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Nagasaki K, Nishizaki Y, Shinozaki T, Shimizu T, Yamamoto Y, Shikino K, Fukui S, Nishiguchi S, Kurihara M, Katayama K, Kobayashi H, Tokuda Y. Association between prolonged weekly duty hours and self-study time among residents: a cross-sectional study. Postgrad Med J 2023; 99:1080-1087. [PMID: 37265446 DOI: 10.1093/postmj/qgad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/26/2023] [Accepted: 05/06/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE In 2024, the Japanese government will enforce a maximum 80-hour weekly duty hours (DHs) regulation for medical residents. Although this reduction in weekly DHs could increase the self-study time (SST) of these residents, the relationship between these two variables remains unclear. The aim of the study was to investigate the relationship between the SST and DHs of residents in Japan. METHODS In this nationwide cross-sectional study, the subjects were candidates of the General Medicine In-Training Examination in the 2020 academic year. We administered questionnaires and categorically asked questions regarding daily SST and weekly DHs during the training period. To account for hospital variability, proportional odds regression models with generalized estimating equations were used to analyse the association between SST and DHs. RESULTS Of the surveyed 6117 residents, 32.0% were female, 49.1% were postgraduate year-1 residents, 83.8% were affiliated with community hospitals, and 19.9% worked for ≥80 hours/week. Multivariable analysis revealed that residents working ≥80 hours/week spent more time on self-study than those working 60-70 hours/week. Conversely, residents who worked <50 hours/week spent less time on self-study than those who worked 60-70 hours/week. The factors associated with longer SST were sex, postgraduate year, career aspiration for internal medicine, affiliation with community hospitals, academic involvement, and well-being. CONCLUSION Residents with long DHs had longer SSTs than residents with short DHs. Future DH restrictions may not increase but rather decrease resident SST. Effective measures to encourage self-study are required, as DH restrictions may shorten SST.
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Affiliation(s)
- Kazuya Nagasaki
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki 310-0015, Japan
| | - Yuji Nishizaki
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, 113-8421, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Yu Yamamoto
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
| | - Kiyoshi Shikino
- Department of General Medicine, Chiba University Hospital, Chiba, Japan
| | - Sho Fukui
- Department of Emergency and General Medicine, Kyorin University, Tokyo, Japan
| | - Sho Nishiguchi
- Department of General Internal Medicine, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Masaru Kurihara
- Department of Patient Safety, Nagoya University Hospital, Nagoya, Japan
| | - Kohta Katayama
- Department of General Internal Medicine, St. Marianna University School of Medicine, Tokyo, Japan
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hiroyuki Kobayashi
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki 310-0015, Japan
| | - Yasuharu Tokuda
- Muribushi Okinawa Center for Teaching Hospitals, Okinawa, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
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Dunham CM, Burger AJ, Hileman BM, Chance EA, Lisko P. Effect of contemplating patient care spiritual flow principles and mindfulness on trauma center nurses' wellbeing: a pilot trial. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2021; 11:477-485. [PMID: 35111383 PMCID: PMC8784743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Trauma nurses commonly encounter stress and burnout and have increased negative affect states and decreased positive affect traits. This study investigated whether trauma center nurses would have improvements in wellbeing scores after reading and contemplating Spiritual Flow: Pathways to Proficient Patient Care and Nurse & Physician Wellbeing (Spiritual Flow). Trauma center surgical intensive care unit nurses completed a baseline and follow-up survey before and after reading and contemplating Spiritual Flow, which provides insights into spirituality and mindfulness. The survey contained four positive affect (PA) items, each rated 1-very little to 5-extremely, that were summed to create a PA score (PAS). The seven negative affect (NA) survey items were similarly rated and reverse coded, 1-extremely to 5-very little, to create a nonstress score (NSS). The PAS (4-20) and NSS (7-35) were summed to create a wellbeing score (WS). Nurses rated the degree to which they felt more peaceful or inspired after contemplating the book. Thirty-seven of 39 (95%) routine nursing staff members completed both surveys. Follow-up values increased for WS (P = 0.0001) and NSS (P = 0.0001) after reading and contemplating Spiritual Flow compared to baseline values. No changes occurred for PAS (P = 0.1606). Because 16% of nurses had a high PAS on the baseline survey, further analyses were performed on the other 84%. Significantly increased values were noted on follow-up for PAS (P = 0.0171), NSS (P = 0.0015), and WS (P = 0.0003) compared to baseline scores. Of 37 nurses, 24 (64.9%) rated feeling more peaceful and/or inspired as moderately or quite a bit. This pilot study suggests that contemplating Spiritual Flow was associated with improvements in surgical intensive care trauma center nurse wellbeing. These preliminary findings need to be confirmed in an investigation that includes a control group and randomization.
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Affiliation(s)
- Carl M Dunham
- Trauma, Critical Care, and General Surgery Services, St. Elizabeth Youngstown Hospital1044 Belmont Ave, Youngstown OH 44501, USA
| | - Amanda J Burger
- Behavioral Medicine, St. Elizabeth Family Medicine Residency1044 Belmont Ave, Youngstown OH 44501, USA
| | - Barbara M Hileman
- Trauma and Neuroscience Research Department, St. Elizabeth Youngstown Hospital1044 Belmont Ave, Youngstown OH 44501, USA
| | - Elisha A Chance
- Trauma and Neuroscience Research Department, St. Elizabeth Youngstown Hospital1044 Belmont Ave, Youngstown OH 44501, USA
| | - Paul Lisko
- Pastoral Services, St. Charles Borromeo Catholic Church7345 Westview Dr, Boardman OH 44512, USA
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Kind T, Olvet DM, Farina G, Kenda L, Sarandos SL, Yasunaga AJ, Jokela JA, Simons RJ. Reading and Study Habits of Medical Students on Clerkships and Performance Outcomes: a Multi-institutional Study. MEDICAL SCIENCE EDUCATOR 2021; 31:1957-1966. [PMID: 34956707 PMCID: PMC8651945 DOI: 10.1007/s40670-021-01409-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/19/2021] [Indexed: 05/31/2023]
Abstract
PURPOSE To describe medical students' reading habits and resources used during clinical clerkships, and to assess whether these are associated with performance outcomes. METHOD Authors administered a cross-sectional survey to medical students at 3 schools midway through the clerkship year. Closed and open-ended questions focused on resources used to read and learn during the most recent clerkship, time spent and purpose for using these resources, influencers on study habits, and barriers. A multiple regression model was used to predict performance outcomes. RESULTS Overall response rate was 53% (158/293). Students spent most of their time studying for clerkship exams and rated question banks and board review books as most useful for exam preparation. Sixty-seven percent used textbooks (including pocket-size). For patient care, online databases and pocket-sized textbooks were rated most useful. The main barrier to reading was time. Eighty percent of students ranked classmates/senior students as most influential regarding recommended resources. Hours spent reading for exams was the only significant predictor of USMLE Step 2 scores related to study habits. The predominant advice offered to future students was to read. CONCLUSIONS These findings can help inform students and educational leadership about resources students use, how they use them, and links to performance outcomes, in an effort to guide them on maximizing learning on busy clerkships. With peers being most influential, it is important not only to provide time to help students build strong reading and study habits early, but also to guide them towards reliable resources, so they will recommend useful information to others.
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Affiliation(s)
- Terry Kind
- Department of Pediatrics, Children’s National Hospital, 111 Michigan Ave, Washington, NW 20010 USA
- The George Washington University School of Medicine and Health Sciences, Washington, DC USA
| | - Doreen M. Olvet
- Department of Science Education, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
| | - Gino Farina
- Department of Emergency Medicine and Science Education, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
| | - Loren Kenda
- Office of Evaluation, The George Washington University School of Medicine and Health Sciences, Washington, DC USA
| | - Stephanie L. Sarandos
- Office of Evaluation, The George Washington University School of Medicine and Health Sciences, Washington, DC USA
| | - April J. Yasunaga
- Department of Medicine, University of Illinois College of Medicine at Urbana-Champaign, Urbana, IL USA
| | - Janet A. Jokela
- Department of Medicine, University of Illinois College of Medicine at Urbana-Champaign, Urbana, IL USA
| | - Richard J. Simons
- Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC USA
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Gopwani SR, Adams E, Rooney A, Tousimis E, Ramsey K, Warusha S. Impact of a Workflow-Integrated Web Tool on Resource Utilization and Information-Seeking Behavior in an Academic Anesthesiology Department: Longitudinal Cohort Survey Study. JMIR MEDICAL EDUCATION 2021; 7:e26325. [PMID: 34309566 PMCID: PMC8367122 DOI: 10.2196/26325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/30/2021] [Accepted: 05/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Medical resident reading and information-seeking behavior is limited by time constraints as well as comfort in accessing and assessing evidence-based resources. Educational technology interventions, as the preferred method for millennial leaners, can reduce these barriers. We implemented an educational web tool, consisting of peer-reviewed articles as well as local and national protocols and policies, built into the daily workflow of a university-based anesthesiology department. We hypothesized that this web tool would increase resource utilization and overall perceptions of the educational environment. OBJECTIVE The goal of this study was to demonstrate that an educational web tool designed and built into the daily workflow of an academic anesthesia department for trainees could significantly decrease barriers to resource utilization, improve faculty-trainee teaching interactions, and improve the perceptions of the educational environment. METHODS Following Institutional Review Board approval, a longitudinal cohort survey study was conducted to assess trainee resource utilization, faculty evaluation of trainees' resource utilization, and trainee and faculty perceptions about the educational environment. The survey study was conducted in a pre-post fashion 3 months prior to web tool implementation and 3 months following implementation. Data were deidentified and analyzed unpaired using Student t tests for continuous data and chi-square tests for ordinal data. RESULTS Survey response rates were greater than 50% in all groups: of the 43 trainees, we obtained 27 (63%) preimplementation surveys and 22 (51%) postimplementation surveys; of the 46 faculty members, we obtained 25 (54%) preimplementation surveys and 23 (50%) postimplementation surveys. Trainees showed a significant improvement in utilization of peer-reviewed articles (preimplementation mean 8.67, SD 6.45; postimplementation mean 18.27, SD 12.23; P=.02), national guidelines (preimplementation mean 2.3, SD 2.40; postimplementation mean 6.14, SD 5.01; P<.001), and local policies and protocols (preimplementation mean 2.23, SD 2.72; postimplementation mean 6.95, SD 6.09; P=.02). There was significant improvement in faculty-trainee educational interactions (preimplementation mean 1.67, SD 1.33; postimplementation mean 6.05, SD 8.74; P=.01). Faculty assessment of trainee resource utilization also demonstrated statistically significant improvements across all resource categories. Subgroups among trainees and faculty showed similar trends toward improvement. CONCLUSIONS Learning technology interventions significantly decrease the barriers to resource utilization, particularly among millennial learners. Further investigation has been undertaken to assess how this may impact learning, knowledge retention, and patient outcomes.
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Affiliation(s)
- Sumeet R Gopwani
- Department of Anesthesiology, MedStar Georgetown University Hospital, Washington, DC, United States
| | - Erin Adams
- Department of Anesthesiology, Weill Cornell Medical College, New York, NY, United States
| | - Alexandra Rooney
- Department of Anesthesiology, Brigham and Women's Hospital, Boston, MA, United States
| | - Eleni Tousimis
- Department of Surgery, Breast Center, MedStar Georgetown University Hospital, Washington, DC, United States
| | - Katherine Ramsey
- Department of Anesthesiology, Kaiser Permanente Mid-Atlantic Permanente Group, Rockville, MD, United States
| | - Sohan Warusha
- Department of Anesthesiology, Temple University Hospital, Philadelphia, PA, United States
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Bernstein E, Bhardwaj N, Pfoh ER, Yudelevich E. A Nationwide Survey of Educational Resource Utilization and Perception Among Internal Medicine Residents. J Gen Intern Med 2021; 36:1598-1604. [PMID: 33506391 PMCID: PMC7840077 DOI: 10.1007/s11606-020-06441-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 12/10/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND New virtual resources ("novel resources") have been incorporated into medical education. No recent large studies about their use and perception among internal medicine (IM) residents exist. OBJECTIVE Characterize the use and perceived helpfulness of educational resources. DESIGN Nationwide survey from December 2019 to March 2020. PARTICIPANTS IM residents in the USA. MAIN MEASURES Residents were surveyed on their use and their perceived helpfulness of resources for both attaining general medical knowledge and for point-of-care (POC) learning. Traditional resources included board review resources, clinical experience, digital clinical resources (e.g., UpToDate), journal articles, pocket references, professional guidelines, textbooks, and residency curricula. Novel resources included Twitter, video streaming platforms (e.g., YouTube), online blogs, podcasts, and Wikipedia. KEY RESULTS We had 662 respondents from 55 residency programs across 26 states. On average, residents used 9 total resources (7 traditional and 2 novel). Digital clinical resources and clinical experience were used by all residents and found helpful by the highest percentage of residents (96% and 94%, respectively). Journal articles were next (used by 90%), followed by board review resources and residency curricula (both used by 85%). Their perceived helpfulness varied, from 90% for board review resources, to 66% for journal articles and 64% for residency curricula, the lowest perceived helpfulness of any traditional resource. Podcasts and video streaming platforms were used as frequently as textbooks (58-59%), but were rated as helpful more frequently (75% and 82% vs 66%, respectively). CONCLUSIONS Digital clinical resources, video streaming platforms, and podcasts were perceived as helpful, underscoring the importance of ensuring their integration into medical education to complement clinical experience and other traditional resources which remain highly valued by residents. IMPORTANCE Our findings can inform residency programs as they transition to virtual curricula in the wake of the COVID-19 pandemic.
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Affiliation(s)
- E Bernstein
- Department of Internal Medicine and Geriatrics, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - N Bhardwaj
- Department of Internal Medicine and Geriatrics, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - E R Pfoh
- Center for Value Based Care, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - E Yudelevich
- Department of Internal Medicine and Geriatrics, Cleveland Clinic Foundation, Cleveland, OH, USA.
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Alkhamees M, Al-Zahrani MA, Almutairi S, Alkanhal H, Almuhaideb M, Abumelha SM. Study Habits of Urology Residents in Saudi Arabia: Identifying Defects and Areas for Curricular Development - A Trainee-Based Survey. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2020; 11:707-715. [PMID: 33117040 PMCID: PMC7547132 DOI: 10.2147/amep.s269059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/06/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE This study evaluated the study habits of Saudi urology residents throughout their residency training. It examines the study time and quality of study materials used by Saudi urology residents and identifies ways to maximize study benefits. PATIENTS AND METHODS An online questionnaire was distributed to 152 registered residents in regions throughout Saudi Arabia (response rate: 93.4%). The questionnaire addressed study habits throughout training, motivations for studying, preferred study resources, impressions on teaching quality, study preparation methods, and exam preparedness among junior and senior residents. RESULTS Among all residents, 37.3% read for 2-5 hours weekly. Juniors read significantly more than seniors (P = 0.034). Marital status affects seniors' study habits (P = 0.029). For most seniors, preparation for the final board exam is the greatest motivation for studying (P = 0.006). The AUA/EAU guidelines were useful information source for seniors (P = 0.001). Fifty-four percent (54.4%) of residents felt that their residency program did not provide protected study time prior to the board exams. Moreover, the majority (64.8%) felt that the training program did not adequately prepare them for the board exams. CONCLUSION We recommend that local program directors implement more effective teaching methods. Structured reading habits and specific study materials were found to be positive predictors of successful performance. Residents should also be educated in balancing working hours, social life, and study.
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Affiliation(s)
- Mohammad Alkhamees
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Meshari A Al-Zahrani
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Sulaiman Almutairi
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Hammam Alkanhal
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Mana Almuhaideb
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saad M Abumelha
- Division of Urology, Department of Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh11426, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh11426, Saudi Arabia
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French H, Gray M, Gillam-Krakauer M, Bonachea EM, Carbajal M, Payne A, Vasquez MM, Rubinos L, Falck A, Izatt S, Dadiz R. Flipping the classroom: a national pilot curriculum for physiology in neonatal-perinatal medicine. J Perinatol 2018; 38:1420-1427. [PMID: 30087455 DOI: 10.1038/s41372-018-0185-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/13/2018] [Accepted: 06/29/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To explore interest, feasibility, perceived effectiveness, and acceptability of a standardized, national physiology curriculum for neonatal-perinatal medicine (NPM) fellows using online videos for knowledge acquisition paired with flipped classrooms (FCs) for knowledge application. STUDY DESIGN Two educational programs pairing online videos with FCs were developed and peer-reviewed. These programs were piloted at five institutions. Fellows completed surveys, and fellows and educators participated in focus groups after their FC experiences. RESULTS Thirty-five fellows responded to the survey. Forty-one fellows and six educators participated in focus groups. Fellows and educators preferred online videos paired with FCs over didactic teaching and perceived them to be effective for knowledge acquisition and application. CONCLUSION Fellows and educators preferred FC learning over traditional didactics and reported that FCs facilitated creation of a learning community, fostering active learning. The favorable response toward this pilot project and the feasibility of its use supports further development of a standardized NPM physiology curriculum for fellowship training.
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Affiliation(s)
- Heather French
- Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Megan Gray
- Division of Neonatology, University of Washington School of Medicine, Seattle, WA, USA
| | | | | | - Melissa Carbajal
- Division of Neonatology, Baylor College of Medicine, Houston, TX, USA
| | - Allison Payne
- Division of Neonatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Margarita M Vasquez
- Division of Neonatology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Laura Rubinos
- Division of Neonatology, University of Texas Southwestern, Dallas, TX, USA
| | - Alison Falck
- Division of Neonatology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Susan Izatt
- Division of Neonatology, Duke University Medical Center, Durham, NC, USA
| | - Rita Dadiz
- Division of Neonatology, University of Rochester Medical Center, Rochester, NY, USA
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McLean SF. Case-Based Learning and its Application in Medical and Health-Care Fields: A Review of Worldwide Literature. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2016; 3:10.4137_JMECD.S20377. [PMID: 29349306 PMCID: PMC5736264 DOI: 10.4137/jmecd.s20377] [Citation(s) in RCA: 258] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/28/2016] [Accepted: 03/30/2016] [Indexed: 05/09/2023]
Abstract
INTRODUCTION Case-based learning (CBL) is a newer modality of teaching healthcare. In order to evaluate how CBL is currently used, a literature search and review was completed. METHODS A literature search was completed using an OVID© database using PubMed as the data source, 1946-8/1/2015. Key words used were "Case-based learning" and "medical education", and 360 articles were retrieved. Of these, 70 articles were selected to review for location, human health care related fields of study, number of students, topics, delivery methods, and student level. RESULTS All major continents had studies on CBL. Education levels were 64% undergraduate and 34% graduate. Medicine was the most frequently represented field, with articles on nursing, occupational therapy, allied health, child development and dentistry. Mean number of students per study was 214 (7-3105). The top 3 most common methods of delivery were live presentation in 49%, followed by computer or web-based in 20% followed by mixed modalities in 19%. The top 3 outcome evaluations were: survey of participants, knowledge test, and test plus survey, with practice outcomes less frequent. Selected studies were reviewed in greater detail, highlighting advantages and disadvantages of CBL, comparisons to Problem-based learning, variety of fields in healthcare, variety in student experience, curriculum implementation, and finally impact on patient care. CONCLUSIONS CBL is a teaching tool used in a variety of medical fields using human cases to impart relevance and aid in connecting theory to practice. The impact of CBL can reach from simple knowledge gains to changing patient care outcomes.
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Affiliation(s)
- Susan F. McLean
- Department of Surgery, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
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Hale LS, Wallace MM, Adams CR, Kaufman ML, Snyder CL. Considering Point-of-Care Electronic Medical Resources in Lieu of Traditional Textbooks for Medical Education. J Physician Assist Educ 2015; 26:161-166. [PMID: 26309211 DOI: 10.1097/jpa.0000000000000035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Selecting resources to support didactic courses is a critical decision, and the advantages and disadvantages must be carefully considered. During clinical rotations, students not only need to possess strong background knowledge but also are expected to be proficient with the same evidence-based POC resources used by clinicians. Students place high value on “real world” learning and therefore may place more value on POC resources that they know practicing clinicians use as compared with medical textbooks. The condensed nature of PA education requires students to develop background knowledge and information literacy skills over a short period. One way to build that knowledge and those skills simultaneously is to use POC resources in lieu of traditional medical textbooks during didactic training. Electronic POC resources offer several advantages over traditional textbooks and should be considered as viable options in PA education.
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Affiliation(s)
- LaDonna S Hale
- LaDonna S. Hale, PharmD, is a professor in the Department of Physician Assistant Studies, Wichita State University, Wichita, Kansas. Michelle M. Wallace, MPAS, PA-C, is a clinical educator in the Department of Physician Assistant Studies, Wichita State University, Wichita, Kansas. Courtney R. Adams, BS, is a Master of Physician Assistant Studies student at Wichita State University, Wichita, Kansas. Michelle L. Kaufman, BS, is a Master of Physician Assistant Studies student at Wichita State University, Wichita, Kansas. Courtney L. Snyder, BS, is a Master of Physician Assistant Studies student at Wichita State University, Wichita, Kansas
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Patel R, Green W, Shahzad MW, Larkin C. Use of Mobile Clinical Decision Support Software by Junior Doctors at a UK Teaching Hospital: Identification and Evaluation of Barriers to Engagement. JMIR Mhealth Uhealth 2015; 3:e80. [PMID: 26272411 PMCID: PMC4705011 DOI: 10.2196/mhealth.4388] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 06/04/2015] [Accepted: 06/19/2015] [Indexed: 01/20/2023] Open
Abstract
Background Clinical decision support (CDS) tools improve clinical diagnostic decision making and patient safety. The availability of CDS to health care professionals has grown in line with the increased prevalence of apps and smart mobile devices. Despite these benefits, patients may have safety concerns about the use of mobile devices around medical equipment. Objective This research explored the engagement of junior doctors (JDs) with CDS and the perceptions of patients about their use. There were three objectives for this research: (1) to measure the actual usage of CDS tools on mobile devices (mCDS) by JDs, (2) to explore the perceptions of JDs about the drivers and barriers to using mCDS, and (3) to explore the perceptions of patients about the use of mCDS. Methods This study used a mixed-methods approach to study the engagement of JDs with CDS accessed through mobile devices. Usage data were collected on the number of interactions by JDs with mCDS. The perceived drivers and barriers for JDs to using CDS were then explored by interviews. Finally, these findings were contrasted with the perception of patients about the use of mCDS by JDs. Results Nine of the 16 JDs made a total of 142 recorded interactions with the mCDS over a 4-month period. Only 27 of the 114 interactions (24%) that could be categorized as on-shift or off-shift occurred on-shift. Eight individual, institutional, and cultural barriers to engagement emerged from interviews with the user group. In contrast to reported cautions and concerns about the impact of clinicians’ use of mobile phone on patient health and safety, patients had positive perceptions about the use of mCDS. Conclusions Patients reported positive perceptions toward mCDS. The usage of mCDS to support clinical decision making was considered to be positive as part of everyday clinical practice. The degree of engagement was found to be limited due to a number of individual, institutional, and cultural barriers. The majority of mCDS engagement occurred outside of the workplace. Further research is required to verify these findings and assess their implications for future policy and practice.
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Affiliation(s)
- Rakesh Patel
- University of Leicester, Department of Medical & Social Care Education, Leicester, United Kingdom.
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Jenssen BP, Desai BR, Callahan JM. Randomized Controlled Trial of RSS Reader Use and Resident Familiarity With Primary Literature. J Grad Med Educ 2014; 6:341-4. [PMID: 24949145 PMCID: PMC4054740 DOI: 10.4300/jgme-d-13-00249.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Revised: 11/30/2013] [Accepted: 01/15/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Awareness of the primary literature is important for clinicians. Lack of time, poor access to information, and lack of personal initiative may be barriers for some trainees. Really Simple Syndication (RSS) readers aggregate web content, such as journal abstracts, in a single location for easy viewing. OBJECTIVE We assessed whether use of an RSS reader would increase resident reading frequency, familiarity, and understanding of the primary literature. METHODS We conducted a single-center, prospective, randomized, nonblinded, controlled trial of the effect of RSS reader use on knowledge of recent literature among pediatrics residents. Residents were randomly assigned to the RSS group (education in RSS use and receipt of the Pediatrics RSS feed) or a control group that followed standard reading practices. Outcome measures were differences on baseline and monthly surveys of reading frequency, familiarity with recent publications, and knowledge of recent articles (familiarity validation). RESULTS Of 144 eligible residents, 79 (55%) were enrolled in the survey, with 81% (64 of 79) of participants completing all surveys. The RSS reader use was correlated with greater familiarity with selected articles, but not with improved understanding (as measured by ability to answer multiple-choice questions about content). Participants reported satisfaction with the RSS reader based on its ease of use, accessibility, and as an aid in supplementing reading. CONCLUSIONS The RSS reader use was accepted by residents and associated with increased familiarity with the primary literature but not with increased understanding.
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Duran-Nelson A, Gladding S, Beattie J, Nixon LJ. Should we Google it? Resource use by internal medicine residents for point-of-care clinical decision making. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2013; 88:788-94. [PMID: 23619072 DOI: 10.1097/acm.0b013e31828ffdb7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
PURPOSE To determine which resources residents use at the point-of-care (POC) for decision making, the drivers for selection of these resources, and how residents use Google/Google Scholar to answer clinical questions at the POC. METHOD In January 2012, 299 residents from three internal medicine residencies were sent an electronic survey regarding resources used for POC decision making. Resource use frequency and factors influencing choice were determined using descriptive statistics. Binary logistic regression analysis was performed to determine relationships between the independent variables. RESULTS A total of 167 residents (56%) responded; similar numbers responded at each level of training. Residents most frequently reported using UpToDate and Google at the POC at least daily (85% and 63%, respectively), with speed and trust in the quality of information being the primary drivers of selection. Google, used by 68% of residents, was used primarily to locate Web sites and general information about diseases, whereas Google Scholar, used by 30% of residents, tended to be used for treatment and management decisions or locating a journal article. CONCLUSIONS The findings suggest that internal medicine residents use UpToDate most frequently, followed by consultation with faculty and the search engines Google and Google Scholar; speed, trust, and portability are the biggest drivers for resource selection; and time and information overload appear to be the biggest barriers to resources such as Ovid MEDLINE. Residents frequently used Google and may benefit from further training in information management skills.
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Affiliation(s)
- Alisa Duran-Nelson
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA.
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Chahla M, Eberlein M, Wright S. The effect of providing a USB syllabus on resident reading of landmark articles. MEDICAL EDUCATION ONLINE 2010; 15:10.3402/meo.v15i0.4639. [PMID: 20165697 PMCID: PMC2822652 DOI: 10.3402/meo.v15i0.4639] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Revised: 12/04/2009] [Accepted: 12/09/2009] [Indexed: 05/28/2023]
Abstract
BACKGROUND The acquisition of new knowledge is a primary goal of residency training. Retrieving and retaining influential primary and secondary medical literature can be challenging for house officers. We set out to investigate the effect of a Universal Serial Bus (USB) drive loaded with landmark scientific articles on housestaff education in a pilot study. METHODS We created a USB syllabus that contains 187 primary scientific research articles. The electronic syllabus had links to the full-text articles and was organized using an html webpage with a table of contents according to medical subspecialties. We performed a prospective cohort study of 53 house officers in the internal medicine residency program who received the USB syllabus. We evaluated the impact of the USB syllabus on resident education with surveys at the beginning and conclusion of the nine-month study period. RESULTS All 50 respondents (100%) reported to have used the USB syllabus. The self-reported number of original articles read each month was higher at the end of the nine-month study period compared to baseline. Housestaff rated original articles as being a more valuable educational resource after the intervention. CONCLUSIONS An electronic syllabus with landmark scientific articles placed on a USB drive was widely utilized by housestaff, increased the self-reported reading of original scientific articles and seemed to have positively influenced residents' attitude toward original medical literature.
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Affiliation(s)
- Mayy Chahla
- Division of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Eberlein
- Critical Care Medicine Department, National Institutes of Health, Bethesda, MD, USA
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Scott Wright
- Division of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Edson RS, Beckman TJ, West CP, Aronowitz PB, Badgett RG, Feldstein DA, Henderson MC, Kolars JC, McDonald FS. A multi-institutional survey of internal medicine residents' learning habits. MEDICAL TEACHER 2010; 32:773-775. [PMID: 20795809 DOI: 10.3109/01421591003692698] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Resident physicians are expected to demonstrate medical knowledge. However, little is known about the residents' reading habits and learning preferences. AIM To assess residents' reading habits and preferred educational resources. METHODS Residents at five internal medicine training programs were surveyed regarding their reading and learning habits and preferences. RESULTS The majority (77.7%) of residents reported reading less than 7 h a week. Most residents (81.4%) read in response to patient care encounters. The preferred educational format was electronic; 94.6% of residents cited UpToDate as the most effective resource for knowledge acquisition, and 88.9% of residents reported that UpToDate was their first choice for answering clinical questions. CONCLUSIONS Residents spent little time reading and sought knowledge primarily from electronic resources. Most residents read in the context of patient care. Future research should focus on strategies for helping resident physicians learn in the electronic age.
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Affiliation(s)
- Randall S Edson
- Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
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Why are Cochrane hepato-biliary reviews undervalued by physicians as an aid for clinical decision-making? Dig Liver Dis 2010; 42:1-5. [PMID: 19665955 DOI: 10.1016/j.dld.2009.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Accepted: 07/02/2009] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cochrane systematic reviews are of higher quality than reviews published in scientific journals, yet are used less than other sources for clinical decision-making. AIM To assess whether the characteristics of the Cochrane systematic reviews can account for their scant use by physicians. MATERIALS AND METHODS We analysed the 87 Cochrane hepato-biliary reviews dealing with therapeutic topics posted in the Cochrane Database of Systematic Reviews through December 2008, which we classified according to four characteristics: empty reviews; outdated reviews; content of reviews; implications for practice. RESULTS Six empty reviews found no eligible randomised trials and six found one trial, precluding a systematic review; some empty reviews investigated irrelevant topics. Twenty-one reviews investigated outdated interventions, and thirteen of them were posted ten or more years after the publication of the most recent trial included. Most reviews were too lengthy (median: 40 pages) and their consultation was time-consuming with respect to clinical content. They generally compared two treatments, disregarding other options, and usually did not report any non-randomised (although convincing) evidence of potential use in clinical decision-making. CONCLUSIONS If generalized to the entire Cochrane Database of Systematic Reviews, these characteristics may largely explain why physicians undervalue the Cochrane reviews as a source of evidence for clinical decision-making.
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