How Can I Be Heard?

Today is the second day of five one-hour tutorials on The Case of the Fainting Soccer Player. The six first-year medical students have been struggling to explain the sequence of events experienced by the 17 year old woman in the case who collapses while playing soccer with subsequent ventricular fibrillation and coma. An older female student, Pat, had spoken little during the first 15 minutes of discussion as the group alternately considered the role of brain and heart in the patient\u27s collapse. Finally, Pat quietly commented

Using Cases about Teaching for Faculty Development

Creating and Collecting Cases Setting Up Case-Based Workshops Facilitating Case Discussions Setting Clear Expectations Managing Time Asking and Encouraging Questions Listening Organizing and Structuring Avoiding Common Problems Conclusion References Other Resource

Assessing Patient-centered Care: One Approach to Health Disparities Education

Patient-centered care has been described as one approach to cultural competency education that could reduce racial and ethnic health disparities by preparing providers to deliver care that is respectful and responsive to the preferences of each patient. In order to evaluate the effectiveness of a curriculum in teaching patient-centered care (PCC) behaviors to medical students, we drew on the work of Kleinman, Eisenberg, and Good to develop a scale that could be embedded across cases in an objective structured clinical examination (OSCE). To compare the reliability, validity, and feasibility of an embedded patient-centered care scale with the use of a single culturally challenging case in measuring students′ use of PCC behaviors as part of a comprehensive OSCE. A total of 322 students from two California medical schools participated in the OSCE as beginning seniors. Cronbach’s alpha was used to assess the internal consistency of each approach. Construct validity was addressed by establishing convergent and divergent validity using the cultural challenge case total score and OSCE component scores. Feasibility assessment considered cost and training needs for the standardized patients (SPs). Medical students demonstrated a moderate level of patient-centered skill (mean = 63%, SD = 11%). The PCC Scale demonstrated an acceptable level of internal consistency (alpha = 0.68) over the single case scale (alpha = 0.60). Both convergent and divergent validities were established through low to moderate correlation coefficients. The insertion of PCC items across multiple cases in a comprehensive OSCE can provide a reliable estimate of students′ use of PCC behaviors without incurring extra costs associated with implementing a special cross-cultural OSCE. This approach is particularly feasible when an OSCE is already part of the standard assessment of clinical skills. Reliability may be increased with an additional investment in SP training

Concluding comments.

New directions for teaching and learning; no. 68;

Development of Learning Objectives to Guide Enhancement of Chronic Disease Prevention and Management Curricula in Undergraduate Medical Education

Phenomenon: Chronic disease is a leading cause of death and disability in the United States. With an increase in the demand for healthcare and rising costs related to chronic care, physicians need to be better trained to address chronic disease at various stages of illness in a collaborative and cost-effective manner. Specific and measurable learning objectives are key to the design and evaluation of effective training, but there has been no consensus on chronic disease learning objectives appropriate to medical student education. Approach: Wagner’sChronic Care Model (CCM) was selected as a theoretical framework to guide development of an enhanced chronic dis-ease prevention and management (CDPM) curriculum. Findings of a literature review of CDPM competencies, objectives, and topical statements were mapped to each of the six domains of the CCM to understand the breadth of existing learning topics within each domain. At an in-person meeting, medical educators prepared a survey for the modified Delphi approach. Attendees iden-tified 51 possible learning objectives from the literature review mapping, rephrased the CCM domains as competencies, constructed possible CDPM learning objectives for each competency with the goal of reaching multi-institutional consensus on a limited number of CDPM learning objectives that would be feasible for institutions to use to guide enhancement of medical student curricula related to CDPM. After the meeting, the group developed a survey which included 39 learning objectives. In the study phase of the modified Delphi approach, 32 physician CDPM experts and educators completed an online survey to prioritize the top 20 objectives. The next step occurred at a CDPM interest group in-person meeting with the goal of identifying the top 10 objectives. Findings: The CCM domains were reframed as the following competencies for medical student education: patient self-care management, decision support, clinical information systems, community resources, delivery systems and teams, and health system practice and improvement. Eleven CDPM learning objectives were identified within the six competencies that were most important in developing curriculum for medical students. Insights: These learning objectives cut across education on the prevention and management of individual chronic diseases and frame chronic disease care as requiring the health system science competencies identified in the CCM. They are intended to be used in combination with traditional disease-specific pathophysiology and treatment objectives. Additional efforts are needed to identify specific curricular strategies and assessment tools for each learning objective

POD Network News, 1984

1. 1984 CONFERENCE 2. POD MEMBERSHIP DIRECTORY--SPECIAL EDITION 3. MEMBERSHIP RENEWAL FOR 1984-1985 4. SUMMER TRAINING INSTITUTE 5. SURVEY OF POD-TYPE CENTERS AND PROGRAMS 6. CORE COMMITTEE ELECTIONS 7. 1985 POD CONFERENCE 8. RESOURCES AND ANNOUNCEMENTS: POSITION ANNOUNCEMENT, BOOK, PROJECT DESCRIPTION, BOOK, BOOK, BOOKS AND ARTICLES, VIDEOTAPE, MICROCOMPUTER MATERIAL, JOURNAL, ORGANIZATIO

Learning in a Clinical Setting

Modeling Active, Appropriate Practice Pleasant Conditions Clarity Feedback Conclusion Reference