Team-based learning

BACKGROUND: In an era where subtotal resection (STR) is increasingly utilized, we have encountered a growing number of patients referred to our institution with limited resection of large vestibular schwannomas (VS), at times associated with grave complications. OBJECTIVE: We highlight lessons learned in the management of large VS and provide a rationale for specialized care. METHODS: A prospectively maintained database of over 2,000 patients with VS evaluated at our institution between 2000 and 2016 was reviewed...

In many respects the evolution of baseball statistics mirrors advances made in the field of genetic toxicology. From its inception, baseball and statistics have been inextricably linked. Generations of players and fans have used a number of relatively simple measurements to describe team and individual player's current performance, as well as for historical record-keeping purposes. Over the years, baseball analytics has progressed in several important ways. Early advances were based on deriving more meaningful metrics from simpler forerunners...

Objectives To examine the quality of UK-based oral health promotion materials (OHPM) for parents of young children aged 0-5 years old.Data sources OHPM were obtained via email request to dental public health consultants and oral health promotion teams in the UK, structured web-based searches or collected from oral health events.Data selection Materials were included if: they were freely available; they were in English; they were parent facing and included oral health advice aimed at children aged 0-5-years-old...

BACKGROUND: Slowing the decline in participation in physical activity among adolescent girls is a public health priority. This study reports the outcomes from a multi-component school-based intervention (Girls in Sport), focused on promoting physical activity among adolescent girls. METHODS: Group randomized controlled trial in 24 secondary schools (12 intervention and 12 control). Assessments were conducted at baseline (2009) and at 18 months post-baseline (2010)...

Since its introduction in 2011, Liver Imaging Reporting and Data System (LI-RADS) has become an increasingly utilized method for radiologists to categorize lesions for hepatocellular carcinoma (HCC) in patients at risk (American College of Radiology, www.acr.org/quality-safety/resources/lirads 2016). This overview article presents insight into methods of incorporating LI-RADS into an existing clinical practice, highlighting concrete ways to establish this system as a mainstay in any radiologist's evidence-based armamentarium...

Objective. To design and implement an instrument capable of providing students with valuable peer feedback on team behaviors and to provide results of the administration of the instrument. Methods. A three-part instrument was designed that requires teammate rankings with justification on attributes aligned with school outcomes and team functioning, reporting of student behaviors, and provision of feedback on the value of peer contributions to their team. Score results after three years of administration were analyzed...

BACKGROUND: Meticulous tracking of study data must begin early in the study recruitment phase and must account for regulatory compliance, minimize missing data, and provide high information integrity and/or reduction of errors. In behavioral intervention trials, participants typically complete several study procedures at different time points. Among HIV-infected patients, behavioral interventions can favorably affect health outcomes. In order to empower newly diagnosed HIV positive individuals to learn skills to enhance retention in HIV care, we developed the behavioral health intervention Integrating ENGagement and Adherence Goals upon Entry (iENGAGE) funded by the National Institute of Allergy and Infectious Diseases (NIAID), where we deployed an in-clinic behavioral health intervention in 4 urban HIV outpatient clinics in the United States...

OBJECTIVE: The broad purpose of this project is to improve health in Native Hawaiian communities through the prevention of substance use. Our community-academic partnership (CAP) team developed an intervention called Puni Ke Ola for this purpose. This paper provides a brief overview of the intervention, then describes challenges and lessons learned in piloting Puni Ke Ola. METHODS: A single module of the Puni Ke Ola intervention was implemented, after which the intervention leaders (N=3) convened for a debriefing meeting...

Gaps remain in understanding whether family planning (FP) programs can change urban women's FP behaviors. Even less is known about what works among poor urban women. This article presents results of the impact evaluation of the Nigerian Urban Reproductive Health Initiative (NURHI). Findings are based on recently collected longitudinal data from women and facilities in six cities in Nigeria. Over the four-year follow-up period, there was an increase of about ten percentage points in modern method use. Impact evaluation analyses using fixed-effects regression methods indicate that both demand- and supply-side program activities increased modern method use...

Chronic obstructive pulmonary disease (COPD) is a leading cause of death, morbidity, and health-care spending. The Halifax, Nova Scotia-based INSPIRED COPD Outreach Program™ has proved highly beneficial for patients and the health-care system. With direct investment of <$1-million CAD, a pan-Canadian quality improvement collaborative (QIC) supported the spread of INSPIRED to 19 teams in the 10 Canadian provinces contingent upon participation in evaluation. The collaborative evaluation followed a mixed-methods summative approach relying on collated quantitative data, team documents, and surveys sent to core members of the 19 teams...

Profound anatomical knowledge is the basis for modern demands in medicine and surgery, but many countries worldwide including Australia and New Zealand have discontinued offering dissection courses to medical and dental students during the past decades. This educational project done in Australia aimed at enhancing basic and advanced anatomy teaching by engaging a sub-group of second-year undergraduate students of a compulsory prosection- and model-based anatomy course (n = 54/170) in an optional multimodal course, which should easily articulate with a vertical curriculum...

Mental health conditions are common, disabling, potentially life-threatening, and costly; however, they are mostly treatable with early detection and intervention. Unfortunately, mental healthcare is in significantly short supply both nationally and locally, and particularly in small, rural, and relatively isolated communities. This article provides physicians and other health practitioners with a primer on the basic rationale and principles of integrating behavioral healthcare - particularly psychiatric specialty care - in primary care settings, including effective use of teleconferencing...

Competency-based medical education (CBME) is both an educational philosophy and an approach to educational design. CBME has already had a broad impact on medical schools, residency programs, and continuing professional development in health professions around the world. As the CBME movement evolves and CBME programs are implemented, a wide range of emerging research questions will warrant scholarly examination. In this paper, we describe a proposed CBME research agenda developed by the International CBME Collaborators...

BACKGROUND: A notable gap in the evidence base for outpatient palliative care (PC) for cancer is that most trials were conducted in specialized oncology or academic centers with limited translation and further evaluation in "real-world" settings. Health systems are desperate for guidance regarding the most effective and sustainable PC service models. OBJECTIVE: Describe the study protocol to evaluate the dissemination of a previously tested nurse-led PC intervention (PCI) for patients with lung cancer and their family caregiver in community-based settings, lessons learned in adapting and implementing the PCI, and implications for future dissemination-translational efforts Design: Two-group, prospective sequential, quasi-experimental design with Phase 1 (Usual care) followed by Phase 2 (Intervention) setting/subjects...

ISSUE: Homebound and functionally limited individuals are often unable to access office-based primary care, leading to unmet needs and increased health care spending. GOAL: Show how home-based primary care affects outcomes and costs for Medicare and Medicaid beneficiaries with complex care needs. METHODS: Qualitative synthesis of expert perspectives and the experiences of six case-study sites. FINDINGS AND CONCLUSIONS: Successful home-based primary care practices optimize care by: fielding interdisciplinary teams, incorporating behavioral care and social supports into primary care, responding rapidly to urgent and acute care needs, offering palliative care, and supporting family members and caregivers...

BACKGROUND: The district health system (DHS) has a critical role to play in the delivery of primary healthcare (PHC). Effective district management, particularly leadership is considered to be crucial element of the DHS. Internationally, the debate around developing leadership competencies such as motivation or empowerment of staff, managing relationships, being solution driven as well as fostering teamwork are argued to be possible through approaches such as formal and informal training...

BACKGROUND AND OBJECTIVE: In response to a low number of Baby-Friendly-designated hospitals in the United States, the Centers for Disease Control and Prevention funded the National Institute for Children's Health Quality to conduct a national quality improvement initiative between 2011 and 2015. The initiative was entitled Best Fed Beginnings and enrolled 90 hospitals in a nationwide initiative to increase breastfeeding and achieve Baby-Friendly designation. METHODS: The intervention period lasted from July 2012 to August 2014...

BACKGROUND: Clinical decision making in oncology is based on both inter- and multidisciplinary approach. Hence teaching future doctors involved in oncology or general health practice is crucial. The aim of the Vienna Summer School on Oncology (VSSO) as an international, integrated, undergraduate oncology course is to teach medical students interdisciplinary team communication and application of treatment concepts/algorithms in a multidisciplinary setting. METHOD: The teaching is based on an inter- and multidisciplinary faculty and a multimodal education approach to address different learning styles...

Introduction: The German Council of Science and Humanities as well as a number of medical professional associations support the strengthening of scientific competences by developing longitudinal curricula for teaching scientific competences in the undergraduate medical education. The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) has also defined medical scientific skills as learning objectives in addition to the role of the scholar. The development of the Mannheim science curriculum started with a systematic inventory of the teaching of scientific competences in the Mannheim Reformed Curriculum of Medicine (MaReCuM)...

This article discusses the lessons learned by an interdisciplinary team in a large metropolitan specialty hospital during the implementation of the Code Aorta protocol for aortic emergencies and the subsequent application of technological enhancements to improve data transfer. Aortic dissections require rapid diagnosis and surgical treatment; thus, in order to optimize patient outcomes, clinicians must be accessible, data must be readily available, and proper prompts and notifications must be made to alert and ready teams...