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clinical reasoning education

Che-Wei Lin, Elizabeth H Chang, Daniel L Clinciu, Yun-Ting Peng, Wen-Chen Huang, Chien-Chih Wu, Jen-Chieh Wu, Yu-Chuan Li
BACKGROUND AND OBJECTIVE: Objective Structured Clinical Examination (OSCE) has been used in many areas of healthcare training over the years. However, it constantly needs to be upgraded and enhanced due to technological and teaching changes. We aim at implementing an integrative OSCE method which employs informatics via the virtual patient within the pharmacy education curriculum at Taipei Medical University to enhance the pharmacy students' competence for using and disseminating information and to also improve critical thinking and clinical reasoning...
May 2018: Computer Methods and Programs in Biomedicine
Renata C Gallagher, Laura Pollard, Anna I Scott, Suzette Huguenin, Stephen Goodman, Qin Sun
Disclaimer: These ACMG Standards are intended as an educational resource for clinical laboratory geneticists to help them provide quality clinical laboratory genetic services. Adherence to these Standards is voluntary and does not necessarily assure a successful medical outcome. These Standards should not be considered inclusive of all proper procedures and tests, or exclusive of others that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, clinical laboratory geneticists should apply their professional judgment to the specific circumstances presented by the patient or specimen...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Linda Lee, W Wayne Weston, Loretta M Hillier
BACKGROUND AND OBJECTIVES: Dementia often goes undiagnosed. A workshop was developed to provide primary care clinicians with a structured clinical reasoning approach to dementia diagnosis and brain map tool to differentiate type of dementia. The purpose of this study was to examine the impact of this approach on self-perceived changes in knowledge, confidence, and ability to assess and manage memory problems and on self-reported application of learning to clinical practice. METHODS: Participants of 20 workshops (N=392) were invited to complete a reaction survey and of these, participants of 12 consecutive workshops (N=242) were invited to complete a 3-month follow-up survey to assess application of new learning to clinical practice and challenges experienced in doing so...
March 2018: Family Medicine
Toye Gabriel Olajide, Kayode Shuaib Aremu, Olaide T Esan, Adepeju Oluwatona Dosunmu, Mustapha Muhammad Raji
Background: Self-medication is a common habit in our country; Nigeria, especially among patients with otorhinolaryngological disorders. Medication when taken wrongly may bring dire consequences to the individual, such as masking developing diseases and may cause many other undesirable effects. The aim of this study was to determine the prevalence and to analyze topical ear drop self-medication practices among respondents attending the Ear, Nose, and Throat Clinic of Federal Teaching Hospital Ido Ekiti, Nigeria...
April 2018: Annals of African Medicine
S C Thust, S Heiland, A Falini, H R Jäger, A D Waldman, P C Sundgren, C Godi, V K Katsaros, A Ramos, N Bargallo, M W Vernooij, T Yousry, M Bendszus, M Smits
OBJECTIVES: At a European Society of Neuroradiology (ESNR) Annual Meeting 2015 workshop, commonalities in practice, current controversies and technical hurdles in glioma MRI were discussed. We aimed to formulate guidance on MRI of glioma and determine its feasibility, by seeking information on glioma imaging practices from the European Neuroradiology community. METHODS: Invitations to a structured survey were emailed to ESNR members (n=1,662) and associates (n=6,400), European national radiologists' societies and distributed via social media...
March 13, 2018: European Radiology
Anussara Prayongrat, Kikuo Umegaki, Arjen van der Schaaf, Albert C Koong, Steven H Lin, Thomas Whitaker, Todd McNutt, Naruhiro Matsufuji, Edward Graves, Masahiko Mizuta, Kazuhiko Ogawa, Hiroyuki Date, Kensuke Moriwaki, Yoichi M Ito, Keiji Kobashi, Yasuhiro Dekura, Shinichi Shimizu, Hiroki Shirato
Particle beam therapy (PBT), including proton and carbon ion therapy, is an emerging innovative treatment for cancer patients. Due to the high cost of and limited access to treatment, meticulous selection of patients who would benefit most from PBT, when compared with standard X-ray therapy (XRT), is necessary. Due to the cost and labor involved in randomized controlled trials, the model-based approach (MBA) is used as an alternative means of establishing scientific evidence in medicine, and it can be improved continuously...
February 24, 2018: Journal of Radiation Research
Frank Edelmann, Christoph Knosalla, Klaus Mörike, Christiane Muth, Peggy Prien, Stefan Störk
BACKGROUND: Chronic heart failure (CHF) is the most common reason for hospital admissions in Germany. For the National Disease Management Guideline (NDMG) on CHF, a multidisciplinary expert panel revised the chapters on drug therapy, invasive therapy, and care coordination, following the methods of evidence-based medicine. METHODS: Recommendations are based on international guideline adaptations or systematic literature search. They were developed by a multidisciplinary expert panel, approved in a formal consensus procedure, and tested in open consultation, as specified by the requirements for S3 guidelines...
February 23, 2018: Deutsches Ärzteblatt International
Catherine R Alexander, Fiona Bogossian
BACKGROUND: An allegation of negligence or an adverse outcome during childbirth can lead to clinical investigation of a midwife's practice. Anecdotal evidence suggests midwives find this stressful and disturbing. AIM: Synthesise the evidence relating to midwives' experiences of investigation and the effects on clinical practice and personal wellbeing. METHODS: Two database searches were conducted between 2015 and 2016 to identify primary research published between 1990 and 2016...
March 7, 2018: Women and Birth: Journal of the Australian College of Midwives
Danelle Cayea, Kim Tartaglia, Amit Pahwa, Heather Harrell, Amy Shaheen, Valerie J Lang
PURPOSE: The clinical skills needed to practice high-value care (HVC) are core to all medical disciplines. Medical students form practice habits early and HVC instruction is essential to this formation. The purpose of this study was to describe the state of HVC instruction and assessment in internal medicine clerkships and identify needs for additional curricula. METHOD: In 2014, the Clerkship Directors in Internal Medicine conducted its annual survey of 121 U.S...
March 6, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Maria Mylopoulos, Kulamakan Kulasegaram, Nicole N Woods
In this era of increasing complexity, there is a growing gap between what we need our medical experts to do and the training we provide them. While medical education has a long history of being guided by theories of expertise to inform curriculum design and implementation, the theories that currently underpin our educational programs do not account for the expertise necessary for excellence in the changing health care context. The more comprehensive view of expertise gained by research on both clinical reasoning and adaptive expertise provides a useful framing for re-shaping physician education, placing emphasis on the training of clinicians who will be adaptive experts...
March 8, 2018: Journal of Evaluation in Clinical Practice
Carryn Danzinger, Matthhäus Fellinger, Waltraud Fellinger-Vols, Georg Psota, Johannes Wancata, Alice Wimmer, Thomas Wochele-Thoma
This paper is general statement about the psychosocial care of refugees, developed by the of the Austrian Society for Psychiatry, Psychotherapy and Psychosomatics as well as by the Austrian Society for Social Psychiatry. Reasons of recent wave of refugees and the usual mental disorders among refugees are described. The increasing number of refugees, asylum seekers and irregular migrants poses a challenge for mental health services in Europe. As a consequence, several expert recommendations were given. As a first step, basic needs of refugees such as regular housing facilities, sufficient nutrition and safety in everyday life should be met...
March 7, 2018: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
C Bottger, L Bernard, V Briand, C Bougouma, J Triendebeogo, V Ridde
Background: In Africa, fever is the main reason for consultation, with malaria playing a prominent role. Studies have reported that the widespread use of rapid diagnostic tests for malaria, implemented since 2010, has revealed an increasing proportion of non-malaria acute febrile illnesses (NMAFI). It is an important public health issue because evidence shows that mortality is higher among patients presenting with non-malarial fever than among those with malaria. Methods: This cross-sectional study assessed the professional practices of healthcare providers in the management of NMAFI in urban and rural sites in Burkina Faso...
March 2, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Rodrigo Guimarães Dos Santos Almeida, Beatriz Maria Jorge, Valtuir Duarte Souza-Junior, Alessandra Mazzo, José Carlos Amado Martins, Elaine Cristina Negri, Isabel Amélia Costa Mendes
AIM: The aim of the study was to identify and reflect on evidence regarding the use of simulation in nursing education. BACKGROUND: The use of simulation as a teaching strategy in nursing is expanding. It is important to check the evidence deriving from research. METHOD: Departing from a guiding question, an international literature search was undertaken between January 2008 and March 2014 in Portuguese, English, and Spanish. RESULTS: Out of 160 articles, 68...
March 2, 2018: Nursing Education Perspectives
Kerry Wilbur, Arwa Sahal, Dina Elgaily
Purpose Patient safety is gaining prominence in health professional curricula. Patient safety must be complemented by teaching and skill development in practice settings. The purpose of this paper is to explore how experienced pharmacists identify, prioritize and communicate adverse drug effects to patients. Design/methodology/approach A focus group discussion was conducted with cardiology pharmacy specialists working in a Doha hospital, Qatar. The topic guide sought to explore participants' views, experiences and approaches to educating patients regarding specific cardiovascular therapy safety and tolerability...
February 12, 2018: International Journal of Health Care Quality Assurance
Smriti Kapoor, Rory Catton, Hisham Khalil
Background: Student-led podcasts were developed by 5th year Peninsula Medical School students as part of an educational grant. The students completed 35 video podcasts using PREZI software, and based on clinical indicative presentations of the Peninsula Medical School curriculum. Methods: Third, 4th and 5th year medical students were invited to complete the evaluation of the indicative presentation video podcasts they watched. Both quantitative and qualitative data were collected through anonymized questionnaires...
2018: Advances in Medical Education and Practice
Ayşe Büyükcam, Ateş Kara, Tuğba Bedir, Belgin Gülhan, Halil Özdemir, Murat Sütçü, Mine Düzgöl, Aslı Arslan, Tuna Tekin, Solmaz Çelebi, Musa Gürel Kukul, Gülsüm İclal Bayhan, Muhammet Köşker, Adem Karbuz, Melda Çelik, Zümrüt Kocabay Sütçü, Özge Metin, Sebahat Karakaşlılar, Abdullah Dağlı, Soner Sertan Kara, Eda Albayrak, Saliha Kanık, Hasan Tezer, Aslınur Parlakay, Ergin Çiftci, Ayper Somer, İlker Devrim, Zafer Kurugöl, Ener Çağrı Dinleyici, Pınar Atla
OBJECTIVES: Acute otitis media (AOM) is predominantly a disease of childhood and one of the common reasons for prescribing antibiotics. Ear pain is the main symptom of AOM, with the result that parents frequently seek immediate medical assistance for their children. Antibiotic therapy for AOM does not provide symptomatic relief in the first 24 hours, and analgesics are commonly recommended for relieving the pain associated with AOM. The aims of the present study were to assess pediatricians' attitudes toward AOM and ear pain management in Turkey...
April 2018: International Journal of Pediatric Otorhinolaryngology
Soohyun Kim, Lawrence Chang, Bianca Weinstock-Guttman, Sirin Gandhi, Dejan Jakimovski, Ellen Carl, Robert Zivadinov, Murali Ramanathan
OBJECTIVES: To investigate the factors associated with complementary and alternative medicine (CAM) usage by multiple sclerosis (MS) patients. Design, Setting/Location: Single-center, prospective clinical study at an academic MS center in the northeastern United States. METHODS: This study included CAM data from 524 MS patients and 304 healthy controls (HC) enrolled in a prospective study of clinical, neuroimaging, and environmental risk factors in MS at an academic MS Center...
March 2, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Laura M Amendola, Jill O Robinson, Ragan Hart, Sawona Biswas, Kaitlyn Lee, Barbara A Bernhardt, Kelly East, Marian J Gilmore, Tia L Kauffman, Katie L Lewis, Myra Roche, Sarah Scollon, Julia Wynn, Carrie Blout
Clinical and research settings are increasingly incorporating genomic sequencing (GS) technologies. Previous research has explored reasons for declining genetic testing and participation in genetic studies; however, there is a dearth of literature regarding why potential participants decline participation in GS research, and if any of these reasons are unique to GS. This knowledge is essential to promote informed decision-making and identify potential barriers to research participation and clinical implementation...
March 1, 2018: Journal of Genetic Counseling
Inga Hege, Andrzej A Kononowicz, Norman B Berman, Benedikt Lenzer, Jan Kiesewetter
Background: Clinical reasoning is a complex skill students have to acquire during their education. For educators it is difficult to explain their reasoning to students, because it is partly an automatic and unconscious process. Virtual Patients (VPs) are used to support the acquisition of clinical reasoning skills in healthcare education. However, until now it remains unclear which features or settings of VPs optimally foster clinical reasoning. Therefore, our aims were to identify key concepts of the clinical reasoning process in a qualitative approach and draw conclusions on how each concept can be enhanced to advance the learning of clinical reasoning with virtual patients...
2018: GMS Journal for Medical Education
Reyhan Eskiyurt, Birgul Ozkan
Aim: This study was carried out to determine the reasons of the suicide probability and reasons for living of the inpatients hospitalized at the psychiatry clinic and to analyze the relationship between them. Materials and Methods: The sample of the study consisted of 192 patients who were hospitalized in psychiatric clinics between February and May 2016 and who agreed to participate in the study. In collecting data, personal information form, suicide probability scale (SPS), reasons for living inventory (RFL), and Beck's depression inventory (BDI) were used...
October 2017: Indian Journal of Psychiatry
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