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Chan GK, Cummins MR, Taylor CS, Rambur B, Auerbach DI, Meadows-Oliver M, Cooke C, Turek EA, Pittman PP. An overview and policy implications of national nurse identifier systems: A call for unity and integration. Nurs Outlook 2023; 71:101892. [PMID: 36641315 DOI: 10.1016/j.outlook.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/12/2022] [Accepted: 10/15/2022] [Indexed: 01/15/2023]
Abstract
There is a clear and growing need to be able record and track the contributions of individual registered nurses (RNs) to patient care and patient care outcomes in the US and also understand the state of the nursing workforce. The National Academies of Sciences, Engineering, and Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (2021), identified the need to track nurses' collective and individual contributions to patient care outcomes. This capability depends upon the adoption of a unique nurse identifier and its implementation within electronic health records. Additionally, there is a need to understand the nature and characteristics of the overall nursing workforce including supply and demand, turnover, attrition, credentialing, and geographic areas of practice. This need for data to support workforce studies and planning is dependent upon comprehensive databases describing the nursing workforce, with unique nurse identification to support linkage across data sources. There are two existing national nurse identifiers- the National Provider Identifier and the National Council of State Boards of Nursing Identifier. This article provides an overview of these two national nurse identifiers; reviews three databases that are not nurse specific to understand lessons learned in the development of those databases; and discusses the ethical, legal, social, diversity, equity, and inclusion implications of a unique nurse identifier.
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Affiliation(s)
- Garrett K Chan
- Associate Adjunct Professor, School of Nursing, University of California, San Francisco, President & CEO, HealthImpact, San Francisco, CA.
| | - Mollie R Cummins
- Professor, Jon M. Huntsman Presidential Chair, Associate Dean for Research and the PhD Program, College of Nursing, University of Utah, Salt Lake City, UT
| | - Cheryl S Taylor
- Associate Professor and Chair of the Graduate School Nursing Program, Southern University, Baton Rouge, LA
| | - Betty Rambur
- Professor and Routhier Endowed Chair for Practice, University of Rhode Island, Kingston, RI
| | | | | | - Cindy Cooke
- Adjunct Faculty, University of Mary, Bismark, ND
| | - Emily A Turek
- Government Affairs and Policy Coordinator, American Association of Colleges of Nursing, Washington, DC
| | - Patricia Polly Pittman
- Fitzhugh Mullan Professor and Director, Mullan Institute for Health Workforce Equity, George Washington University, Washington, DC
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Wothe JK, Wanberg LJ, Hohle RD, Sakher AA, Bosacker LE, Khan F, Olson APJ, Satin DJ. Academic and Wellness Outcomes Associated with use of Anki Spaced Repetition Software in Medical School. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231173289. [PMID: 37187920 PMCID: PMC10176558 DOI: 10.1177/23821205231173289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES Medical students are increasingly using a spaced repetition software called Anki to study. There are limited studies evaluating the relationship between Anki and learner outcomes. In this study, we describe the history of Anki use in medical school and assess the potential relationships between use of Anki and medical student academic, extracurricular, and wellness outcomes. METHODS We used cross-sectional data from a 50-item online survey and retrospective academic performance data from our institution's outcomes database. Participants were medical students. The survey assessed the frequency and timing of Anki use, student perceived stress, sleep quality, burnout risk, and involvement in extracurricular activities. Academic success was measured by USMLE Step 1 and Step 2 scores. RESULTS 165 students responded survey. 92 (56%) identified as daily Anki users. Daily Anki use was correlated with increased Step 1 score (P = .039), but not Step 2 scores. There was an association between Anki use and increased sleep quality (P = .01), but no difference for other measurements of wellness or extracurricular involvement. CONCLUSION The study demonstrates potential benefits of daily use of Anki but also confirms that a variety of study methods can be used to achieve similar medical school outcomes.
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Affiliation(s)
- Jillian K Wothe
- Medical School, University of Minnesota, Minneapolis, MN, USA
| | | | - Rae D Hohle
- Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Aliya A Sakher
- Medical School, University of Minnesota, Minneapolis, MN, USA
| | | | - Faizel Khan
- Medical Education Outcomes Center, University of Minnesota, Minneapolis, MN, USA
| | - Andrew PJ Olson
- Medical Education Outcomes Center, University of Minnesota, Minneapolis, MN, USA
- Department of Medicine, Division of
Hospital Medicine, University of Minnesota, Minneapolis, MN, USA
- Department of Pediatrics, Division of
Hospital Medicine, University of Minnesota, Minneapolis, MN, USA
| | - David J Satin
- Department of Family Medicine, University of Minnesota, Minneapolis, MN, USA
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Phillips RL, George BC, Holmboe ES, Bazemore AW, Westfall JM, Bitton A. Measuring Graduate Medical Education Outcomes to Honor the Social Contract. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:643-648. [PMID: 35020616 PMCID: PMC9028305 DOI: 10.1097/acm.0000000000004592] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The graduate medical education (GME) system is heavily subsidized by the public in return for producing physicians who meet society's needs. Under the terms of this implicit social contract, decisions about how this funding is allocated are deferred to the individual training sites. Institutions receiving public funding face potential conflicts of interest, which have at times prioritized institutional purposes and needs over societal needs, highlighting that there is little public accountability for how such funding is used. The cost and institutional burden of assessing many fundamental GME outcomes, such as specialty, geographic physician distribution, training-imprinted cost behaviors, and populations served, could be mitigated as data sources and methods for assessing GME outcomes and guiding training improvement already exist. This new capacity to assess system-level outcomes could help institutions and policymakers strategically address the greatest public needs. Measurement of educational outcomes can also be used to guide training improvement at every level of the educational system (i.e., the individual trainee, individual teaching institution, and collective GME system levels). There are good examples of institutions, states, and training consortia that are already assessing and using GME outcomes in these ways. The ultimate outcome could be a GME system that better meets the needs of society and better honors what is now only an implicit social contract.
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Affiliation(s)
- Robert L. Phillips
- R.L. Phillips Jr is executive director, Center for Professionalism & Value in Health Care, American Board of Family Medicine Foundation, Washington, DC; ORCID: https://orcid.org/0000-0001-7882-1560
| | - Brian C. George
- B.C. George is director, Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, Michigan, executive director, Society for Improving Medical Professional Learning, Boston, Massachusetts, and senior scholar, Center for Professionalism & Value in Health Care, American Board of Family Medicine Foundation, Washington, DC
| | - Eric S. Holmboe
- E.S. Holmboe is chief, Research, Milestones Development and Evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Andrew W. Bazemore
- A.W. Bazemore is senior vice president for research and policy, American Board of Family Medicine, and co-director, Center for Professionalism & Value in Health Care, American Board of Family Medicine Foundation, Washington, DC
| | - John M. Westfall
- J.M. Westfall is director, Robert Graham Center, American Academy of Family Physicians, Washington, DC
| | - Asaf Bitton
- A. Bitton is executive director, Ariadne Labs, associate professor of medicine, Division of General Medicine, Brigham and Women’s Hospital, associate professor of health care policy, Harvard Medical School, Boston, Massachusetts, and part-time senior advisor for primary care policy, Center for Medicare & Medicaid Innovation, Baltimore, Maryland
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Wood B, Fitzgerald M, Kendall C, Cameron E. Integrating socially accountable health professional education and learning health systems to transform community health and health systems. Learn Health Syst 2021; 5:e10277. [PMID: 34277943 PMCID: PMC8278438 DOI: 10.1002/lrh2.10277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/15/2021] [Accepted: 05/10/2021] [Indexed: 12/28/2022] Open
Abstract
A learning health system aims to create value in health systems using data-driven innovations, quality improvement techniques, and collaborations between health system partners. Although the concept is mobilized through cycles of learning, most instantiations of the learning health system overlook the importance of formalized learning in educational settings. Social accountability in health professional education focuses on measurably improving people's health and health care, specifically through education and training activities. In this commentary, we argue that the idea of social accountability clearly articulates a rationale and a broad range of aspirations, whereas the learning health system offers an approach to achieve these goals. With a similar aim to a learning health system, social accountability promotes partnerships between health professional education, the health system, and communities in a way that allows for co-designed and contextualized interventions. On the other hand, learning health systems prioritize data, research, and analytic capacities to facilitate quality improvement. An integrative framework could enhance learning cycles by collectively designing interventions and innovations with people and communities from health, research, and education systems. As well as aspiring to improve population health and health equity, such a framework will consider broader impacts, including the degree of participation amongst a range of partners and the level of responsiveness to partners' priorities.
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Affiliation(s)
- Brianne Wood
- Medical Education Research Lab in the NorthNorthern Ontario School of MedicineThunder BayOntarioCanada
| | - Michael Fitzgerald
- C.T. Lamont Primary Health Care Research CentreBruyère Research InstituteOttawaOntarioCanada
| | - Claire Kendall
- C.T. Lamont Primary Health Care Research CentreBruyère Research InstituteOttawaOntarioCanada
- Office of Social Accountability, Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
- Institut du Savoir Montfortl'Hôpital MontfortOttawaOntarioCanada
- Clinical Epidemiology Research ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
- Li Ka Shing Knowledge InstituteSt. Michael's HospitalTorontoOntarioCanada
| | - Erin Cameron
- Medical Education Research Lab in the NorthNorthern Ontario School of MedicineThunder BayOntarioCanada
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Olson APJ, Rosenberg ME. From Nihilism to Opportunity. Clin J Am Soc Nephrol 2020; 15:917-919. [PMID: 32579129 PMCID: PMC7341766 DOI: 10.2215/cjn.07260520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Andrew P J Olson
- Office of Medical Education, University of Minnesota Medical School, Minneapolis, Minnesota
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