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A Novel Approach to Patient Education: Emergency Physicians in the Classroom [Meeting Abstract]

Johnson, L.; Hultgren, A.; Su, M. K.; Goldfrank, L. R.; Laskowski, L. K.
ISI:000489265600286
ISSN: 0196-0644
CID: 4155982

Kumawu polyclinic: A needs assessment of a district facility in Ghana [Meeting Abstract]

Soiefer, L R; Hein, P N; Soghoian, S E; Hultgren, A L
Background: Many district hospitals and medical centers in Ghana are limited with regard to the number of employed medical staff, hospital resources, and services available. Our team went to Kumawu Polyclinic to learn about the detailed operations of the hospital, resources, and to determine the challenges faced by the facility. A needs assessment was developed that can be used as a model for how to briefly and efficiently evaluate a district facility in Sub Saharan Africa. Methods: A team consisting of an emergency physician working at a tertiary referral hospital in Ghana and medical students from the United States developed a needs assessment and conducted a visit to Kumawu Polyclinic (Sekyere Afram Plains District, Ashanti Region, Ghana) over three consecutive days in July 2015. The team surveyed the facility, observed rounds with the medical staff, and conducted informal interviews with the polyclinic director and staff. Findings: Kumawu Polyclinic is a district health facility with 23 inpatient beds, split between three wards. There is only one medical officer (physician) at the hospital, along with one physician's assistant and a physician assistant in training. 25 nurses work at the hospital but only 8 are formally trained. The most common patient presentations are fever in children under five, pregnancy and delivery, and complications of noncommunicable diseases such as stroke and hypertensive crisis. The clinic faces several challenges, one being an unreliable supply of essential consumables from the Ghana Health Service. The polyclinic also has limited capability to run laboratory tests and has to send patients 45 minutes away to a larger facility for any imaging. Electric supply is intermittent and requires the use of a backup generator during periods of electrical failure. Interpretation: Our team recommended establishing a triage system for patient intake to increase the efficiency of the clinic. In addition, the needs assessment addressed the clinic's limited range of drugs it can prescribe, moving forward on a 25-bed extension, and the challenges of intermittent electricity. This method of assessing the needs of a district facility can be employed at other polyclinics in Ghana and in developing countries in Africa
EMBASE:614045180
ISSN: 2214-9996
CID: 2415762

Emergency medicine selective enhanced mid-clerkship feedback process using an iPad application [Meeting Abstract]

Kass, D; Hultgren, A; Pusic, M; Lee, S; Yingling, S
Background: Mid-clerkship feedback (MCF), required by the Liaison Committee on Medical Education, ensures that students receive formative feedback during clerkships. However, reflective metrics are not commonly used in MCF. New York University School of Medicine (NYUSOM) uses an iPad app to collect students' self-assessment data alongside preceptor assessment of student performance during the MCF. Educational Objectives: We introduced the app into our emergency medicine Selective (EM-Sel) and compared its functioning to that of a paper rating form. Methods: Starting in March 2014, all NYUSOM students receive iPads for use in clerkships. NYU developed an app that presents a 6-item form to students [S] to selfrate and then to their preceptors [P] to submit ratings during the MCF process. The items are based on the Reporter-Interpreter-Manager-Educator framework, and Professionalism and Procedural Skills. Upon completion, the app displays a composite view that frames the MCF conversation. This data is stored in our data warehouse. For comparison, we also present the ratings collected on paper forms for the students without iPads. All sessions were conducted by the same two preceptors. Results: From January to November 2014, 72 students engaged in an EM-Sel MCF. The app was used in 26 sessions and the paper form was used in 46 sessions. On review, we had complete PRIMES ratings data from both students and preceptors for 100% (26/26) of the iPad sessions but only 63% (29/46) of the sessions with paper forms. Of the 72 data sets collected, 55 paired ratings were complete (76%); 26 were collected on iPads and 29 were collected on paper. Average [S-P] rating concordance ranged from 56% for Professionalism to 78% for Interpreting. Conclusion: Use of this app resulted in complete documentation of [S-P] ratings for the Em-Sel MCF, which was not seen with the paper form. Storage of complete data allows students and preceptors to reflect on the contents of the MSF sessions at a later date
EMBASE:620924477
ISSN: 1936-9018
CID: 2977242