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Medical education autonomy

Natalie Colaneri, Mark Sheldon, Andrew Adesman
PURPOSE OF REVIEW: Given the pervasiveness of psychotropic medication in the youth population and an increasingly competitive culture regarding educational performance, children, teenagers, and/or their parents may increasingly seek psychotropic substances in an effort to enhance a student's cognitive abilities and/or academic performance. Physicians must become aware of this very important and clinically relevant issue and work to ensure that medications remain in the hands of patients seeking wellness and not enhancement...
March 13, 2018: Current Opinion in Pediatrics
Steven Lin, Cathina Nguyen, Emily Walters, Paul Gordon
BACKGROUND AND OBJECTIVES: Worsening faculty shortages in medical schools and residency programs are threatening the US medical education infrastructure. Little is known about the factors that influence the decision of family medicine residents to choose or not choose academic careers. Our study objective was to answer the following question among family medicine residents: "What is your greatest concern or fear about pursuing a career in academic family medicine?" METHODS: Participants were family medicine residents who attended the Faculty for Tomorrow Workshop at the Society of Teachers of Family Medicine Annual Spring Conference in 2016 and 2017...
March 2018: Family Medicine
Viktor Riklefs, Gulmira Abakassova, Aliya Bukeyeva, Sholpan Kaliyeva, Bakhtiyar Serik, Alma Muratova, Raushan Dosmagambetova
BACKGROUND: Medical education in Kazakhstan has been literally transformed in the past 10 years. Kazakhstan inherited the Soviet-time discipline-based teacher-centered system of education when no decisions could be made independently. The curriculum was mostly governed in a traditional way, with lectures being the core, little use of e-learning tools, and assessment through oral exams and multiple-choice questions. Most of the universities still preserve the subject-based curriculum with elements of integrated learning...
March 11, 2018: Medical Teacher
Diana-Alexandra Ertl, Andreas Gleiss, Katharina Schubert, Caroline Culen, Peer Hauck, Johannes Ott, Alois Gessl, Gabriele Haeusler
BACKGROUND: Previous studies have shown that only a minority of patients with Turner syndrome (TS) have adequate medical care after transfer to adult care. AIM OF THIS STUDY: To assess the status of medical care and quality of life (QoL) in adult women diagnosed with TS and followed-up until transfer. To compare the subjective and objective view of the medical care quality and initiate improvements based on patients' experiences and current recommendations. METHODS: 39 adult women with TS out of 64 patients contacted were seen for a clinical and laboratory check, cardiac ultrasound, standardized and structured questionnaires (SF-36v2 and Beck depression inventory)...
March 7, 2018: Endocrine Connections
Oksana Babenko, Anna Oswald
AIM: Competency-based medical education aims to foster mastery goals in learners. We examined medical students' mastery approach (beneficial) and mastery avoidance (maladaptive) goals and their associations with students' basic psychological needs, self-compassion, and self-efficacy. METHODS: This was a cross-sectional study employing an online questionnaire. Two hundred medical students in all four years of the medical program completed the questionnaire, containing measures of mastery goals, basic psychological needs (autonomy, competence, relatedness), self-compassion, and self-efficacy...
March 1, 2018: Medical Teacher
Chrystal Rutledge, Catharine M Walsh, Nathan Swinger, Marc Auerbach, Danny Castro, Maya Dewan, Mona Khattab, Alyssa Rake, Ilana Harwayne-Gidansky, Tia T Raymond, Tensing Maa, Todd P Chang
Gamification involves the application of game design elements to traditionally non-game contexts. It is increasingly being used as an adjunct to traditional teaching strategies in medical education to engage the millennial learner and enhance adult learning. The extant literature has focused on determining whether the implementation of gamification results in better learning outcomes, leading to a dearth of research examining its theoretical underpinnings within the medical education context. The authors define gamification, explore how gamification works within the medical education context using self-determination theory as an explanatory mechanism for enhanced engagement and motivation, and discuss common roadblocks and challenges to implementing gamification...
February 20, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Severine Z Cao, Steven T Chen
The appropriate balance between autonomy and supervision in graduate medical education remains an understudied question within dermatology. A recent survey of residents in a large academic dermatology residency program revealed concerns over inadequate autonomy in outpatient clinics. Residents in this program rotate through general and specialty clinics as well as two continuity clinics, but the degree of autonomy remains attending dependent, with most clinics following an "apprenticeship model" where residents function as assistants to their attending...
February 14, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
B A Timmins, C Thomas Riché, M W Saint-Jean, J Tuck, L Merry
AIM: To describe the facilitators and barriers for nurses to perform quality wound care in three surgical wards of a hospital in Port-au-Prince, Haiti. BACKGROUND: Up to a quarter of patients in low- and middle-income countries may acquire at least one infection while hospitalized. There is a paucity of research investigating nursing wound care practices in low- and middle-income countries regarding the prevention of hospital-acquired infections. METHODS: The design was qualitative descriptive...
February 13, 2018: International Nursing Review
Dominique G J Waterval, Janneke M Frambach, Erik W Driessen, Arno Muijtjens, Albert J J A Scherpbier
INTRODUCTION: A new form of internationalization has been trending upward in the medical education realm: crossborder medical curriculum partnerships established to deliver the same, or adapted, curriculum to groups of geographically separated students. This study aims to investigate crossborder medical curriculum partnerships by exploring the experiences of teachers at the recipient institution who have a key role in delivering the program. METHODS: From four pioneering recipient medical schools, 24 teachers participated in a Q-sort study...
February 7, 2018: Medical Teacher
Ryan Grant, Neha Vapiwala
Headlines have previously acknowledged the risk of a "bubble and crash" phenomenon in the physician workforce pipeline. A growing number of medical career dissatisfiers, including emotional and physical burnout, loss of autonomy and burdensome regulations, compound the longstanding fundamental issue of the prohibitive direct and opportunity costs associated with medical training. For U.S. medical education and, in turn, healthcare to remain robust and high-quality, creative solutions are needed to address the untenable physician debt-to-income ratios and to ensure not only that the quantity and quality of medical school aspirants remains favorable to the profession, but that the profession remains responsible to its future members...
January 29, 2018: Medical Teacher
Sandra Zoni, Marie-Elise Verga, Michael Hauschild, Marie-Paule Aquarone-Vaucher, Teresa Gyuriga, Anne-Sylvie Ramelet, Andrew A Dwyer
PURPOSE: We aimed to evaluate patient self-management activities, patient perceptions of the therapeutic relationship and satisfaction with nurse-led consultations as part of a structured, pilot program transitioning young adults with type 1 diabetes (T1DM) to adult-oriented community-based practices. DESIGN AND METHODS: A descriptive, cross-sectional study of patients receiving nurse-led consultations. Patients provided sociodemographic/health information, glycated hemoglobin (HbA1c) measures and completed questionnaires assessing self-management (Revised Self-Care Inventory) and the therapeutic relationship (Caring Nurse-Patient Interaction - short scale)...
January 2018: Journal of Pediatric Nursing
Carey S Clark
BACKGROUND: Cannabis, also known as marijuana, is legal either medicinally or recreationally in 29 states and the District of Columbia, with a majority of the U.S. adult population now living in states where cannabis is legal for medicinal use. As an advocate for patient autonomy and informed choice, the oncology nurse has an ethical responsibility to educate patients about and support their use of cannabis for palliation. . OBJECTIVES: This article aims to discuss the human endocannabinoid system as a basis for better understanding the palliative and curative nature of cannabis as a medicine, as well as review cannabis delivery methods and the emerging role of the oncology nurse in this realm...
February 1, 2018: Clinical Journal of Oncology Nursing
Julia Farquhar, Robert Kamei, Arpana Vidyarthi
Objectives: To improve programs aimed to enhance medical student resiliency, we examined both medical student and faculty advisor perspectives on resiliency-building in an Asian medical school. Methods: In two separate focus groups, a convenience sample of 8 MD-PhD students and 8 faculty advisors were asked to identify strategies for enhancing resilience. Using thematic analysis, two researchers independently examined discussion transcripts and field notes and determined themes through a consensus process...
January 12, 2018: International Journal of Medical Education
Lesley Stafford, Michelle Sinclair, Jane Turner, Louise Newman, Claire Wakefield, Mei Krishnasamy, G Bruce Mann, Leslie Gilham, Kylie Mason, Paula Rauch, Julia Cannell, Penelope Schofield
Background: Parents with cancer have high rates of psychological morbidity, and their children are at risk of poor psychosocial outcomes, particularly in the context of parental distress and poor family communication. Parents express concerns about the impact of cancer on their children and report a lack of professional guidance in meeting their children's needs. Few parenting interventions exist and current interventions have extensive infrastructure demands making them unsuitable for routine use in most health settings...
2017: Pilot and Feasibility Studies
Carlo Egysto Cicero-Oneto, Edith Valdez-Martinez, Miguel Bedolla
BACKGROUND: The world literature shows that empirical research regarding the process of decision-making when cancer in adolescents is no longer curable has been conducted in High-income, English speaking countries. The objective of the current study was to explore in-depth and to explain the decision-making process from the perspective of Mexican oncologists, parents, and affected adolescents and to identify the ethical principles that guide such decision-making. METHODS: Purposive, qualitative design based on individual, fact-to-face, semi-structured, in-depth interviews...
December 11, 2017: BMC Medical Ethics
Lucyna Tomaszek, Grażyna Dębska
AIMS AND OBJECTIVES: (i) To compare knowledge and compliance with good clinical practices regarding control of postoperative pain among nurses employed at hospitals with and without a "Hospital without Pain" certificate, (ii) to identify the determinants of nurses' knowledge and (iii) to define barriers to effective control of postoperative pain. BACKGROUND: Only a slight improvement in postoperative pain control has been observed recently, if any. Implementation of good clinical practices in the control of postoperative pain requires involvement of nurses...
December 8, 2017: Journal of Clinical Nursing
Christopher J King, Andrew Bolton, Jeannette Guerrasio, Adam Trosterman
OBJECTIVES: Program directors have noted that first-year residents struggle with many of the patient care responsibilities they assume as they enter the US graduate medical education system. A national description of medical students' patient care experience in advance of graduation has not been published. We sought to describe the experience of US medical students during their clinical training by surveying the student representatives of each school. METHODS: We developed a mixed-methods survey that was delivered to representatives of 82 schools via an e-mail link to an online survey...
December 2017: Southern Medical Journal
Laurence Guignat, Emmanuelle Proust-Lemoine, Yves Reznik, Delphine Zenaty
Patients with adrenal insufficiency require regular, specialised monitoring in order to optimise their replacement therapy, to detect signs of under- and over-dosage, and to examine for possible associated disorders (auto-immune disorders in the case of auto-immune primary adrenal insufficiency either isolated or as part of auto-immune polyendocrinopathy syndrome type 1; illnesses with underlying monogenic causes). The transition period between adolescence and adulthood represents an added risk of a breakdown in monitoring which requires particular attention from medical teams and coordination between adult and pediatric medical teams...
December 2017: Annales D'endocrinologie
Elizabeth Gaufberg, David Bor, Perry Dinardo, Edward Krupat, Elizabeth Pine, Barbara Ogur, David A Hirsh
Graduates of Harvard Medical School's Cambridge Integrated Clerkship (CIC) describe several core processes that may underlie professional identity formation (PIF): encouragement to integrate pre-professional and professional identities; support for learner autonomy in discovering meaningful roles and responsibilities; learning through caring relationships; and a curriculum and an institutional culture that make values explicit. The authors suggest that the benefits of educational integrity accrue when idealistic learners inhabit an educational model that aligns with their own core values, and when professional development occurs in the context of an institutional home that upholds these values...
2017: Perspectives in Biology and Medicine
Tara M Prairie, Bethany Wrye, Sarah Murfree
The purpose of this study is to explore the ways that some health care providers perceive the intersectionality of their autonomy, religious faith, and their medical practice, specifically when it comes to providing care for the LGBT+ (lesbian, gay, bisexual, transgender, queer, intersex, and asexual) community. Physicians (n = 25) and medical residents (n = 17) located in the southeast completed a qualitative survey regarding their views of working with LGBT+ patients. Five main themes resulted from the analysis: adequate education, communication, discrimination, duty versus physician autonomy, and religious exemption...
November 1, 2017: Health Promotion Practice
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