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Leadership in medicine

Sabine Salloch, Ina C Otte, Anke Reinacher-Schick, Jochen Vollmann
The impact of patient preferences in evidence-based medicine is a complex issue which touches on theoretical questions as well as medical practice in the clinical context. The interaction between evidence-based recommendations and value-related patient preferences in clinical practice is, however, highly complex and requires not only medical knowledge but social, psychological and communicative competencies on the side of the physician. The multi-layered process of oncology physicians' clinical decision-making was explored in 14 semi-structured interviews with respect to a first diagnosis of a pancreatic adenocarcinoma...
March 12, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Donald M Hilty, Terry Rabinowitz, Robert M McCarron, David J Katzelnick, Trina Chang, Amy M Bauer, John Fortney
INTRODUCTION: In this era of patient-centered care, telepsychiatry (TP; video or synchronous) provides quality care with outcomes as good as in-person care, facilitates access to care, and leverages a wide range of treatments at a distance. METHOD: This conceptual review article explores TP as applied to newer models of care (e.g., collaborative, stepped, and integrated care). RESULTS: The field of psychosomatic medicine (PSM) has developed clinical care models, educates interdisciplinary team members, and provides leadership to clinical teams...
December 26, 2017: Psychosomatics
Kathleen A Calzone, Jean Jenkins, Stacey Culp, Laurie Badzek
BACKGROUND: The Precision Medicine Initiative will accelerate genomic discoveries that improve health care, necessitating a genomic competent workforce. PURPOSE: This study assessed leadership team (administrator/educator) year-long interventions to improve registered nurses' (RNs) capacity to integrate genomics into practice. METHODS: We examined genomic competency outcomes in 8,150 RNs. DISCUSSION: Awareness and intention to learn more increased compared with controls...
November 13, 2017: Nursing Outlook
Zornitza Stark, Sebastian Lunke, Gemma R Brett, Natalie B Tan, Rachel Stapleton, Smitha Kumble, Alison Yeung, Dean G Phelan, Belinda Chong, Miriam Fanjul-Fernandez, Justine E Marum, Matthew Hunter, Anna Jarmolowicz, Yael Prawer, Jessica R Riseley, Matthew Regan, Justine Elliott, Melissa Martyn, Stephanie Best, Tiong Y Tan, Clara L Gaff, Susan M White
PurposeThe purpose of the study was to implement and prospectively evaluate the outcomes of a rapid genomic diagnosis program at two pediatric tertiary centers.MethodsRapid singleton whole-exome sequencing (rWES) was performed in acutely unwell pediatric patients with suspected monogenic disorders. Laboratory and clinical barriers to implementation were addressed through continuous multidisciplinary review of process parameters. Diagnostic and clinical utility and cost-effectiveness of rWES were assessed.ResultsOf 40 enrolled patients, 21 (52...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Jennifer W Goldsberry
Healthcare delivery has become increasingly complex and fragmented. Leading healthcare organizations, such as the Institute of Medicine and the World Health Organization, have recognized that interprofessional collaboration is essential to improve healthcare delivery. The process of integrating interprofessional collaboration is complex and involves overcoming historical hierarchical factors and professional boundaries. The integration of interprofessional education in healthcare professions can help to alleviate these barriers...
February 28, 2018: Nurse Education Today
Samantha E Kaplan, Christine M Gunn, Anthony K Kulukulualani, Anita Raj, Karen M Freund, Phyllis L Carr
BACKGROUND: Despite individual and institutional awareness of the inequity in retention, promotion and leadership of racially and ethnically underrepresented minority faculty in academic medicine, the number of such faculty remains unacceptably low. The authors explored challenges to the recruitment, retention and promotion of underrepresented faculty among a sample of leaders at academic medical centers. METHODS: Semi-structured interviews were conducted from 2011 to 2012 with 44 senior faculty leaders, predominantly members of the Group on Diversity and Inclusion (GDI) and/or the Group on Women in Medical Sciences (GWIMS), at the 24 randomly selected medical schools of the National Faculty Survey of 1995...
February 2018: Journal of the National Medical Association
Colin P West, Liselotte N Dyrbye, Tait D Shanafelt
Physician burnout, a work-related syndrome involving emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment, is prevalent internationally. Rates of burnout symptoms that have been associated with adverse effects on patients, the health care workforce, costs, and physician health exceed 50% in studies of both physicians-in-training and practicing physicians. This problem represents a public health crisis with negative impacts on individual physicians, patients, and health care organizations and systems...
March 5, 2018: Journal of Internal Medicine
Karen E Pinder, Jennifer A Shabbits
BACKGROUND: The past decade has witnessed successful expansion, distribution and curricular renewal at the University of British Columbia (UBC) medical school. The expansion and distribution of the medical program doubled enrollment and established the first North American medical school training students across multiple geographical locations. The more recent competency-based curriculum renewal demonstrates sustained innovation within UBC medicine. AIMS: This paper describes that a significant contributor to these successes has been a team of teaching faculty whose exclusive roles have been providing curricular support...
March 5, 2018: Medical Teacher
Maral J Rouhani, Eleanor J Burleigh, Chloe Hobbis, Charlotte Dunford, Nadir I Osman, Christine Gan, Norma B Gibbons, Hashim U Ahmed, Saiful Miah
Background: We aimed to determine UK medical students' perceptions and attitudes and interest toward medical leadership and clinician managers. Methods: A cross-sectional study was conducted during the academic year 2015-2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers...
2018: Advances in Medical Education and Practice
Timothy J Bloom
Objective. To determine whether there is a distinctive pattern of StrengthsQuest Signature Themes or leadership domains for Doctor of Pharmacy students compared to students in other health care professional programs. Methods. Students in Doctor of Pharmacy (PharmD), Master of Physician Assistant (PA), Doctor of Physical Therapy (DPT), and Doctor of Osteopathic Medicine (DO) programs at Campbell University completed the online Clifton StrengthsQuest assessment and received their Signature Themes. The frequency of individual themes and the leadership domains into which they are sorted by Gallup was analyzed for each program...
February 2018: American Journal of Pharmaceutical Education
H Bryant Nguyen, Carey C Thomson, Naftali Kaminski, Lynn M Schnapp, J Mark Madison, Robb W Glenny, Anne E Dixon
An academic medical career traditionally revolves around patient care, teaching, and scholarly projects. Thus, when an opportunity for a leadership role arises, such as Division Chief, the new leader is often unprepared with little or no formal leadership training. In this article, academic leaders of the Association of Pulmonary, Critical Care and Sleep Division Directors reviewed several leadership concepts adapted from the business sector and applied years of their experience to aid new division chiefs with their first day on the job...
February 27, 2018: Annals of the American Thoracic Society
Mary Norine Walsh
Cardiology remains a specialty that is dominated by men. Even though half of all medical students and over 40% of internal medicine residents are women, the number of women in the field of cardiology remains low. The reasons for the persistent lack of increase in cardiology trainees are not well understood and are likely multifactorial. Despite this under-representation, women cardiologists are increasingly visible in leadership roles, including those in research science, health systems administration, professional societies, and clinical practice...
February 27, 2018: Clinical Cardiology
Bridget Johnston, Anne Patterson, Lydia Bird, Eleanor Wilson, Kathryn Almack, Gillian Mathews, Jane Seymour
BACKGROUND: The Midhurst Macmillan Specialist Palliative Care at Home Service was founded in 2006 to improve community-based palliative care provision. Principal components include; early referral; home-based clinical interventions; close partnership working; and flexible teamwork. Following a successful introduction, the model was implemented in six further sites across England. This article reports a mixed methods evaluation of the implementation across these 'Innovation Centres'. The evaluation aimed to assess the process and impact on staff, patients and carers of providing Macmillan Specialist Care at Home services across the six sites...
February 23, 2018: BMC Palliative Care
Lisa Jane Gould, Peter Griffiths, Hannah Ruth Barker, Paula Libberton, Ines Mesa-Eguiagaray, Ruth M Pickering, Lisa Jane Shipway, Jackie Bridges
OBJECTIVE: Compassionate care continues to be a focus for national and international attention, but the existing evidence base lacks the experimental methodology necessary to guide the selection of effective interventions for practice. This study aimed to evaluate the Creating Learning Environments for Compassionate Care (CLECC) intervention in improving compassionate care. SETTING: Ward nursing teams (clusters) in two English National Health Service hospitals randomised to intervention (n=4) or control (n=2)...
February 22, 2018: BMJ Open
Marcia Perry, Andrew Linn, Brendan W Munzer, Laura Hopson, Ambrosya Amlong, Michael Cole, Sally A Santen
Background : Programmatic assessment is the intentional collection of key data from multiple sources for both assessment of learning and assessment for learning . Objective : We developed a system of programmatic assessment (PA) to identify competency progression (summative) and assessment for learning to assist residents in their formative development. Methods : The programmatic assessment was designed iteratively from 2014 through 2016...
February 2018: Journal of Graduate Medical Education
Hugh A Stoddard, Erica D Brownfield
PROBLEM: Undergraduate medical education (UME) has trended toward outcomes-based education, unveiling new issues for UME program organization and leadership. Using a common language for categorizing and linking all program components is essential. The Emory Curriculum Alignment Taxonomy (ECAT) was designed as a common vocabulary for curriculum mapping in the outcomes-based environment of the Emory University School of Medicine. APPROACH: The ECAT, developed in 2016, uses a set of 291 controlled identifiers, or "tags," to describe every educational activity's content, instruction, assessment, and outcomes, and thereby to align teaching inputs with student outcomes...
February 20, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
S Claiborne Johnston
Artificial intelligence and other forms of information technology are only just beginning to change the practice of medicine. The pace of change is expected to accelerate as tools improve and as demands for analyzing a rapidly growing body of knowledge and array of data increase. The medical students of today will practice in a world where information technology is sophisticated and omnipresent. In this world, the tasks of memorization and analysis will be less important to them as practicing physicians. On the other hand, the non-analytical, humanistic aspects of medicine-most importantly, the art of caring-will remain a critical function of the physician, and facility with improving systems of care will be required...
February 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Hale Z Toklu, Jacklyn C Fuller
Scholarly activities (i.e., the discovery of new knowledge; development of new technologies, methods, materials, or uses; integration of knowledge leading to new understanding) are intended to measure the quality and quantity of dissemination of knowledge. A successful mentorship program is necessary during residency to help residents achieve the six core competencies (patient care, medical knowledge, practice-based learning and improvement, systems-based practice, professionalism, interpersonal and communication skills) required by the Accreditation Council for Graduate Medical Education (ACGME)...
December 5, 2017: Curēus
Laura Torbeck, Grace Rozycki, Gary Dunnington
BACKGROUND: Leadership has emerged as a crucial component of professional development for physicians in academic medicine. Most leadership skills can be learned and therefore best practices of delivering leadership development are in high demand. For practicing surgeons, specific strategies to teach leadership have been lacking. OBJECTIVE: The purpose of this paper is to describe the structure of a tier-based leadership development program called Leaders Growing Leaders, to identify the major curricular components to each tier including measures and outcomes, and to share lessons learned for those who may want to begin a similar leadership development program...
February 7, 2018: Journal of Surgical Education
H Barrett Fromme, Michael S Ryan, Alix Darden, Donna D'Alessandro, Leora Mogilner, Steven Paik, Teri L Turner
Education, like clinical medicine, should be based on the most current evidence in the field. Unfortunately, medical educators can be overwhelmed by the sheer volume and range of resources for this literature. This article provides an overview of 15 articles from 2016 that the authors consider the top articles in the field of pediatric medical education. The seven authors, all medical educators with combined leadership and expertise across the continuum of pediatric medical education, used an interative, three-stage process to review more than 6339 abstracts published in 2016...
February 6, 2018: Academic Pediatrics
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