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Competency-based medical education

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https://www.readbyqxmd.com/read/29777463/considerations-that-will-determine-if-competency-based-assessment-is-a-sustainable-innovation
#1
W Dale Dauphinee, John R Boulet, John J Norcini
Educational assessment for the health professions has seen a major attempt to introduce competency based frameworks. As high level policy developments, the changes were intended to improve outcomes by supporting learning and skills development. However, we argue that previous experiences with major innovations in assessment offer an important road map for developing and refining assessment innovations, including careful piloting and analyses of their measurement qualities and impacts. Based on the literature, numerous assessment workshops, personal interactions with potential users, and our 40 years of experience in implementing assessment change, we lament the lack of a coordinated approach to clarify and improve measurement qualities and functionality of competency based assessment (CBA)...
May 18, 2018: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/29774439/surgical-education-simulation-and-simulators-updating-the-concept-of-validity
#2
REVIEW
Mitchell Goldenberg, Jason Y Lee
PURPOSE OF REVIEW: Competency-based medical education (CBME) is rooted in the use of iterative assessments. We must ensure that the assessments used in CBME are valid, to make acceptable and accurate decisions regarding the competency of a trainee. Until recently, much of the educational and assessment literature in urology have used a now-outdated method of determining validity, based on theory and recommendations from over 50 years ago. We describe a contemporary approach to gathering construct validity evidence for the assessment of urologic trainees, for use in both clinical and simulation environments...
May 17, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29771224/discipline-specific-competency-based-curricula-for-leadership-learning-in-medical-specialty-training
#3
Sandra Turner, Ming-Ka Chan, Judy McKimm, Graham Dickson, Timothy Shaw
Purpose Doctors play a central role in leading improvements to healthcare systems. Leadership knowledge and skills are not inherent, however, and need to be learned. General frameworks for medical leadership guide curriculum development in this area. Explicit discipline-linked competency sets and programmes provide context for learning and likely enhance specialty trainees' capability for leadership at all levels. The aim of this review was to summarise the scholarly literature available around medical specialty-specific competency-based curricula for leadership in the post-graduate training space...
May 8, 2018: Leadership in Health Services
https://www.readbyqxmd.com/read/29768072/an-integrated-developmental-four-year-medical-school-curriculum-in-palliative-care-a-longitudinal-content-evaluation-based-on-national-competency-standards
#4
Erin M Denney-Koelsch, Robert Horowitz, Timothy Quill, Constance D Baldwin
BACKGROUND: While palliative care (PC) competencies for medical school graduates have been defined, the lack of established curriculum models and assessment tools hampers curricular evaluation. OBJECTIVE: To describe the scope and content of the University of Rochester's longitudinal, integrated four-year PC curriculum after 17 years of implementation, review student evaluative responses, and compare the curriculum to national competency standards. DESIGN AND SETTING: Combining and reorganizing a published PC curriculum assessment tool and a list of medical school PC competencies, we created a novel nine-topic framework to assess the content coverage of our curriculum...
May 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29766520/the-role-of-electronic-health-records-in-clinical-reasoning
#5
REVIEW
Markus Berndt, Martin R Fischer
Electronic health records (eHRs) play an increasingly important role in documentation and exchange of information in multi-and interdisciplinary patient care. Although eHRs are associated with mixed evidence in terms of effectiveness, they are undeniably the health record form of the future. This poses several learning opportunities and challenges for medical education. This review aims to connect the concept of eHRs to key competencies of physicians and elaborates current learning science perspectives on diagnostic and clinical reasoning based on a theoretical framework of scientific reasoning and argumentation...
May 16, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29765259/shadowing-emergency-medicine-residents-by-medical-education-specialists-to-provide-feedback-on-non-medical-knowledge-based-acgme-sub-competencies
#6
Anna L Waterbrook, Karen C Spear Ellinwood, T Gail Pritchard, Karen Bertels, Ariel C Johnson, Alice Min, Lisa R Stoneking
Objective: Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Methods: Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29763388/how-should-trauma-patients-informed-consent-or-refusal-be-regarded-in-a-trauma-bay-or-other-emergency-settings
#7
Ashley Suah, Peter Angelos
The precipitous and unexpected nature of trauma requires training health care practitioners to think and act quickly, according to the best medical interest of the patient. The urgency of treatment for trauma patients, who frequently have temporary alterations in their abilities to make autonomous and competent decisions, often results in presumed consent for medically necessary treatment. Academic trauma centers use protocol-based management of injuries to facilitate their simultaneous evaluation by multiple clinicians and to avoid delays in treatment, ensuring that trauma patients receive the best possible care...
May 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29762795/addressing-racism-in-medical-education-an-interactive-training-module
#8
Tanya White-Davis, Jennifer Edgoose, Joedrecka S Brown Speights, Kathryn Fraser, Jeffrey M Ring, Jessica Guh, George W Saba
BACKGROUND AND OBJECTIVES: Education of health care clinicians on racial and ethnic disparities has primarily focused on emphasizing statistics and cultural competency, with minimal attention to racism. Learning about racism and unconscious processes provides skills that reduce bias when interacting with minority patients. This paper describes the responses to a relationship-based workshop and toolkit highlighting issues that medical educators should address when teaching about racism in the context of pernicious health disparities...
May 2018: Family Medicine
https://www.readbyqxmd.com/read/29760581/educational-program-for-middle-level-public-health-nurses-to-develop-new-health-services-regarding-community-health-needs-protocol-for-a-randomized-controlled-trial
#9
Kyoko Yoshioka-Maeda, Takafumi Katayama, Misa Shiomi, Noriko Hosoya
Background: Developing health services is a key strategy for improving the community health provided by public health nurses. However, an effective educational program for improving their skills in planning such services has not been developed. To describe our program and its evaluation protocol for the education of middle-level public health nurses to improve their skills in developing new health services to fulfil community health needs in Japan. Methods: In this randomized control trial, eligible participants in Japan will be randomly allocated to an intervention group and a control wait-list group...
2018: BMC Nursing
https://www.readbyqxmd.com/read/29736352/comparing-real-time-versus-delayed-video-assessments-for-evaluating-acgme-sub-competency-milestones-in-simulated-patient-care-environments
#10
Robert Isaak, Marjorie Stiegler, Gene Hobbs, Susan M Martinelli, David Zvara, Harendra Arora, Fei Chen
Background Simulation is an effective method for creating objective summative assessments of resident trainees. Real-time assessment (RTA) in simulated patient care environments is logistically challenging, especially when evaluating a large group of residents in multiple simulation scenarios. To date, there is very little data comparing RTA with delayed (hours, days, or weeks later) video-based assessment (DA) for simulation-based assessments of Accreditation Council for Graduate Medical Education (ACGME) sub-competency milestones...
March 4, 2018: Curēus
https://www.readbyqxmd.com/read/29732601/longitudinal-ultrasound-curriculum-incorporation-at-west-virginia-university-school-of-medicine-a-description-and-graduating-students-perceptions
#11
Joseph Minardi, Holly Ressetar, Theresa Foreman, Kristen Craig, Melinda Sharon, John Bassler, Stephen Davis, Anthony Machi, Scott Cottrell, Nicolas Denne, Norman Ferrari, Kenneth Landreth, Bruce Palmer, Gregory Schaefer, Robert Tallaksen, David Wilks, Dorian Williams
OBJECTIVES: Sonography is a clinical tool being incorporated in multiple medical specialties with evidence of improved patient care and cost. Some schools have begun implementing ultrasound curricula. We hope to build upon that foundation and provide another potential framework of incorporation. There are several barriers, including curricular space, equipment and physical space, adequate faculty, and performing assessment. METHODS: At West Virginia University, we began a longitudinal ultrasound curriculum in 2012 with incorporation of didactic and practical sessions into gross anatomy, our systems-based second-year curriculum, physical diagnosis course, and clinical rotations...
May 6, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29725559/trapped-as-a-group-escape-as-a-team-applying-gamification-to-incorporate-team-building-skills-through-an-escape-room-experience
#12
Xiao Chi Zhang, Hyunjoo Lee, Carlos Rodriguez, Joshua Rudner, Teresa M Chan, Dimitrios Papanagnou
Teamwork, a skill critical for quality patient care, is recognized as a core competency by the Accreditation Council for Graduate Medical Education (ACGME). To date, there is no consensus on how to effectively teach these skills in a forum that engages learners, immerses members in life-like activities, and builds both trust and rapport. Recreational 'Escape Rooms' have gained popularity in creating a life-like environment that rewards players for working together, solving puzzles, and completing successions of mind-bending tasks in order to effectively 'escape the room' in the time allotted...
March 2, 2018: Curēus
https://www.readbyqxmd.com/read/29720792/preventing-neurophobia-remodeling-neurology-education-for-21-st-century-medical-students-through-effective-pedagogical-strategies-for-neurophilia
#13
REVIEW
Bhaskara P Shelley, Thomas V Chacko, Balakrishnan R Nair
Neurology has a reputation, particularly as a complex "head-to-toe" discipline for undergraduate medical students. Neurophobia syndrome, a global phenomenon, fundamentally stems from pedagogical deficiencies during the undergraduate curriculum, the lack of vertical integration between basic neurosciences and clinical bedside neurology, the lack of clinical reasoning exercises, cognitive heuristics, and clinical problem-solving, errors in diagnostic competence, and hyposkilia. This ultimately results in poor clinical competence and proficiency in clinical neurology and causes attrition in nurturing a passion for learning the neurology discipline...
January 2018: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/29715256/an-interprofessional-web-based-teaching-module-to-enhance-competency-of-the-advanced-practice-nursing-clinical-education-in-the-emergency-department
#14
Kumhee Ro, Christy Weiland, Mo-Kyung Sin
Many advanced practice registered nursing (APRN) students struggle to thrive in their clinical rotation due to the wide variability in their clinical knowledge. To address the variability and gaps in knowledge, we created an interprofessional web-based, self-directed curriculum for APRN students that is clinically relevant and specific to the emergency department (ED) rotation. The modules are a product of collaboration between the medical, nursing, and pharmacy faculty at an academic medical center. This web-based curricular preceptorship model that incorporates new technology and innovation in clinical rotations can provide an opportunity to enhance the clinical education of the APRN students in the ED...
April 2018: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29712711/medical-nutrition-education-training-and-competencies-to-advance-guideline-based-diet-counseling-by-physicians-a-science-advisory-from-the-american-heart-association
#15
REVIEW
Karen E Aspry, Linda Van Horn, Jo Ann S Carson, Judith Wylie-Rosett, Robert F Kushner, Alice H Lichtenstein, Stephen Devries, Andrew M Freeman, Allison Crawford, Penny Kris-Etherton
Growing scientific evidence of the benefits of heart-healthy dietary patterns and of the massive public health and economic burdens attributed to obesity and poor diet quality have triggered national calls to increase diet counseling in outpatients with atherosclerotic cardiovascular disease or risk factors. However, despite evidence that physicians are willing to undertake this task and are viewed as credible sources of diet information, they engage patients in diet counseling at less than desirable rates and cite insufficient knowledge and training as barriers...
April 30, 2018: Circulation
https://www.readbyqxmd.com/read/29710333/creating-entrustable-professional-activities-to-assess-internal-medicine-residents-in-training-a-mixed-methods-approach
#16
David R Taylor, Yoon Soo Park, Christopher A Smith, Jolanta Karpinski, William Coke, Ara Tekian
Background: Competency-based medical education has not advanced residency training as much as many observers expected. Some medical educators now advocate reorienting competency-based approaches to focus on a resident's ability to do authentic clinical work. Objective: To develop descriptions of clinical work for which internal medicine residents must gain proficiency to deliver meaningful patient care (for example, "Admit and manage a medical inpatient with a new acute problem")...
April 17, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29704169/how-are-competency-frameworks-perceived-and-taught-an-exploratory-study-in-the-context-of-pharmacy-education
#17
Elise Paradis, Rebecca Zhao, Jamie Kellar, Alison Thompson
INTRODUCTION: Faculties of Pharmacy worldwide have to adapt their curriculum to accreditation criteria. The present study explored how the Association of Faculties of Pharmacy of Canada's (AFPC's) 2010 Educational Outcomes are perceived and taught at the Leslie Dan Faculty of Pharmacy (LDFP). These outcomes were adapted from the CanMeds Physician Competency Framework which describes both medical expert and non-expert roles. METHODS: We wondered if pharmacy would struggle, as medicine has, to integrate these roles into curricula in meaningful ways, given the absence of previous studies from Pharmacy...
April 27, 2018: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29703096/a-practical-framework-for-remediating-unprofessional-behavior-and-for-developing-professionalism-competencies-and-a-professional-identity
#18
Pieter C Barnhoorn, Mirjam Houtlosser, Marleen W Ottenhoff-de Jonge, Geurt T J M Essers, Mattijs E Numans, Anneke W M Kramer
The relatively new term "Professional Identity Formation" (PIF) complements behavior-based and attitude-based perspectives on professionalism. Unprofessional behavior and its remediation should also be addressed from this perspective. However, a framework is needed to guide discussion and remediation of unprofessional behavior, which can encompass behavior-based, attitude-based, and identity-based perspectives on professionalism. To this end, the authors propose a multi-level professionalism framework which describes, apart from professional behavior, more levels which influence professional performance: environment, competencies, beliefs, values, identity, and mission...
April 27, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29699593/can-elearning-be-used-to-teach-palliative-care-medical-students-acceptance-knowledge-and-self-estimation-of-competence-in-palliative-care-after-elearning
#19
Christian Schulz-Quach, Ursula Wenzel-Meyburg, Katharina Fetz
BACKGROUND: Undergraduate palliative care education (UPCE) was mandatorily incorporated in medical education in Germany in 2009. Implementation of the new cross-sectional examination subject of palliative care (QB13) continues to be a major challenge for medical schools. It is clear that there is a need among students for more UPCE. On the other hand, there is a lack of teaching resources and patient availabilities for the practical lessons. Digital media and elearning might be one solution to this problem...
April 27, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29697426/does-mindfulness-training-enhance-the-professional-development-of-residents-a-qualitative-study
#20
Hanne Verweij, Hiske van Ravesteijn, Madelon L M van Hooff, Antoine L M Lagro-Janssen, Anne E M Speckens
PURPOSE: In addition to developing diagnostic and clinical skills, postgraduate medical education should stimulate residents' professional development. Teaching medical professionalism is challenging and is often left largely to the informal and hidden curricula. An intervention that might be beneficial for medical residents is Mindfulness-Based Stress Reduction (MBSR). The authors implemented MBSR as an optional course for residents and qualitatively explored how it influenced residents professionally...
April 24, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
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