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Development of a hospitalist-led-and-directed physical examination curriculum
Janjigian, Michael P; Charap, Mitchell; Kalet, Adina
BACKGROUND: Deficiencies in physical examination skills among medical students, housestaff, and even faculty have been reported for decades, though specifics on how to address this deficit are lacking. METHODS: Our institution has made a commitment to improving key physical examination competencies across our general medicine faculty. Development of the Merrin Bedside Teaching Program was guided by a comprehensive needs assessment and based on a learner-centered educational model. First, selected faculty fellows achieve expertise through mentorship with a master clinician. They then develop a bedside teaching curriculum in the selected domain and conclude by delivering the curriculum to peer faculty. RESULTS: We have developed curricula in examination of the heart, shoulder, knee, and skin. Currently, curricula are being developed in the examination of the lungs, critical care bedside rounds, and motivational interviewing. Curricula are integrated with educational activities of the internal medicine residency and medical school whenever possible. CONCLUSIONS: A hospitalist-led physical examination curriculum is an innovative way to address deficits in physical exam skills at all levels of training, engenders enthusiasm for skills development from faculty and learners, offers scholarship opportunities to general medicine faculty, encourages collaboration within and between institutions, and augments the education of residents and medical students. Journal of Hospital Medicine 2012. (c) 2012 Society of Hospital Medicine.
PMID: 22791266
ISSN: 1553-5592
CID: 179078
Engaging Health Professional Students in Substance Abuse Research: Development and Early Evaluation of the SARET Program
Truncali, Andrea; Kalet, Adina L; Gillespie, Colleen; More, Frederick; Naegle, Madeline; Lee, Joshua D; Huben, Laura; Kerr, David; Gourevitch, Marc N
OBJECTIVE: : There is a need to build the ranks of health care professionals engaged in substance abuse (SA)-focused clinical research. The authors simultaneously developed and evaluated SARET, the Substance Abuse Research Education and Training program. The fundamental goal of this interprofessional program is to stimulate medical, dental, and nursing student interest and experience in SA research. Evaluation aims to understand program feasibility and acceptability and to assess short-term impact. METHODS: : SARET comprises 2 main components: stipend-supported research mentorships and a Web-based module series, consisting of 6, interactive, multimedia modules addressing core SA research topics, delivered via course curricula and in the research mentorships. Authors assessed program feasibility and impact on student interest in conducting SA research by tracking participation and conducting participant focus groups and online surveys. RESULTS: : Thirty early health care professional students completed mentorships (25 summer, 5 yearlong) and 1324 completed at least 1 Web-module. SARET was considered attractive for the opportunity to conduct clinically oriented research and to work with health care professionals across disciplines. Mentorship students reported positive impact on their vision of SA-related clinical care, more positive attitudes about research, and, in some cases, change in career plans. Web-based modules were associated with enhanced interest in SA (35% increase, P = 0.005, in those somewhat/very interested for neurobiology module) and SA research (+38%, P < 0.001 for activation, +45%, P < 0.001 for personal impact, +7%, P = 0.089 for neurobiology). CONCLUSIONS: : The SARET program stimulates SA clinical and research interest among students of nursing, medicine, and dentistry and may lend itself to dissemination.
PMCID:3417229
PMID: 22864401
ISSN: 1932-0620
CID: 174361
BRIEF TOOLS FOR ASSESSING DIETARY QUALITY IN PRIMARY CARE: A PILOT STUDY [Meeting Abstract]
Jay, Melanie; Still, Christopher; Seiler, Jamie; Henderson, Nora; Savarimuthu, Stella; Lobach, Iryna; Gillespie, Colleen; Kalet, Adina
ISI:000209142900089
ISSN: 1525-1497
CID: 2782302
The professionalism curriculum as a cultural change agent in surgical residency education
Hochberg MS; Berman RS; Kalet AL; Zabar SR; Gillespie C; Pachter HL
BACKGROUND: Teaching professionalism effectively to fully engaged residents is a significant challenge. A key question is whether the integration of professionalism into residency education leads to a change in resident culture. METHODS: The goal of this study was to assess whether professionalism has taken root in the surgical resident culture 3 years after implementing our professionalism curriculum. Evidence was derived from 3 studies: (1) annual self-assessments of the residents' perceived professionalism abilities to perform 20 defined tasks representing core Accrediting Council on Graduate Medical Education professionalism domains, (2) objective metrics of their demonstrated professionalism skills as rated by standardized patients annually using the objective structure clinical examination tool, and (3) a national survey of the Surgical Professionalism and Interpersonal Communications Education Study Group. RESULTS: Study 1: aggregate perceived professionalism among surgical residents shows a statistically significant positive trend over time (P = .016). Improvements were seen in all 6 domains: accountability, ethics, altruism, excellence, patient sensitivity, and respect. Study 2: the cohort of residents followed up over 3 years showed a marked improvement in their professionalism skills as rated by standardized patients using the objective structure clinical examination tool. Study 3: 41 members of the national Surgical Professionalism and Interpersonal Communications Education Study Group rated their residents' skills in admitting mistakes, delivering bad news, communication, interdisciplinary respect, cultural competence, and handling stress. Twenty-nine of the 41 responses rated their residents as 'slightly better' or 'much better' compared with 5 years ago (P = .001). Thirty-four of the 41 programs characterized their department's leadership view toward professionalism as 'much better' compared with 5 years ago. CONCLUSIONS: All 3 assessment methods suggest that residents feel increasingly prepared to effectively deal with the professionalism challenges they face. Although professionalism seminars may have seemed like an oddity several years ago, residents today recognize their importance and value their professionalism skills. As importantly, department chairpersons report that formal professionalism education for residents is viewed more favorably compared with 5 years ago
PMID: 21983000
ISSN: 1879-1883
CID: 141463
Assessment of medical student clinical reasoning by "lay" vs physician raters: inter-rater reliability using a scoring guide in a multidisciplinary objective structured clinical examination
Berger, Alexandra J; Gillespie, Colleen C; Tewksbury, Linda R; Overstreet, Ivey M; Tsai, Ming C; Kalet, Adina L; Ogilvie, Jennifer B
BACKGROUND: To determine whether a 'lay' rater could assess clinical reasoning, interrater reliability was measured between physician and lay raters of patient notes written by medical students as part of an 8-station objective structured clinical examination. METHODS: Seventy-five notes were rated on core elements of clinical reasoning by physician and lay raters independently, using a scoring guide developed by physician consensus. Twenty-five notes were rerated by a 2nd physician rater as an expert control. Kappa statistics and simple percentage agreement were calculated in 3 areas: evidence for and against each diagnosis and diagnostic workup. RESULTS: Agreement between physician and lay raters for the top diagnosis was as follows: supporting evidence, 89% (kappa = .72); evidence against, 89% (kappa = .81); and diagnostic workup, 79% (kappa = .58). Physician rater agreement was 83% (kappa = .59), 92% (kappa = .87), and 96% (kappa = .87), respectively. CONCLUSIONS: Using a comprehensive scoring guide, interrater reliability for physician and lay raters was comparable with reliability between 2 expert physician raters
PMID: 22172486
ISSN: 1879-1883
CID: 147696
Just enough, but not too much interactivity leads to better clinical skills performance after a computer assisted learning module
Kalet, Al; Song, H S; Sarpel, U; Schwartz, R; Brenner, J; Ark, T K; Plass, J
Background: Well-designed computer-assisted instruction (CAI) can potentially transform medical education. Yet little is known about whether specific design features such as direct manipulation of the content yield meaningful gains in clinical learning. We designed three versions of a multimedia module on the abdominal exam incorporating different types of interactivity. Methods: As part of their physical diagnosis course, 162 second-year medical students were randomly assigned (1:1:1) to Watch, Click or Drag versions of the abdominal exam module. First, students' prior knowledge, spatial ability, and prior experience with abdominal exams were assessed. After using the module, students took a posttest; demonstrated the abdominal exam on a standardized patient; and wrote structured notes of their findings. Results: Data from143 students were analyzed. Baseline measures showed no differences among groups regarding prior knowledge, experience, or spatial ability. Overall there was no difference in knowledge across groups. However, physical exam scores were significantly higher for students in the Click group. Conclusions: A mid-range level of behavioral interactivity was associated with small to moderate improvements in performance of clinical skills. These improvements were likely mediated by enhanced engagement with the material, within the bounds of learners' cognitive capacity. These findings have implications for the design of CAI materials to teach procedural skills.
PMCID:3826788
PMID: 22917265
ISSN: 0142-159x
CID: 180482
CLINICIAN-EDUCATORS ARE MORE BURNED OUT AS CLINICIANS THAN AS EDUCATORS: IMPLICATIONS FOR TEACHING (AND PRACTICE) [Meeting Abstract]
Dembitzer, Anne; Gillespie, Colleen; Hanley, Kathleen; Crowe, Ruth; Zabar, Sondra; Yeboah, Nina; Grask, Audrey; Nicholson, Joseph; Kalet, Adina; Schwartz, Mark D.
ISI:000209142900107
ISSN: 0884-8734
CID: 4449672
YOU BE THE EMBOLUS: A STUDY OF INTERACTIVE DESIGN FEATURES FOR LEARNING THE PATHOPHYSIOLOGY OF THROMBOEMBOLIC STROKE [Meeting Abstract]
Kalet, Adina; Song, Hyuk-Soon; Pusic, Martin; Nick, Michael; Plass, Jan
ISI:000208812703338
ISSN: 1525-1497
CID: 2726522
READ AROUND YOUR CASES: DOES CLINICAL EXPOSURE ACTIVATE MEDICAL STUDENTS TO LEARN MORE FROM COMPUTER MODULES? [Meeting Abstract]
Kalet, Adina; Song, Hyuk-Soon; Nick, Michael; Pusic, Martin
ISI:000208812701300
ISSN: 1525-1497
CID: 2726512
A WED-BASED MODULE ON NEUROBIOLOGY TO ENGAGE STUDENTS IN SUBSTANCE ABUSE RESEARCH [Meeting Abstract]
Truncali, Andrea; Gillespie, Colleen; Lee, Joshua; Ross, Stephen; Kerr, David; Huben, Laura; More, Frederick; Naegle, Madeline; Kalet, Adina; Gourevitch, Marc
ISI:000208812703296
ISSN: 1525-1497
CID: 2782362