Community-based distributive medical education: Advantaging society

This paper presents a narrative summary of an increasingly important trend in medical education by addressing the merits of community-based distributive medical education (CBDME). This is a relatively new and compelling model for teaching and training physicians in a manner that may better meet societal needs and expectations. Issues and trends regarding the growing shortage and imbalanced distribution of physicians in the USA are addressed, including the role of international medical graduates. A historical overview of costs and funding sources for medical education is presented, as well as initiatives to increase the training and placement of physicians cost-effectively through new and expanded medical schools, two- and four-year regional or branch campuses and CBDME. Our research confirms that although medical schools have responded to Association of American Medical Colleges calls for higher student enrollment and societal concerns about the distribution and placement of physicians, significant opportunities for improvement remain. Finally, the authors recommend further research be conducted to guide policy on incentives for physicians to locate in underserved communities, and determine the cost-effectiveness of the CBDME model in both the near and long terms

Women in contemporary cancer research

Despite recent advances, gender inequality persists in many scientific fields, including medicine. Thus far, no study has extensively analyzed the gender composition of contemporary researchers in the oncology field. We examined 40 oncological journals (Web of Science, ONCOLOGY category) with different impact factors (Q1-Q4) and extracted all the articles and reviews published during 2015 17, in order to identify the gender of their authors. Our data showed that women represent about 38% of all the authorships, both in articles and reviews. In relative terms, women are overrepresented as first authors of articles (43.8%), and clearly underrepresented as last or senior authors (<30%). This double pattern, also observed in other medical fields, suggests that age, or more specifically, seniority, may play some role in the gender composition of cancer researchers. Examining the pattern of collaboration, an interesting finding was observed: the articles signed by a woman in the first or in the last position roughly showed gender parity in the byline. We found also some differences in the content of the articles depending on which gender occupies the first and last positions of the authorships

SYMBIOSIS: Development, Implementation, and Assessment of a Model Curriculum across Biology and Mathematics at the Introductory Level

“It takes a lot of courage to release the familiar and seemingly secure, to embrace the new. But there is no real security in what is no longer meaningful. There is more security in the adventurous and exciting, for in movement there is life, and in change there is power.”Alan Cohen (Used by permission. All rights reserved. For more information on Alan Cohen's books and programs, see (www.alancohen.com.

Teaching the electrical origins of the electrocardiogram: An introductory physics laboratory for life science students

We present the design, pedagogical logic, and assessment of a laboratory and supporting materials that integrate a clinical academic cardiologist\u27s understanding of the origins of the electrocardiogram (ECG) with a physics educator\u27s insights into how to teach the underlying physics at the introductory level to life science students. In this article, we explain the choices made throughout the design process, connect a more advanced treatment of the physics to our approach, and present our assessment of the curriculum. Before the laboratory, students learn the cellular origins of the electric dipole potential produced by the heart on the body\u27s surface, including a simple physical model for the electrical activity of excitable cells, and learn to interpret the measured voltages of an ECG as probing components of the heart\u27s time-varying electric dipole moment. In the laboratory, students measure their own ECGs and analyze the data accordingly; they animate their data to display their own heart\u27s dipole moment for a single heartbeat. Our results from the assessment of student understanding and attitudes indicate that although students find the content challenging, nearly all students find it at least moderately interesting, and for about a quarter of the students in the course, this lab plays a highly meaningful part in connecting physics to medicine

Impacting student anxiety for the USMLE Step 1 through process-oriented preparation

Background: Standardized examinations are the key components of medical education. The USMLE Step 1 is the first of these important milestones. Success on this examination requires both content competency and efficient strategies for study and review. Students employ a wide variety of techniques in studying for this examination, with heavy reliance on personal study habits and advice from other students. Nevertheless, few medical curricula formally address these strategies. Methods: In response to student-generated critique at our institution, a five-part seminar series on process-oriented preparation was developed and implemented to address such concerns. The series focused on early guidance and preparation strategies for Step 1 and the many other important challenges in medical school. Emphasis was placed on facilitating conversation and mentorship opportunities between students. Results &amp; Conclusions: A profoundly positive experience was reported by our medical students that included a decreased anxiety level for the Step 1 examination

Implementation of Integrated Learning Program in neurosciences during first year of traditional medical course: Perception of students and faculty

<p>Abstract</p> <p>Background</p> <p>Our college introduced an integrated learning program (ILP) for first year undergraduates with an aim to develop, implement and evaluate a module for CNS in basic sciences and to assess the feasibility of an ILP in phase I of medical education in a college following traditional medical curriculum.</p> <p>Methods</p> <p>The idea of implementing ILP for Central Nervous System (CNS) in phase one was conceived by curriculum development committee drawn from faculty of all phases. After a series of meetings of curriculum development committee, inputs from basic science and clinical departments, a time table was constructed. Various teaching learning methods, themes for integrated didactic lectures, case based learning and clinical exposure were decided. Basic science faculty were made to participate actively in both case based learning and hospital visits along with clinical experts. The completed program was evaluated based on structured questionnaire.</p> <p>Results</p> <p>Sixty percent students rated the program good to excellent with reference to appreciation, understanding and application of basic science knowledge in health and disease. Seventy eight percent felt that this program will help them perform better in later days of clinical training. However sixty percent students felt that ILP will not help them perform better at the first professional examination. Seventy two per cent of faculty agreed that this program improved understanding and application of basic science knowledge of students. Ninety percent of faculty felt that this program will help them perform better in later days of clinical training.</p> <p>Conclusion</p> <p>The adoption of present integrated module for CNS and the use of multiple teaching learning methods have been proven to be useful in acquisition of knowledge from the student satisfaction point of view. Students and faculty expressed an overall satisfaction towards ILP for CNS. The study showed that it is possible to adopt an integrated learning module in the first year of medical course under a conventional curriculum.</p

Improving Utilization of the Family History in the Electronic Health Record

The purpose of this article is to provide an overview of Family History in the Electronic Health Record and to identify opportunities to advance the contributions of nurses in obtaining, updating and assessing family history in order to improve the health of all individuals and populations.; The article presents an overview of the obstacles to charting Family History within the Electronic Health Record and recommendations for using specific Family History tools and core Family History data sets.; Opportunities to advance nursing contributions in obtaining, updating, and assessing family history in order to improve the health of all individuals were identified. These opportunities are focused within the area of promoting the importance of communication within families and between healthcare providers to obtain, document, and update family histories.; Nurses can increase awareness of existing resources that can guide collection of a comprehensive and accurate family history and facilitate family discussions. In this paper, opportunities to advance nursing contributions in obtaining, updating, and assessing family history in order to improve the health of all individuals were identified.; Aligned with the clinical preparation of nurses, family health should be used routinely by nurses for risk assessment and to help inform patient and family members on screening, health promotion, and disease prevention. The quality of family health information is critical in order to leverage the use of genomic healthcare information and derive new knowledge about disease biology, treatment efficacy, and drug safety. These actionable steps need to be performed in the context of promoting evidence-based applications of family history that will be essential for implementing personalized genomic healthcare approaches and disease prevention efforts.; Family health history is one of the most important tools for identifying the risk of developing rare and chronic conditions, including cardiovascular disease, cancer, and diabetes, and represents an integration of disease risk from genetic, environmental, and behavioral/lifestyle factors. In fact, family history has long been recognized as a strong independent risk factor for disease and is the current best practice used in clinical practice to guide risk assessment

Facilitated Peer Mentorship to Support Aging Research: A RE‐AIM Evaluation of the CoMPAdRE Program

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149354/1/jgs15792.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149354/2/jgs15792_am.pd

Sociodemographic and geographic characteristics associated with patient visits to osteopathic physicians for primary care

<p>Abstract</p> <p>Background</p> <p>Health care reform promises to dramatically increase the number of Americans covered by health insurance. Osteopathic physicians (DOs) are recognized for primary care, including a "hands-on" style with an emphasis on patient-centered care. Thus, DOs may be well positioned to deliver primary care in this emerging health care environment.</p> <p>Methods</p> <p>We used data from the National Ambulatory Medical Care Survey (2002-2006) to study sociodemographic and geographic characteristics associated with patient visits to DOs for primary care. Descriptive analyses were initially performed to derive national population estimates (NPEs) for overall patient visits, primary care patient visits, and patient visits according to specialty status. Osteopathic and allopathic physician (MD) patient visits were compared using cross-tabulations and multiple logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs) for DO patient visits. The latter analyses were also conducted separately for each geographic characteristic to assess the potential for effect modification based on these factors.</p> <p>Results</p> <p>Overall, 134,369 ambulatory medical care visits were surveyed, representing 4.6 billion (NPE) ± 220 million (SE) patient visits when patient visit weights were applied. Osteopathic physicians provided 336 million ± 30 million (7%) of these patient visits. Osteopathic physicians provided 217 million ± 21 million (10%) patient visits for primary care services; including 180 million ± 17 million (12%) primary care visits for adults (21 years of age or older) and 37 million ± 5 million (5%) primary care visits for minors. Osteopathic physicians were more likely than MDs to provide primary care visits in family and general medicine (OR, 6.03; 95% CI, 4.67-7.78), but were less likely to provide visits in internal medicine (OR, 0.37; 95% CI, 0.24-0.58) or pediatrics (OR, 0.21; 95% CI, 0.11-0.40). Overall, patients in the pediatric and geriatric ages, Blacks, Hispanics, and persons in the South and West were less likely to utilize DOs, although there was some evidence of effect modification according to United States Census region.</p> <p>Conclusions</p> <p>Health care reform provides unprecedented opportunities for DOs to reach historically underserved populations and to overcome the "pediatric primary-care paradox."</p