkinson disease (PD) by means of a meta-analysis with cross-validation. Materials and Methods For this prospective study, a systematic literature search in the PubMed and EMBASE databases was performed for resting-state functional magnetic resonance (MR) imaging studies of PD published between January 2000 and May 2017. Then, a coordinate-based meta-analysis was conducted by Effect Size-Signed Differential Mapping...
March 7, 2018: Radiology
Aleksander Zarzeka, Mariusz Panczyk, Halina Zmuda-Trzebiatowska, Jaroslawa Belowska, Lukasz Samolinski, Lucyna Iwanow, Joanna Gotlib
In Poland, since 1 January 2016 nurses who graduated from the master studies or hold a title of a specialist may ordain and prescribe specific medicines ("independent nurse prescribing" - INP). Nurses, who completed bachelor studies or hold a title of a specialist are allowed to prescribe drugs to continue the patient's treatment as ordered by a physician ("supplementary nurse prescribing" - SNP). The aim of this paper was to analyze the knowledge and attitudes of the Polish nurse specialists to their new professional rights in the independent ordaining of some drugs and drug prescribing...
May 2017: Acta Poloniae Pharmaceutica
Keerthi Reddy, Mary Kearns, Santiago Alvarez-Arango, Ismael Carrillo-Martin, Nathaly Cuervo-Pardo, Lyda Cuervo-Pardo, Ves Dimov, David M Lang, Sonia Lopez-Alvarez, Brian Schroer, Kaushik Mohan, Mark Dula, Simin Zheng, Claudia Kozinetz, Alexei Gonzalez-Estrada
BACKGROUND: Food allergy affects an estimated 8% of children and 3% of adults in the US. Food-allergic individuals increasingly use the web for medical information. We sought to determine the educational quality of food allergy YouTube videos. METHODS: We performed a YouTube search using keywords "food allergy" and "food allergies". The 300 most viewed videos were included and analyzed for characteristics, source, and content. Source was further classified as health care provider, alternative medicine provider, patient, company, media, and professional society...
March 7, 2018: Pediatric Allergy and Immunology
Alex Tsui, Diana Kuh, Linda Cardozo, Daniel Davis
OBJECTIVE: To investigate the prevalence of urgency urinary incontinence (UUI) at age 68 years and the contribution of vascular risk factors to male and female UUI pathogenesis in addition to the associations with raised body mass index (BMI). SUBJECTS AND METHODS: In all, 1 762 participants from the Medical Research Council (MRC) National Survey for Health and Development birth cohort who answered the International Consultation on Incontinence Questionnaire short form (ICIQ-SF), at age 68 years, were included...
March 7, 2018: BJU International
Charlotte Vaysse, Elodie Chantalat, Odile Beyne-Rauzy, Louise Morineau, Fabien Despas, Jean-Marc Bachaud, Nathalie Caunes, Muriel Poublanc, Elie Serrano, Roland Bugat, Marie-Eve Rougé Bugat, Anne-Laure Fize
BACKGROUND: Oncology involves complex care and multidisciplinary management of patients; however, misinformation and ineffective communication remain problematic. OBJECTIVE: The educational objective of our study was to develop a new teaching method to improve cancer treatment and management by emphasizing the link between hospitals (inpatients) and their surrounding communities (outpatients). METHODS: A team of 22 professionals from public and private institutions developed a small private online course (SPOC)...
March 5, 2018: JMIR Medical Education
J Breckwoldt, S K Beckers, G Breuer, A Marty
Entrustable professional activities (EPAs) are characterized as self-contained units of work in a given typical clinical context, which may be entrusted to a trainee for independent execution at a certain point of training. An example could be the intraoperative anesthesia management of an ASA 1 patient for an uncomplicated surgical intervention as an EPA in early postgraduate anesthesia training. The EPAs can be described as an evolution of a competency-based medical educational concept, applying the concept of the competencies of a person to specific workplace contexts...
March 2, 2018: Der Anaesthesist
Anne Martin, Josephine N Booth, Yvonne Laird, John Sproule, John J Reilly, David H Saunders
BACKGROUND: The global prevalence of childhood and adolescent obesity is high. Lifestyle changes towards a healthy diet, increased physical activity and reduced sedentary activities are recommended to prevent and treat obesity. Evidence suggests that changing these health behaviours can benefit cognitive function and school achievement in children and adolescents in general. There are various theoretical mechanisms that suggest that children and adolescents with excessive body fat may benefit particularly from these interventions...
March 2, 2018: Cochrane Database of Systematic Reviews
Hari S Raman, David D Limbrick, Wilson Z Ray, Dean W Coble, Sophie Church, Ralph G Dacey, Gregory J Zipfel
OBJECTIVE The challenging nature of neurosurgical residency necessitates that appropriate measures are taken by training programs to ensure that residents are properly progressing through their education. Residents who display a pattern of performance deficiencies must be identified and promptly addressed by faculty and program directors to ensure that resident training and patient care are not affected. While studies have been conducted to characterize these so-called "problem residents" in other specialties, no current data regarding the prevalence and management of such residents in neurosurgery exist...
March 2, 2018: Journal of Neurosurgery
Julie Silverman, James Krieger, George Sayre, Karin Nelson
To describe community health workers (CHWs) roles in a diabetes self-management intervention. Retrospective qualitative inductive analysis of open text home visit encounter form from Peer Support for Achieving Independence in Diabetes (Peer AID), a randomized controlled trial in which low-income individuals with poorly controlled diabetes received either CHW home visits or usual care. Following visits, CHWs completed encounter forms documenting the health goal of the visit, the self-management strategies discussed and participant concerns...
March 1, 2018: Journal of Community Health
R Todd Watkins, Linc J Conn, Robert G Gellin, Theresa S Gonzales, Lindsey M Hamil, Monica J Cayouette, Michael G Schmidt
The analysis of dental students' clinical production/participation has been used to assess whether a prospective graduate is capable of unsupervised and independent practice (that is, competent to perform that practice). This method and others have inherent biases that may not accurately reflect whether the student has mastered the associated concepts and techniques required for dentistry. The aim of this study was to assess an informatics system that assigned curriculum meta-tags with time-based relative educational value units (ReVUs) to each clinical procedure performed by Medical University of South Carolina (MUSC) students...
March 2018: Journal of Dental Education
K H Ma, Z Y Cui, L Li, H Chao, Y Wang
Objective: To investigate the relationship between personality characteristics and turnover intention of the medical staff in an infectious diseases hospital. Methods: Using the cluster sampling method, a total of 366 members of medical staff were selected from different departments in an infectious disease hospital from May to August, 2013. The general information, such as sex, age, education level, and professional title, were collected and they were subjected to a survey using Cattell's 16 Personality Factor Questionnaire and Turnover Intention Scale...
December 20, 2017: Chinese Journal of Industrial Hygiene and Occupational Diseases
Heléne E K Sundelin, Zheng Chang, Henrik Larsson, Paul Lichtenstein, Catarina Almqvist, Torbjörn Tomson, Jonas F Ludvigsson
OBJECTIVES: To investigate the association between epilepsy and antiepileptic drugs and serious transport accidents requiring emergency care or resulting in death. METHODS: We identified 29,220 individuals 18 years or older with epilepsy without cerebral palsy or intellectual disability and 267,637 matched controls using Swedish registers. This nationwide cohort was followed from 2006 to 2013 for serious transport accidents. We used Cox regression to analyze the risk of serious transport accidents between individuals with epilepsy and matched controls, and then stratified Cox regression to compare the risk during periods of medication with the risk during nonmedication period within the same individual with epilepsy...
February 28, 2018: Neurology
Inga Hege, Anita Dietl, Jan Kiesewetter, Jörg Schelling, Isabel Kiesewetter
BACKGROUND: Virtual patients (VPs) are narrative-based educational activities to train clinical reasoning in a safe environment. Our aim was to explore the influence of the design of the narrative and level of difficulty on the clinical reasoning process, diagnostic accuracy and time-on-task. METHODS: In a randomized controlled trial, we analyzed the clinical reasoning process of 46 medical students with six VPs in three different variations: (1) patients showing a friendly behavior, (2) patients showing a disruptive behavior and (3) a version without a patient story...
February 28, 2018: Medical Teacher
Ann R Kaisen, Janet A Parkosewich, Kelly A Bonito
Purpose The purpose of the study was to identify the rate and factors associated with timely mealtime capillary blood glucose (CBG) testing and insulin coverage in hospitalized patients with diabetes. Methods A descriptive-correlational design was used with a random sample of patients (n = 77) and nurses (n = 36) on a medicine and a neuroscience unit of a large Magnet hospital. After written consent was obtained, post-meal patient and nurse interviews were conducted to collect information about patient, nurse, and situational factors known to influence timely mealtime diabetes care...
February 1, 2018: Diabetes Educator
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