Posts Tagged ‘medical’
Self-development groups reduce medical school stress: a controlled intervention study
Background:
High stress levels and mental health problems are common among medical students, but there is a lack of studies on group interventions that aim to reduce such distress during medical school.
Methods:
A full class of students (n = 129) participated in group sessions during their third year of medical school in Bergen, Norway. The subsequent third-year class (n = 152) acted as control group, in order to create a quasi-experimental design. Two types of group intervention sessions were offered to the first class. One option was self-development groups led by trained group psychotherapists. Alternatively, students could choose discussion groups that focused on themes of special relevance to doctors, led by experienced general practitioners. The intervention comprised of 12 weekly group sessions each lasting 90 minutes. Data were gathered before the intervention (T1), and three months post intervention (T2). Distress was measured using the Perceived Medical School Stress (PMSS) and Symptom Check List-5 (SCL-5) assessments.
Results:
The intervention group showed a significant reduction in PMSS over the observation period. The subsequent year control group stayed on the same PMSS levels over the similar period. The intervention was a significant predictor of PMSS reduction in a multiple regression analysis adjusted for age and sex, beta = -1.93 (-3.47 to -0.38), P = 0.02. When we analysed the effects of self-development and discussion groups with the control group as reference, self-development group was the only significant predictor of PMSS reduction, beta = -2.18 (-4.03 to -0.33), P = 0.02. There was no interaction with gender in our analysis. This implicates no significant difference between men and women concerning the effect of the self-development group. There was no reduction in general mental distress (SCL-5) over this period.
Conclusion:
A three-month follow-up showed that the intervention had a positive effect on perceived medical school stress among the students, and further analyses showed this was due to participation in self-development groups.
Using standardized patients to assess communication skills in medical and nursing students
Background:
A number of recent developments in medical and nursing education have highlighted the importance of communication and consultation skills (CCS). Although such skills are taught in all medical and nursing undergraduate curriculums, there is no comprehensive screening or assessment programme of CCS using professionally trained Standardized Patients Educators (SPE’s) in Ireland. This study was designed to test the content, process and acceptability of a screening programme in CCS with Irish medical and nursing students using trained SPE’s and a previously validated global rating scale for CCS.
Methods:
Eight tutors from the Schools of Nursing and Medicine at University College Cork were trained in the use of a validated communication skills and attitudes holistic assessment tool. A total of forty six medical students (Year 2 of 5) and sixty four nursing students (Year 2/3 of 4) were selected to under go individual CCS assessment by the tutors via an SPE led scenario. Immediate formative feedback was provided by the SPE’s for the students. Students who did not pass the assessment were referred for remediation CCS learning.
Results:
Almost three quarters of medical students (33/46; 72%) and 81% of nursing students (56/64) passed the CCS assessment in both communication and attitudes categories. All nursing students had English as their first language. Nine of thirteen medical students referred for enhanced learning in CCS did not have English as their first language.
Conclusions:
A significant proportion of both medical and nursing students required referral for enhanced training in CCS. Medical students requiring enhanced training were more likely not to have English as a first language.
Medical ID Thefts Can Harm Patients’ Health; Prosecutors Go After Medicare Fraud
News outlets covered different aspects of fraud in the health care system. NPR/KSMU: “Experts say a different type of identity theft is on the rise — one that could compromise both the victim’s credit and physical safety…
How Expanded Medicare Authority Can Drive Improvements In The Medical Delivery System
Despite the loss of the Democrats’ supermajority necessary to pass comprehensive national healthcare reform, new federal legislation is needed to promote greater efficiency in the medical delivery system. Comprehensive reform of Medicare’s provider-payment system would accelerate delivery system change but would be highly disruptive for many hospitals and physicians…
Federal Officials Focus On Radiation Practices At Florida Clinic; Medical Scan Makers Announce New Efforts To Prevent Mistakes
Medicare regulations require that when patients receive some types of highly specialized cancer treatments, their radiation oncologist must be on site. But The New York Times reports that federal officials are investigating a Florida cancer clinic that billed Medicare for such treatments while the doctors were absent, sometimes on overseas trips…
Medical student engagement and leadership within a new learning community
Background:
Many medical schools are establishing learning communities to foster cohesion among students and to strengthen relationships between students and faculty members. Emerging learning communities require nurturing and attention; this represents an opportunity wherein medical students can become involved as leaders. This study sought to understand issues related to active involvement among students who chose to become highly engaged in a newly developed learning community.MethodBetween April and June 2008, 36 students who assumed leadership roles within the Colleges Program were queried electronically with open-ended questions about their engagement. Qualitative analysis of the written responses was independently performed by two investigators; coding was compared for agreement. Content analysis identified major themes.
Results:
35 students (97%) completed the questionnaire. Motives that emerged as reasons for getting involved included: endorsing the need for the program; excitement with the start-up; wanting to give back; commitment to institutional excellence; and collaboration with talented peers and faculty. Perceived benefits were grouped under the following domains: connecting with others; mentoring; learning new skills; and recognition. The most frequently identified drawbacks were the time commitment and the opportunity costs. Ideas for drawing medical students into new endeavors included: creating defined roles; offering a breadth of opportunities; empowering students with responsibility; and making them feel valued.
Conclusions:
Medical students were drawn to and took on leadership roles in a medical school curricular innovation. This example may prove helpful to others hoping to engage students as leaders in learning communities at their schools or those wishing to augment student involvement in other programs.
Countdown To Medicare Meltdown: Day 6 – Texas Medical Association
The following can be attributed to William H. Fleming III, MD, president of the Texas Medical Association. Dr. Fleming’s statement addresses the Medicare physician payment cuts slated for March 1, 2010. “Texas physicians have pleaded with Congress to fix Medicare for the past decade. It is the insurance senior citizens and people with disabilities depend on for health care…
AMGA Lauds Senator Stabenow For Her Efforts To Ensure EMR Incentives For Medical Groups
The American Medical Group Association (AMGA) applauds Senator Debbie Stabenow (D-MI) for her efforts to assure fairness in payment of electronic medical record (EMR) incentive payments under the American Recovery and Reinvestment Act of 2009 (ARRA)…
Gender differences in specialty preference and mismatch with real needs in Japanese medical students
Background:The shortage of doctors and maldistribution among specialties are of great concern in the Japanese health care system. This study investigated specialty preference in medical students of one university, and examined gender differences and compared their preference with real needs.Methods:We conducted a self-administered questionnaire including specialty preference in all students of one medical university. Preference was assessed by the five-level probability of their future choice: 1 = very low, 2 = low, 3 = moderate, 4 = high, and 5 = very high. The proportion of 4 or 5 was calculated as the preference rate. The real needs (magnitude of doctor shortage) in the prefecture were drawn from two different surveys. The relationship between the sex-specific preference rate by specialty and real needs was assessed by Spearman’s correlation coefficient.Results:Internal medicine showed the highest preference rate, followed by general surgery, pediatrics, and emergency medicine. There was no significant correlation between the preference rates of men and women (r = 0.27, p = 0.34). The preference rates for general surgery, orthopedics, neurosurgery, and emergency medicine were significantly higher in men than in women, while those of obstetrics & gynecology, pediatrics, and dermatology were significantly higher in women. The magnitude of doctor shortage by specialty from two surveys were significantly correlated with the total preference rate and men’s preference rate (r = 0.54 to 0.74), but not with women’s preference rate (r = 0.06 and 0.32).Conclusions:This study elucidated not only gender differences in specialty preference but also the relationship to real needs. Critical gender differences and mismatch with real needs were found in women. In addition to traditional gender roles and insufficient support for women’s participation in Japan, gender differences and mismatch influence the current and future maldistribution of specialties. Systematic changes in the working environment in medical society are required to solve these problems.
Accreditation council for graduate medical education (ACGME) annual anesthesiology residency and fellowship program review: a “report card” model for continuous improvement
Background:The Accreditation Council for Graduate Medical Education (ACGME) requires an annual evaluation of all ACGME-accredited residency and fellowship programs to assess program quality. The results of this evaluation must be used to improve the program. This manuscript describes a metric to be used in conducting ACGME-mandated annual program review of ACGME-accredited anesthesiology residencies and fellowships.Methods:A variety of metrics to assess anesthesiology residency and fellowship programs are identified by the authors through literature review and considered for use in constructing a program “report card.”Results:Metrics used to assess program quality include success in achieving American Board of Anesthesiology (ABA) certification, performance on the annual ABA/American Society of Anesthesiology In-Training Examination, performance on mock oral ABA certification examinations, trainee scholarly activities (publications and presentations), accreditation site visit and internal review results, ACGME and alumni survey results, National Resident Matching Program (NRMP) results, exit interview feedback, diversity data and extensive program/rotation/faculty/curriculum evaluations by trainees and faculty. The results are used to construct a “report card” that provides a high-level review of program performance and can be used in a continuous quality improvement process.Conclusions:An annual program review is required to assess all ACGME-accredited residency and fellowship programs to monitor and improve program quality. We describe an annual review process based on metrics that can be used to focus attention on areas for improvement and track program performance year-to-year. A “report card” format is described as a high-level tool to track educational outcomes.
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