Автор неизвестен - Mededworld and amee 2013 conference connect - страница 112

Страницы:
1  2  3  4  5  6  7  8  9  10  11  12  13  14  15  16  17  18  19  20  21  22  23  24  25  26  27  28  29  30  31  32  33  34  35  36  37  38  39  40  41  42  43  44  45  46  47  48  49  50  51  52  53  54  55  56  57  58  59  60  61  62  63  64  65  66  67  68  69  70  71  72  73  74  75  76  77  78  79  80  81  82  83  84  85  86  87  88  89  90  91  92  93  94  95  96  97  98  99  100  101  102  103  104  105  106  107  108  109  110  111  112  113  114  115  116  117  118  119  120  121  122  123  124  125  126  127  128  129  130  131  132  133  134  135  136  137  138  139  140 

United States)

Melissa Bachhuber (University of California San Francisco/San Francisco VA, Medicine, San Francisco,

United States)

Susan Janson (University of California San Francisco/San Francisco VA, Nursing, San Francisco) (Presenter: Patricia Cornett, University of California San Francisco/San Francisco VA, Medicine, SFVAMC, 4150 Clement St, San Francisco 94121, United States)

Background: Home visits are an important component of healthcare delivery to high-risk patients, yet most trainees have little experience in home visits. Summary of work: We developed a home visit curriculum to engage medical and nurse practitioner (NP) trainees in a shared experience through which they identify patient safety issues, learn the importance of care coordination and interprofessional communication, and see the impact of home visits on clinical practice. The curriculum included an introductory home visit session addressing functional assessment skills and home safety evaluations. Resident and NP student partners, along with a supervising medicine or nursing preceptor, visited two patients during a half-day session. Trainee teams developed multidisciplinary care plans. A group debrief session following the home visits provided an opportunity for trainees to discuss care coordination and patient safety issues.

Summary of results: Twenty-one trainees and 9 faculty preceptors participated in the home visit curriculum. Trainees valued the opportunity to conduct visits with interprofessional colleagues(4.8 out of 5) and reported high likelihood of changing clinical practice as a result of the experience (4.6 out of 5). Analysis of trainees' written reflections (n=15) on home visits highlighted three themes: improved insight into patients' functional status, medication errors, and home safety assessment. Conclusions: Home visits are an excellent opportunity for interprofessional learning and patient-centered care. Our curriculum combined formal training and experiential learning in a way that enhanced trainees' awareness of the need for a coordinated approach to improve patient safety.

Take-home messages: Home visits provide insights into a patient's life and offer valuable opportunities for interprofessional collaboration, reflection and learning.

9L/3

Training For Effective Team-Based Care: A Teamwork Curriculum For Residents And Nurse Practitioner Students in the SF Veteran's Affairs Center of Excellence in Primary Care Education

Bridget O Brien (University of California San Francisco/San Francisco VA, Medicine, San Francisco,

United States)

Patricia Cornett (University of California San Francisco/San Francisco VA, Medicine, San Francisco,

United States)

Maya Dulay (University of California San Francisco/San Francisco VA, Medicine, San Francisco, United States) Susan Janson (University of California San Francisco/San Francisco VA, Nursing, San Francisco, United States) Shalini Patel (University of California San Francisco/San Francisco VA, Medicine, San Francisco, United States) (Presenter: Rebecca Shunk, University of California San Francisco/San Francisco VA, Medicine, SFVAMC, 4150 Clement St, San Francisco 94121, United States)

Background: Primary care clinics in the United States are reorganizing to deliver care using interprofessional teams. This interdisciplinary approach demands new provider and staff skills.   Academic centers must create innovative curriculum to educate learners in this new primary care environment.

Summary of work: In 2010 our primary care clinics reorganized into patient aligned care teams (PACTs). Internal medicine residents and nurse practitioner students work in teams along with nursing and clerical staff in PACT. Curriculum was developed to teach foundational skills in patient-centered communication and interprofessional collaboration. This curriculum, supervised by faculty coaches, included didactic and work-based learning activities such as care coordination meetings (huddles), telephone visits, group clinics, and motivational interviewing. Curriculum evaluation includes trainee feedback at every session and in focus groups. Learning outcomes are evaluated through self-assessment surveys, reflective activities, and direct observation of skills during huddles and an interprofessional team observed structured exercise (ITOSCE). Patient outcomes are assessed through surveys.

Summary of results: PACT trainees are very positive about delivering care and find value in working within teams. Self-assessments, reflective activities, and ITOSCE reveal improved confidence and growth in communication skills. Patient satisfaction remains high exceeding mean clinic provider scores. Conclusions: Systems and curricular changes rarely occur in a coordinated, synchronized fashion. Our program is unique in that the educational curriculum was closely aligned with systems improvement efforts during PACT reorganization. Trainee partners benefited from learning PACT-related skills and applying them in day-to-day patient care.

Take-home messages: Interprofessional trainees can successfully train together to deliver team-based care

ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730

creating positive experiences for both the learners and patient.

9L/4

Uncovering impediments to interprofessional collaboration

Mark Barrow (The University of Auckland, Faculty of

Medical and Health Sciences, Grafton Campus, Park Rd,

Auckland 1042, New Zealand

Sue Gasquoine (Unitec Institute of Technology,

Department of Nursing, Auckland, New Zealand)

Judy McKimm (Swansea University, College of Medicine,

Swansea, United Kingdom)

Deborah Rowe (The University of Auckland, School of Nursing, Auckland, New Zealand)

Background: The expectation that different health professionals will work together with the joint goal of improving health outcomes and the patient experience is commonplace. Delivering on such expectations however requires new forms of practice involving some form of interprofessional collaboration. Summary of work: We conducted semi-structured interviews with senior doctors and nurses in two hospital-based services to collect data about collaborative working experiences. Aspects of activity theory were used to code and analyse data and consider how the broader context of care provision might affect clinicians' conceptions of collaboration. Summary of results: Knowledge, experience and hierarchy determine the extent to which professional groups are prepared to collaborate with one other. Expertise and hierarchical position of doctors affected the extent to which nursing collaboration was activated. Doctors tended to look towards a nurse's length of service to judge her/his collaborative value. Specialist nurses, often lacking experience, but with higher qualifications often found themselves in a liminal world with respect to potential collaborators. Conclusions: Conceptions of 'collaboration' differ. These conceptions manifest in different approaches to aspects of collaborative working: varying degrees of preparedness for reciprocity, acceptance of improvisation, flexibility of practice and ability to work within the discursive practices of others. These prerequisites for interprofessional collaboration are not uniformly apparent across professional groups. Take-home messages: Health care professions' diverse histories, training and registration processes contribute to different, sometimes conflicting, conceptions of collaboration. Educational institutions need to actively pursue opportunities to mould these conceptions to better contribute to the preparation of collaboration-ready graduates.

9L/5

An ethnography of interprofessionalism in discharge in general internal medicine: implications for continuing interprofessional education

Joanne Goldman (University of Toronto, Institute of Medical Science, Wilson Centre, Faculty of Medicine, 200

Elizabeth Street, 1ES-565, Toronto M5G 2C4, Canada)

Scott Reeves (University of California, San Francisco,

Center for Innovation in Interprofessional Healthcare

Education, San Francisco, United States)

Robert Wu (University Health Network, Division of

General Internal Medicine, Toronto, Canada)

Ivan Silver (University of Toronto, Centre for Addiction

and Mental Health, Toronto, Canada)

Kathleen MacMillan (Dalhousie University, School of

Nursing, Halifax, Canada)

Simon Kitto (University of Toronto, Continuing Education and Professional Development, Wilson Centre, Faculty of Medicine, Toronto, Canada)

Background: Minimal research has been undertaken to examine the macro-structural factors that shape interprofessional interactions around processes of discharge in general internal medicine. Findings from this research are valuable for informing the development of relevant and effective continuing interprofessional education activities. Summary of work: This study used an ethnographic methodology to examine health care professionals' perceptions and behaviours of interprofessional interactions in discharge within the dynamic organizational context of a general internal medicine unit. Ethnography involves a combination of observation, interview and documentary analysis methods. A directed content analysis approach informed by sociology of professions and negotiated order theories is being used to analyze the data. Summary of results: Preliminary findings demonstrate that structural factors such as government and hospital policies, the organization of teams, and institutionalized professional relationships shape the opportunities and nature of interprofessional interactions within the context of discharge. These structures also give rise to particular forms of interprofessional relations and negotiations through which professionals attempt to exert their understanding of their role in relation to caring for or managing the patient. Conclusions: The hospital focus on timely patient discharge requires effective interprofessional assessment and collaboration. This study provides insight into the range of factors that constrain and facilitate these interprofessional interactions and which must be understood in efforts to improve such health care services through continuing education and quality improvement initiatives.

Take-home messages: Interprofessional continuing education programs need to address the structural factors that shape interprofessional interactions in discharge if aiming to improve this hospital process.

ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730

9L/6

Interprofessional Collaborator Assessment Rubric (ICAR): A valid and reliable tool for medical educators and learners

Vernon Curran (Memorial University, Faculty of Medicine, St-John's, Canada)

Lynn Casimiro (Hopital Montfort, Direction des affaires universitaires, Ottawa, Canada) (Presenter: Manon Tremblay, Hopital Montfort, Direction des affaires universitaires, 713 Montreal Road, Room 2D137, Ottawa A1C 5S7, Canada)

Background: The Institute of Medicine's report 'Crossing the Quality Chasm' (2001) advocates for the delivery of high performing, patient-centred, team-based care. CanMeds roles clearly outline the need for medical personnel to develop competencies as strong collaborators within the healthcare system. Measuring collaboration however, remains elusive. Summary of work: In 2009, the Interprofessional Collaborator Assessment Rubric (ICAR) was developed in French and English (Curran et al.) and its content validity studied through a pan Canadian expert Delphi process. A second study continued the examination of the psychometric properties of the French language ICAR with a multiprofessional group of healthcare educators. Using the ICAR, the educators were asked to rate 6 actors in a videotaped simulated team meeting, twice within a two-week period. Summary of results: Cronbach's alpha (0.70-0.90) showed a strong internal coherence of the ICAR. Each of the six interprofessional collaborator ICAR competencies demonstrated good intra-evaluator reliability (ICC: 0.78­0.90) as did the competency dimensions (ICC: 0.79­0.89). However, the analysis revealed poor Kappa coefficients (< 0.40) for the individual behavioral indicators that are linked to each dimension. Although inconclusive, the factorial analysis tended towards 8 factors to group the behavioural indicators. Conclusions: The ICAR demonstrated strong internal coherence and good intra-evaluator reliability. The factorial analysis showed a tendency towards eight factors, however, further studies are needed to continue the examination of the ICAR's construct validity. Take-home messages: The ICAR is a valid and reliable tool available in both Canadian official languages that can be used by medical educators to assess the CanMeds collaborator role within a simulated or clinical setting.

9M Short Communications: Research

Location: Club D, PCC

9M/1

Manchester Medical Research Student Society (MMR Soc): Promoting research and preparing medical students for a career in academia

Danielle Nimmons (University of Manchester, School of Medicine, Oxford Road, Manchester M13 9PT, United Kingdom)

Natasha Greenhough (University of Manchester, School of Medicine, Manchester, United Kingdom) Hydar Faruqi (University of Manchester, School of Medicine, Manchester, United Kingdom) Oluwafikunayo Orekoya (University of Manchester, School of Medicine, Manchester, United Kingdom) Tony Freemont (University of Manchester, School of Medicine, Manchester, United Kingdom)

Background: Medical students should be exposed to research and inspired to enter academic medicine, which is important to reverse its decline. MMR Soc is a new student led organisation that aims to promote interest in academic medicine amongst medical students.

Summary of work: Four lectures were delivered by leading academics to promote research amongst medical students and equip them with skills needed for an academic career. Topics included: research principles, intercalated degrees, and presentation and publication skills. Questionnaires were used to evaluate the lectures and investigate changes in intention to undertake research and enter academic medicine. Summary of results: After hearing about academic medicine, 95% (n=130) of attendees felt more inspired to embark on a career in academia when compared to the start of the lecture. After learning about intercalation, 87% of attendees (n=110 attended) felt that they were more likely to intercalate. 70% (n=140) of attendees felt that the lecture on publications and presentations would help them achieve these things in the future. The lecture series has further developed and will be available as an e-learning resource supported by the medical school.

Conclusions: Most attendees found the lectures useful. Moreover, after the lectures many felt well informed about aspects of academic medicine and were more likely to undertake research. Finally, the MMR Soc educational lecture series increased awareness of research and the skills needed in an academic career. Take-home messages: Peer led lectures on academic medicine at medical school are a good way to encourage medical students to enter the field and help reverse its decline.

ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730

9M/2

Tracking medical students' involvement in research and attitudes toward future research

Linda Klein (University of Sydney, Office of Medical Education, Sydney Medical School, Room 135 Edward Ford building (A27), Sydney 2006, Australia) Heather Jeffery (University of Sydney, Public Health, Sydney Medical School, Sydney, Australia) Karen Garlan (Public Health, University of Sydney, Sydney Medical School, Sydney, Australia) Leo Davies (University of Sydney, Office of Medical Education, Sydney Medical School, Sydney, Australia)

Background: Clinician researchers have been called an endangered species and concerns remain about how best to attract students to careers that include research. Such researchers are needed both for translating laboratory discoveries into clinical practice and for the development of meaningful curricula for future clinicians. Correlational studies have demonstrated associations between research experience in medical school and career achievements in academic medicine. Despite this the understanding of medical students' decision-making regarding research involvement remains limited.

Summary of work: Self-report surveys were administered to Year1 Sydney Medical Program (SMP) students in 2009 then repeated at the end of their final year in 2012. The surveys included research experiences before and during medical school, attitudes toward research, and future research aspirations. A sample of fourth year students was interviewed about their decision making processes regarding research. Summary of results: Both research involvement before (46%) and during (42%) medical school had significant impact on future intentions. Experiences within the course ranged from short independent learning projects to substantial honours projects. Attitudes toward research were similar in Years 1 and 4, except fourth year students were less likely to agree that research careers mean a lower salary. Interviews identified factors influencing decisions about research, some amenable to intervention. Students expressed flexibility about future research involvement, even if likelihood ratings were low.

Conclusions: Research experience during and prior to medical school promotes research intentions. Interview findings highlighted areas for action. Take-home messages: Understanding students' research experiences and attitudes provides opportunities to influence their decisions about future research involvement.

9M/3

Undergraduate students' learning processes in a short research programme for medical education

Rintaro Imafuku (Gifu University, Medical Education Development Centre, 1-1 Yanagido, Gifu-city 501-1194, Japan

Takuya Saiki (Gifu University, Medical Education

Development Centre, Gifu-city, Japan)

Chihiro Kawakami (Gifu University, Medical Education

Development Centre, Gifu-city, Japan)

Yasuyuki Suzuki (Gifu University, Medical Education

Development Centre, Gifu-city, Japan)

Kazumi Sakashita (Gifu University, Medical Education

Development Centre, Gifu-city, Japan)

Background: Although the importance of developing research skills for scholarship and professional practice has been acknowledged as a pivotal learning outcome of medical education, little is known about medical undergraduate students' participation in the research activity and perceptions of research experience. The purpose of this pilot study is to examine how undergraduates perceive research and what difficulties they found during the research process. Summary of work: Data collection was undertaken at Gifu University which provides second-year medical students with a 5-week selective course of research. Classroom observations and semi-structured interviews to seven students were conducted over five weeks in 2013. The qualitative data obtained were analysed by coding and categorising of the interview transcripts. Summary of results: Researching prompted undergraduates' inquiring mind and motivated their active learning in a team. They stated an awareness of the relevance of research skill development in relation to their future learning/career. However, they identified practical difficulties in the process of research design, information gathering and critical analysis. Moreover, this study found that students' cultural assumptions were essential factors affecting their participation, including their values of group harmony and hierarchy consciousness related to power relations with facilitators.

Conclusions: Research programme provides a student-centred learning environment which cultivates an inquiring mind to encourage continuing professional development. This study suggests that facilitators need to understand their research process, the difficulties students found during the research process and their perceptions of the extent of their autonomy. Take-home messages: Undergraduate research programme has the potential for enhancing students' research skills and competencies for lifelong learning.

9M/4

Inculcating a research culture in a PBL curriculum

Hossam Hamdy (University of Sharjah, College of Medicine, P O Box 27272, Sharjah, United Arab Emirates) Amal Hussein (University of Sharjah, College of Medicine, Sharjah, United Arab Emirates) Nahed Abdelkhalek (University of Sharjah, College of Medicine, Sharjah, United Arab Emirates)

Background: Research, critical appraisal skills and Evidence-based Medicine are important competencies addressed by all health professionals' education institutions. In order to become a habit, consciously and

ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730

unconsciously practiced, it is important to introduce it early and maintain its practice. The rationale of the approach described is based on the early and repetitive introduction and integration of research in the weekly PBL activities in a PBL curriculum. The aim of this study is to report the experience of applying this strategy in a PBL curriculum.

Summary of work: The Evidence-Based Problem-Based Learning (EBPBL) was introduced in years one, two and three of the five years medical program. Every week, one student in each PBL group would search for and select a research article related to the problem of that week. At the end of the second PBL session, the student presents a summary of the research article and a discussion is carried out within the group. Following this session, the student uploads the article on the blackboard to be seen by all students in the other PBL groups. Accordingly, students will read all articles uploaded and rate each as "Nice" or "Essential" to read. Summary of results: Out of the total 302 students, 66% thought that the EBPBL was important in their medical education. 86% reported that the EBPBL program had introduced them to medical research, 86% said that it helped them to appreciate the importance of research in medicine.

Conclusions: The results demonstrated that an approach helped in inculcating a research culture in the integrated PBL curriculum.

Take-home messages: Research culture should be inculcated early in the curriculum and practiced.

9M/5

Distinction Tracks: Enhancing and Supplementing the Student Learning Experience Through Longitudinal Experiences in Areas of Interest

David L Wiegman (University of Louisville School of Medicine, Academic Affairs, Abell Administration Building, 323 East Chestnut Street, Louisville, Kentucky

40202, United States)

Ruth B Greenberg (University of Louisville School of Medicine, Academic Affairs, Louisville, Kentucky, United

States)

Background: Exposure to research can influence students' decisions about career pathways. Also, students seek research experiences to prepare for competitive residencies and practice. A growing trend is to create "Distinction in Research Tracks," focused, formal, longitudinal experiences, outside of the formal curriculum. We initiated such a track in 2010, and are now launching other tracks. Summary of work: We started with 24 students. Existing tracks use a model in which students find a mentor; develop a project proposal; submit the proposal to a committee; and, if approved, complete and present the project either locally or at an external meeting. We modified this approach by adopting a cohort approach and adding formal didactic sessions. In response to student feedback and demand, we have started additional tacks in global health, and teaching, and will start one in business.

Summary of results: In June, 17 of the first cohort will graduate with distinction in research. About 25 have been accepted in the next two classes. Conclusions: Designing and delivering new distinction tracks required human and financial resources, some of which were unanticipated. Student responses were very positive. Our new track has positively impacted the learning experience and has led to the development of additional tracks.

Take-home messages: Distinction tracks provide students with opportunities to explore their passions in medicine outside of the formal curriculum. However, before launching a distinction track, a school should consider which model to introduce and identify the resources needed. Distinction tracks may represent one strategy to increase the number of students who choose a pathway in academic medicine.

9N Short Communications: Patient Safety 1

Location: Meeting Room 2.1, PCC

9N/1

Exploration of PGME Modernization on an EU level: Visions for Adoption of Patient Safety Principles in PGME

Abe Meininger (University of Groningen, UMC Groningen Postgraduate School of Medicine, University Medical Center Groningen, Netherlands) Raquel de Vito (University of Groningen, Postgraduate School of Medicine, University Medical Center Groningen, Hanzeplein 1, Groningen 9700RB, Netherlands)

Angelique Reinders (University of Groningen, Postgraduate School of Medicine, University Medical Center Groningen, Netherlands)

Johan Groothof (University of Groningen, Department of Health Sciences, Groningen, Netherlands) Jan Borleffs (University of Groningen, Postgraduate School of Medicine, University Medical Center Groningen, Netherlands)

Страницы:
1  2  3  4  5  6  7  8  9  10  11  12  13  14  15  16  17  18  19  20  21  22  23  24  25  26  27  28  29  30  31  32  33  34  35  36  37  38  39  40  41  42  43  44  45  46  47  48  49  50  51  52  53  54  55  56  57  58  59  60  61  62  63  64  65  66  67  68  69  70  71  72  73  74  75  76  77  78  79  80  81  82  83  84  85  86  87  88  89  90  91  92  93  94  95  96  97  98  99  100  101  102  103  104  105  106  107  108  109  110  111  112  113  114  115  116  117  118  119  120  121  122  123  124  125  126  127  128  129  130  131  132  133  134  135  136  137  138  139  140 


Похожие статьи

Автор неизвестен - 13 самых важных уроков библии

Автор неизвестен - Беседы на книгу бытие

Автор неизвестен - Беседы на шестоднев

Автор неизвестен - Богословие

Автор неизвестен - Божественность христа