Posts Tagged ‘training’
Internal medicine residency training for unhealthy alcohol and other drug use: recommendations for curriculum design
Background:
Unhealthy substance use is the spectrum from use that risks harm, to use associated with problems, to the diagnosable conditions of substance abuse and dependence, often referred to as substance abuse disorders. Despite the prevalence and impact of unhealthy substance use, medical education in this area remains lacking, not providing physicians with the necessary expertise to effectively address one of the most common and costly health conditions. Medical educators have begun to address the need for physician training in unhealthy substance use, and formal curricula have been developed and evaluated, though broad integration into busy residency curricula remains a challenge.DiscussionWe review the development of unhealthy substance use related competencies, and describe a curriculum in unhealthy substance use that integrates these competencies into internal medicine resident physician training. We outline strategies to facilitate adoption of such curricula by the residency programs. This paper provides an outline for the actual implementation of the curriculum within the structure of a training program, with examples using common teaching venues. We describe and link the content to the core competencies mandated by the Accreditation Council for Graduate Medical Education, the formal accrediting body for residency training programs in the United States. Specific topics are recommended, with suggestions on how to integrate such teaching into existing internal medicine residency training program curricula.SummaryGiven the burden of disease and effective interventions available that can be delivered by internal medicine physicians, teaching about unhealthy substance use must be incorporated into internal medicine residency training, and can be done within existing teaching venues.
Training Kit For Operating Room Emergencies Now Available
When the anesthesia care provider yells the code “Malignant Hyperthermia!” during a routine surgery there are approximately 15 minutes to save this patient’s life, you are excited but not panicking— why? The Malignant Hyperthermia Association of the United States (MHAUS) introduces a new MH Mock Drill Training Kit for Operating Room Staff to better prepare for MH emergencies…
Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors
Background:
Information about the availability and effectiveness of childhood obesity training during residency is limited.
Methods:
We surveyed residency program directors from pediatric, internal medicine-pediatrics (IM-Peds), and family medicine residency programs between September 2007 and January 2008 about childhood obesity training offered in their programs.
Results:
The response rate was 42.2% (299/709) and ranged by specialty from 40.1% to 45.4%. Overall, 52.5% of respondents felt that childhood obesity training in residency was extremely important, and the majority of programs offered training in aspects of childhood obesity management including prevention (N=240, 80.3%), diagnosis (N=282, 94.3%), diagnosis of complications (N=249, 83.3%), and treatment (N=242, 80.9%). However, only 18.1% (N=54) of programs had a formal childhood obesity curriculum with variability across specialties. Specifically, 35.5% of IM-Peds programs had a formal curriculum compared to only 22.6% of pediatric and 13.9% of family medicine programs (p<0.01). Didactic instruction was the most commonly used training method but was rated as only somewhat effective by 67.9% of respondents using this method. The most frequently cited significant barrier to implementing childhood obesity training was competing curricular demands (58.5%).
Conclusions:
While most residents receive training in aspects of childhood obesity management, deficits may exist in training quality with a minority of programs offering a formal childhood obesity curriculum. Given the high prevalence of childhood obesity, a greater emphasis should be placed on development and use of effective training strategies suitable for all specialties training physicians to care for children.
Training of patient and consumer representatives in the basic competencies of evidence-based medicine: a feasibility study
Background:Evidence based medicine (EBM) has become standard approach in medicine. Patients and health authorities increasingly claim active patient roles in decision making. Education to cope with these roles might be useful. We investigated the feasibility, acceptability and possible impact of EBM training courses for patient and consumer representatives.Methods:We designed a generic one week EBM course based on previous experience with EBM courses for non medical health professionals. A course specific competence test has been developed and validated to measure EBM skills. Formative and summative evaluation of the course comprised: 1) EBM skills; 2) individual learning goals; 3) self reported implementation after six months using semi-structured interviews; 4) group based feedback by content analysis. EBM skills’ achievement was compared to results gathered by a group of undergraduate University students of Health Sciences and Education who had attended a comparable EBM seminar.Results:Fourteen EBM courses were conducted including 161 participants without previous EBM training (n=54 self-help group representatives, n=64 professional counsellors, n=36 patient advocates, n=7 others); 71% had a higher education degree; all but five finished the course. Most participants stated personal learning goals explicitly related to practicing EBM such as acquisition of critical appraisal skills (n=130) or research competencies (n=67). They rated the respective relevance of the course on average with 80% (SD 4) on a visual analogue scale ranging from 0 to 100%.Participants passed the competence test with a mean score of 14.7 (SD 3.0, n=123) out of 19.5 points. The comparison group of students achieved a mean score of 14.4 (SD 3.3, n=43). Group based feedback revealed increases of self confidence, empowerment through EBM methodology and statistical literacy, and acquisition of new concepts of patient information and counselling. Implementation of EBM skills was reported by 84 of the 129 (65%) participants available for follow-up interviews. Barriers included lack of further support, limited possibilities to exchange experiences, and feeling discouraged by negative reactions of health professionals.Conclusions:Training in basic EBM competencies for selected patient and consumer representatives is feasible and accepted and may affect counselling and advocacy activities. Implementation of EBM skills needs support beyond the training course.
Training auscultatory skills: computer simulated heart sounds or additional bedside training? A randomized trial on third-year medical students
Background:The present study compares the value of additional use of computer simulated heart sounds, to conventional bedside auscultation training, on the cardiac auscultation skills of 3rd year medical students at Oslo University Medical School.Methods:In addition to their usual curriculum courses, groups of seven students each were randomized to receive four hours of additional auscultation training either employing a computer simulator system or adding on more conventional bedside training. Cardiac auscultation skills were afterwards tested using live patients. Each student gave a written description of the auscultation findings in four selected patients, and was rewarded from 0-10 points for each patient. Differences between the two study groups were evaluated using student’s t-test.Results:At the auscultation test no significant difference in mean score was found between the students who had used additional computer based sound simulation compared to additional bedside training.Conclusions:Students at an early stage of their cardiology training demonstrated equal performance of cardiac auscultation whether they had received an additional short auscultation course based on computer simulated training, or had had additional bedside training.
Comparative attainment of 5-year undergraduate and 4-year graduate entry medical students moving into foundation training
Background:Graduate entry medicine is a recent innovation in UK medical training. Evidence is sparse at present as to progress and attainment on these programmes. Shared clinical rotations, between an established 5-year and a new graduate entry course, provide the opportunity to compare achievement on clinical assessments. To compare completion and attainment on clinical phase assessments between students on a 4-year graduate entry course and an established 5-year undergraduate medicine course.Methods:Overall completion rates for the 4 and 5 year courses, fails at first attempt, and scores on 14 clinical assessments, were compared between 171 graduate-entry and 450 undergraduate medical students at the University of Nottingham, comprising two graduating cohorts. Percentage assessment marks were converted to z-scores separately for each graduating year and the normalised marks then combined into a single dataset. Z-score transformed percentage marks were analysed by multivariate analysis of variance and univariate analyses of variance for each summative assessment. Numbers of fails at first attempt were analysed aggregated across all assessments initially, then separately for each assessment using Chi2.Results:Completion rates were around 90% overall and significantly higher in the graduate entry course. Failures of assessments overall were similar, but a higher proportion of graduate entry students failed a community follow-up project and the final OSLER. Mean performance on clinical assessments showed a significant overall difference, made up of lower performance on 4 of 5 knowledge-based exams (as well as higher performance on the first exam) by the graduate entry group, but similar levels of performance on all the skills-based and attitudinal assessments.Conclusions:High completion rates are encouraging. The lower performance in some knowledge-based exams may reflect lower prior educational attainment, a substantially different demographic profile (age, gender), or an artefact of the first 2 years of a new graduate entry programme.
Brief Training In Meditation May Help In Pain Management
Living with pain is stressful, but a surprisingly short investment of time in mental training can help you cope. A new study examining the perception of pain and the effects of various mental training techniques has found that relatively short and simple mindfulness meditation training can have a significant positive effect on pain management.
RACGP Disappointed By New Mental Health Training Policy, Australia
Around 20% of adult Australians, or one in five people, will experience a mental illness at some stage in their lives and 7.6% of GP consultations relate to a problem of a psychological character. Many more GP consultations indirectly involve mental health issues. General practitioners are highly skilled and provide a critical part of the mental health care system in Australia.
Incorporating and evaluating an integrated gender-specific medicine curriculum:a survey study in Dutch GP Training
Background:We recently set standards for gender-specific medicine training as an integrated part of the GP training curriculum. This paper describes the programme and evaluation of this training.Methods:The programme is designed for GP registrars throughout the 3-year GP training. The modules emphasize interaction, application, and clinically integrated learning and teaching methods in peer groups. In 2005 – 2008, after completion of each tutorial, GP registrars were asked to fill in a questionnaire on a 5-point Likert scale to assess the programme’s methods and content. GP registrars were also asked to identify two learning points related to the programme.Results:The teaching programme consists of five 3-hour modules that include gender themes related to and frequently seen by GPs such as in doctor-patient communication and cardiovascular disease. GP registrars evaluated the training course positively. The written learning points suggest that GP registrars have increased their awareness of why attention to gender-specific information is relevant.Conclusions:In summary, gender-specific medicine training has been successfully integrated into an existing GP training curriculum. The modules and teaching methods are transferable to other training institutes for postgraduate training. The evaluation of the teaching programme shows a positive impact on GP registrars’ gender awareness.
Brits Invited To Take Part In Mass Brain Training Study
Brain experts and the BBC are launching a mass British experiment to test whether brain games actually improve brain performance. The study launches at 7.30 pm BST on tonight’s (Monday 7 September) episode of the BBC1 television programme Bang Goes The Theory. A host of celebrities will appear on the show to help launch the experiment, said the BBC.
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