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principle of medical education

Carl D Stevens
The sudden, dramatic collapse of the seven-year struggle in Congress to repeal and replace the Affordable Care Act holds important lessons for all would-be reformers, including those advocating fundamental changes in medical education. In this Invited Commentary, the author draws parallels between reform initiatives in health policy and those in medical education, highlighting that, in both settings, stakeholders rarely support "repeal" in the absence of a superior replacement, even when they view the status quo as deeply flawed...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Anne-Marie Reid, Jeremy M Brown, Julie M Smith, Alexandra C Cope, Susan Jamieson
CONTEXT: For medical education researchers, a key concern may be the practicalities of gaining ethical approval where this is a national or local requirement. However, in qualitative studies, where the dynamics of human interaction pervade, ethical considerations are an ongoing process which continues long after approval has been granted. Responding to ethical dilemmas arising 'in the moment' requires a reflexive approach whereby the researcher questions his/her own motivations, assumptions and interests...
March 13, 2018: Perspectives on Medical Education
Aleksandar N Neskovic, Henry Skinner, Susanna Price, Gabriele Via, Stefan De Hert, Ivan Stankovic, Maurizio Galderisi, Erwan Donal, Denisa Muraru, Erik Sloth, Luna Gargani, Nuno Cardim, Alexandros Stefanidis, Matteo Cameli, Gilbert Habib, Bernard Cosyns, Patrizio Lancellotti, Thor Edvardsen, Bogdan A Popescu
There is a growing trend of using ultrasound examination of the heart as a first-line diagnostic tool for initial patient evaluation in acute settings. Focus cardiac ultrasound (FoCUS) is a standardized but restricted cardiac ultrasound examination that may be undertaken by a range of medical professionals with diverse backgrounds. The intention of this core curriculum and syllabus is to define a unifying framework for educational and training processes/programmes that should result in competence in FoCUS for various medical professionals dealing with diagnostics and treatment of cardiovascular emergencies...
February 26, 2018: European Heart Journal Cardiovascular Imaging
Jason N Itri, Sohil H Patel
OBJECTIVE: The field of cognitive science has provided important insights into mental processes underlying the interpretation of imaging examinations. Despite these insights, diagnostic error remains a major obstacle in the goal to improve quality in radiology. In this article, we describe several types of cognitive bias that lead to diagnostic errors in imaging and discuss approaches to mitigate cognitive biases and diagnostic error. CONCLUSION: Radiologists rely on heuristic principles to reduce complex tasks of assessing probabilities and predicting values into simpler judgmental operations...
March 12, 2018: AJR. American Journal of Roentgenology
Connie R Shi, Jasmine Rana, Susan Burgin
Challenge: The "flipped classroom" is a pedagogical model in which instructional materials are delivered to learners outside of class, reserving class time for application of new principles with peers and instructors. Active learning has forever been an elusive ideal in medical education, but the flipped class model is relatively new to medical education. What is the evidence for the "flipped classroom," and how can these techniques be applied to the teaching of dermatology to trainees at all stages of their medical careers?...
April 2018: International Journal of Dermatology
Sarah B Cairo, Malachi Fisher, Brian Clemency, Charlotte Cipparone, Evelyn Quist, Kathryn D Bass
PURPOSE: Patient triage to the appropriate destination is critical to prehospital trauma care. Triage decisions are challenging in a region without collocated pediatric and adult trauma centers. METHODS: A regional survey was administered to emergency medical response units identifying variability and confusion regarding factors influencing patient disposition. A course was developed to guide the triage of pediatric and pregnant trauma patients. Pre- and posttests were administered to address course principles, including decision making and triage...
February 11, 2018: Journal of Pediatric Surgery
Jill M Bowman Peterson, Briar Duffy, Alisa Duran, Sophia P Gladding
BACKGROUND: Current health care costs are unsustainable, with a large percentage of waste attributed to doctor practices. Medical educators are developing curricula to address value-based care (VBC) in education. There is, however, a paucity of curricula and assessments addressing levels higher than 'knows' at the base of Miller's pyramid of assessment. Our objective was to: (1) teach residents the principles of VBC using active learning strategies; and (2) develop and pilot a tool to assess residents' ability to apply principles of VBC at the higher level of 'knows how' on Miller's pyramid...
March 6, 2018: Clinical Teacher
Mohammad Ranjbar Ezzatabadi, Ameneh Khosravi, Mohammad Amin Bahrami, Sima Rafiei
Purpose Developing country workers mainly face important challenges when examining equality in health services utilization among the population and identifying influential factors. The purpose of this paper us to: understand health service use among households with different socio-economic status in Isfahan province; and to investigate probable inequality determinants in service utilization. Design/methodology/approach Almost 1,040 households living in Isfahan province participated in this cross-sectional study in 2013...
February 12, 2018: International Journal of Health Care Quality Assurance
Sue Morris, Kristen Schaefer, Erlene Rosowsky
The aim of this study was to explore the current practices of primary care physicians (PCPs) in providing bereavement care to elderly patients, with implications for medical education. A total of 63 PCPs answered a brief online survey about their typical practices, barriers, comfort level with bereavement, and confidence in their ability to diagnose prolonged grief disorder (PGD). They were recruited through an online newsletter and contacts of one of the authors. The results found that two-thirds of the PCPs do not routinely screen their elderly patients for recent losses, nor do they refer to mental health clinicians when loss is identified...
March 2, 2018: Journal of Clinical Psychology in Medical Settings
Daniel Z Grunspan, Randolph M Nesse, M Elizabeth Barnes, Sara E Brownell
Background and objectives: Evolutionary medicine is a rapidly growing field that uses the principles of evolutionary biology to better understand, prevent and treat disease, and that uses studies of disease to advance basic knowledge in evolutionary biology. Over-arching principles of evolutionary medicine have been described in publications, but our study is the first to systematically elicit core principles from a diverse panel of experts in evolutionary medicine. These principles should be useful to advance recent recommendations made by The Association of American Medical Colleges and the Howard Hughes Medical Institute to make evolutionary thinking a core competency for pre-medical education...
2018: Evolution, Medicine, and Public Health
A I Kryukov, V T Pal'chun, A V Gurov, D S Ogorodnikov, A G Kucherov, O M Doronina
This article was designed to substantiate the main principles of the academic process as practiced at the Department of Otorhinolaryngology of the N.I. Pirogov Russian National Research Medical University under the current conditions of the ongoing modernization of the system of higher medical education. The authors emphasize the necessity of the combination of theoretical and practical training with special reference to the specific features of the curricular and extracurricular activities. The importance of the formation of the properly functioning teaching staff is underscored...
2018: Vestnik Otorinolaringologii
Navin Mukundu Nagesh, Bogdan Chiva Giurca, Suzy Lishman
The trends in modern undergraduate medical education focus on a patient-centred approach through problem-based learning over the traditional modular curriculum. Integrating pathology into this style of learning has resulted in the dilution of core scientific principles which may have contributed to reduced understanding and interest in the subject. We aim to innovate pathology education by utilising National Pathology Week which is organised by the Royal College of Pathologists to develop the public engagement model which empowers students to learn pathology by teaching the public...
February 27, 2018: Virchows Archiv: An International Journal of Pathology
Robert Englander, Carol Carraccio
The paradigm shift to competency-based medical education (CBME) is under way, but incomplete implementation is blunting the potential impact on learning and patient outcomes. The fundamental principles of CBME call for standardizing outcomes addressing population health needs, then allowing time-variable progression to achieving them. Operationalizing CBME principles requires continuity within and across phases of the education, training, and practice continuum. However, the piecemeal origin of the phases of the "continuum" has resulted in a sequence of undergraduate to graduate medical education to practice that may be continuous temporally but bears none of the integration of a true continuum...
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Joanne L Gusella, Anna G Campbell, Kristin Lalji
Family-based treatment (FBT) has emerged as a promising approach for medically stable youth with anorexia nervosa (AN). While there is evidence that therapists embrace the core principles of FBT, most face barriers in implementing the model with fidelity. Little research has been conducted to determine whether adhering to the core methods of placing parents in charge are sufficient in restoring weight in youth with AN. This study involved a chart review of youth under 16 years of age, treated by a Canadian tertiary care health centre-based eating disorders team (EDT)...
August 2017: Paediatrics & Child Health
Rachel Dankner, Uri Gabbay, Leonard Leibovici, Maya Sadeh, Siegal Sadetzki
BACKGROUND: There is increasing agreement among medical educators regarding the importance of improving the integration between public health and clinical education, understanding and implementation of epidemiological methods, and the ability to critically appraise medical literature. The Sackler School of Medicine at Tel-Aviv University revised its public health and preventive medicine curriculum, during 2013-2014, according to the competency-based medical education (CBME) approach in training medical students...
February 20, 2018: Israel Journal of Health Policy Research
Arunaz Kumar, Sam Sturrock, Euan M Wallace, Debra Nestel, Donna Lucey, Sally Stoyles, Jenny Morgan, Peter Neil, Michelle Schlipalius, Philip Dekoninck
OBJECTIVES: The aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick's framework. We explored participants' acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants' perception of usefulness of PROMPT in their clinical practice. STUDY DESIGN: Mixed methods approach with a pre-test/post-test design...
February 17, 2018: BMJ Open
U Mansmann
BACKGROUND: Over the past 100 years, evidence-based medicine has undergone several fundamental changes. Through the field of physiology, medical doctors were introduced to the natural sciences. Since the late 1940s, randomized and epidemiological studies have come to provide the evidence for medical practice, which led to the emergence of clinical epidemiology as a new field in the medical sciences. Within the past few years, big data has become the driving force behind the vision for having a comprehensive set of health-related data which tracks individual healthcare histories and consequently that of large populations...
February 16, 2018: Zeitschrift Für Rheumatologie
Junko Watanabe, Mariko Watanabe, Kazue Yamaoka, Misa Adachi, Asuka Nemoto, Toshiro Tango
INTRODUCTION: Severe subjective psychosomatic symptoms (SPS) in adolescents are a major public health concern, and lifestyle modification interventions for reducing SPS are important topics. Recently, we developed a school-based lifestyle education involving parents for reducing SPS of adolescents (SPRAT), an improved version of the programme from our previous study Programme for adolescent of lifestyle education in Kumamoto (PADOK). This study aimed to evaluate the effectiveness of SPRAT in reducing SPS among adolescents...
February 16, 2018: BMJ Open
Brittany L Rosen, James M Bishop, Skye L McDonald, Jessica A Kahn, Gary L Kreps
BACKGROUND: Human papillomavirus (HPV) vaccination rates fall far short of Healthy People 2020 objectives. A leading reason is that clinicians do not recommend the vaccine consistently and strongly to girls and boys in the age group recommended for vaccination. Although Web-based HPV vaccine educational interventions for clinicians have been created to promote vaccination recommendations, rigorous evaluations of these interventions have not been conducted. Such evaluations are important to maximize the efficacy of educational interventions in promoting clinician recommendations for HPV vaccination...
February 16, 2018: JMIR Cancer
Rosemary Saunders, Helen Dugmore, Karla Seaman, Rachel Singer, Fiona Lake
BACKGROUND: Interprofessional practice amongst health care professionals can facilitate effective collaboration and can improve health outcomes for patients. Interprofessional clinical placements have mainly been established within inpatient settings; however, ambulatory care settings can also provide interprofessional education. This study evaluates an interprofessional placement in ambulatory care for medical and nursing students. METHODS: Medical and nursing students undertook a 2-week interprofessional placement in respiratory, diabetes and chronic pain clinics, as well as within the patient's home...
February 12, 2018: Clinical Teacher
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