Faculty Bibliography

Understanding how medical malpractice occurs and is resolved is important to improving patient safety and preserving the viability of a physician's career in academic medicine. Every physician is likely to be sued by a patient, and how the physician responds can change his or her professional life. However, the principles of medical malpractice are rarely taught or addressed during residency training. In fact, many faculty at academic medical centers know little about malpractice.In this article, the authors propose that information about the inciting causes of malpractice claims and their resolution should be incorporated into residency professionalism curricula both to improve patient safety and to decrease physician anxiety about a crucial aspect of medicine that is not well understood. The authors provide information on national trends in malpractice litigation and residents' understanding of malpractice, then share the results of their in-depth review of surgical malpractice claims filed during 2001-2008 against their academic medical center. The authors incorporated those data into an evidence-driven curriculum for residents, which they propose as a model for helping residents better understand the events that lead to malpractice litigation, as well as its process and prevention

BACKGROUND: The authors developed and evaluated an interactive, Web-based module to train medical students in screening and brief intervention (SBI) for unhealthy alcohol use. METHODS: First-year students were randomized to module versus lecture. Change in knowledge, attitudes, and confidence were compared. Performance was assessed by objective structured clinical examination (OSCE) and analyzed by intention to treat and treatment received. RESULTS: Of 141 consenting students, 64% (n = 90) completed an intervention (54% lecture vs. 70% Web assigned). Knowledge, confidence, and attitudes improved in both groups, with more improvement in Advise-Assist knowledge for Web students (14% vs. -3%, p = .003). Web students outperformed their lecture peers in both general communication (65% vs. 51% items well done, p = .004) and alcohol-specific tasks (54% vs. 41%, p = .021) on OSCE. Analysis by treatment received enhanced between-group differences. CONCLUSION: Use of a Web-based module to teach SBI is associated with greater knowledge gain and skills performance compared with a lecture covering similar content. The module provides an efficient means for training in this area

We developed a Self-Regulation Measure for Computer-based learning (SRMC) tailored toward medical students, by modifying Zimmerman's Self-Regulated Learning Interview Schedule (SRLIS) for K-12 learners. The SRMC's reliability and validity were examined in 2 studies. In Study 1, 109 first-year medical students were asked to complete the SRMC. Bivariate correlation analysis results indicated that the SRMC scores had a moderate degree of correlation with student achievement in a teacher-developed test. In Study 2, 58 third-year clerkship students completed the SRMC. Regression analysis results indicated that the frequency of medical students' usage of self-regulation strategies was associated with their general clinical knowledge measured by a nationally standardized licensing exam. These two studies provided evidence for the reliability and concurrent validity of the SRMC to assess medical students' self-regulation as aptitude. Future work should provide evidence to guide and improve instructional design as well as inform educational policy

PURPOSE: To prepare to develop a medical school curriculum on substance abuse disorders (SADs), the authors conducted a review of the quality of the sparse published literature. METHOD: The authors searched MEDLINE (1950 through December 2008) using OVID, PsycINFO, and PubMed to identify all studies of SAD interventions targeted toward undergraduate medical students. Of the 1,084 studies identified initially, 31 reported sufficient data to allow the authors to evaluate quality using Medical Education Research Study Quality Instrument (MERSQI) scores. The authors also determined the impact of the studies by considering three-year citation rate and journal impact factor. A detailed review of the literature provided data on contact hours and intervention content. RESULTS: The three-rater intraclass correlation coefficient for total MERSQI score was 0.82 (95% confidence interval: 0.70-0.90). The mean MERSQI score was 10.42 of a possible 18 (SD 2.59; range: 6.33-14.83). MERSQI scores were higher for more recently published studies and correlated with three-year citation rate but not impact factor. The mean contact time for 26 studies was 29.25 hours (range: 0.83-200 hours). CONCLUSIONS: The literature provides a variety of educational methods to train medical students in SAD detection and intervention skills. This literature is of variable quality and provides limited guidance for development of curricula and medical education policy. Better methods of curriculum evaluation and publication guidelines would help ensure that this literature has a positive impact on educational practice and public health