Faculty Bibliography
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51
E-Learning with virtual teammates: A novel approach to interprofessional education
The Institute of Medicine identified interprofessional education (IPE) as a key innovation for achieving the triple aim of better care, better outcomes and reduced health care costs. Yet, a shortage of qualified faculty and difficulty with aligning learners' schedules often prevent sustainable and scalable IPE. A virtual IPE intervention was developed to circumvent these barriers and compared to a blended-learning IPE intervention. We used a pre-test and post-test design with two comparison interventions to test the effects of these IPE interventions on changes in teamwork knowledge, skills and attitudes. The interventions were delivered to pre-licensure learners at a large, metropolitan medical and a nursing school. We used one-sample and independent-sample t-tests to analyze data from 220 learners who received the blended-learning intervention in 2011 and 540 learners who received the virtual learning intervention in 2012. The students in the blended-learning intervention did not significantly (p < 0.05) outperform the students in the virtual learning intervention for any of the measured outcomes, except for medical students' attitudes around team value. Virtual IPE learning is an effective, scalable, and sustainable solution for imparting foundational teamwork knowledge in health profession students.
PMID: 26120894
ISSN: 1469-9567
CID: 1649522
Surgical treatment of moderate ischemic mitral regurgitation
BACKGROUND:Ischemic mitral regurgitation is associated with increased mortality and morbidity. For surgical patients with moderate regurgitation, the benefits of adding mitral-valve repair to coronary-artery bypass grafting (CABG) are uncertain. METHODS:We randomly assigned 301 patients with moderate ischemic mitral regurgitation to CABG alone or CABG plus mitral-valve repair (combined procedure). The primary end point was the left ventricular end-systolic volume index (LVESVI), a measure of left ventricular remodeling, at 1 year. This end point was assessed with the use of a Wilcoxon rank-sum test in which deaths were categorized as the lowest LVESVI rank. RESULTS:At 1 year, the mean LVESVI among surviving patients was 46.1±22.4 ml per square meter of body-surface area in the CABG-alone group and 49.6±31.5 ml per square meter in the combined-procedure group (mean change from baseline, -9.4 and -9.3 ml per square meter, respectively). The rate of death was 6.7% in the combined-procedure group and 7.3% in the CABG-alone group (hazard ratio with mitral-valve repair, 0.90; 95% confidence interval, 0.38 to 2.12; P=0.81). The rank-based assessment of LVESVI at 1 year (incorporating deaths) showed no significant between-group difference (z score, 0.50; P=0.61). The addition of mitral-valve repair was associated with a longer bypass time (P<0.001), a longer hospital stay after surgery (P=0.002), and more neurologic events (P=0.03). Moderate or severe mitral regurgitation was less common in the combined-procedure group than in the CABG-alone group (11.2% vs. 31.0%, P<0.001). There were no significant between-group differences in major adverse cardiac or cerebrovascular events, deaths, readmissions, functional status, or quality of life at 1 year. CONCLUSIONS:In patients with moderate ischemic mitral regurgitation, the addition of mitral-valve repair to CABG did not result in a higher degree of left ventricular reverse remodeling. Mitral-valve repair was associated with a reduced prevalence of moderate or severe mitral regurgitation but an increased number of untoward events. Thus, at 1 year, this trial did not show a clinically meaningful advantage of adding mitral-valve repair to CABG. Longer-term follow-up may determine whether the lower prevalence of mitral regurgitation translates into a net clinical benefit. (Funded by the National Institutes of Health and the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT00806988.).
PMID: 25405390
ISSN: 1533-4406
CID: 5451212
IMPACT OF A TARGETED IPE CURRICULUM ON MEDICAL STUDENTS' PERFORMANCE; AN IPC OSCE CASE [Meeting Abstract]
ISI:000340996203121
ISSN: 1525-1497
CID: 1267992
YOUR PATIENT'S SUGAR IS TOO ELEGEM RESIDENT PHYSICIAN INTERPROFESSIONAL PHONE COMMUNICAIION SKILLS [Meeting Abstract]
ISI:000340996201242
ISSN: 1525-1497
CID: 1268112
USING OSCE CASES TO ASSESS RESIDENT PHYSICIANS' COMPETENCE IN INTER-PROFESSIONAL COLLABORATIVE PRACTICE [Meeting Abstract]
ISI:000331939301315
ISSN: 0884-8734
CID: 883212
PATIENT SAFETY AND INTERPROFESSIONAL COLLABORATION ASSESSMENT: A DISTINCT SKILLS SET FOR MEDICAL STUDENTS [Meeting Abstract]
ISI:000331939301084
ISSN: 0884-8734
CID: 882842
NYU3T: teaching, technology, teamwork: a model for interprofessional education scalability and sustainability
Interprofessional education is a critical precursor to effective teamwork and the collaboration of health care professionals in clinical settings. Numerous barriers have been identified that preclude scalable and sustainable interprofessional education (IPE) efforts. This article describes NYU3T: Teaching, Technology, Teamwork, a model that uses novel technologies such as Web-based learning, virtual patients, and high-fidelity simulation to overcome some of the common barriers and drive implementation of evidence-based teamwork curricula. It outlines the program's curricular components, implementation strategy, evaluation methods, and lessons learned from the first year of delivery and describes implications for future large-scale IPE initiatives.
PMID: 22920424
ISSN: 0029-6465
CID: 181882
A primary care residency's core DNA inserted at program outset to bloom into a tight spiral curriculum [Meeting Abstract]
NEEDS AND OBJECTIVES: Our annual residency retreat brainstorms innovations to meet needs. In 2010 needs were: to introduce foundation concepts and enable primary care (PC) residents to feel/be competent in clinic earlier; to spiral learning of core concepts, skills and attitudes from the start; and to have residents and faculty connect from the outset.We aim to equip PC clinicians to deliver bio-psychosocial, comprehensive, best evidence-based systems savvy care and to become change agents, leaders, and scholars. To meet these aims we designed a learner centered, team oriented, skills-based Essentials for PC Clinicians (EPIC) curriculum utilizing an initial, rigorous 4 week block with spiral reinforcement through 3 years. The innovation is a comprehensive, reproducible, effective method to ensure residents' progress on paths of clinical, humanistic, and intellectual excellence consistent with the generalist paradigm. SETTING AND PARTICIPANTS: EPIC is part of the NYU Internal Medicine PC Residency. Residents attend public hospital and community continuity clinics. 8 interns take the EPIC block and 24 residents spiral through the curriculum. DESCRIPTION: EPIC begins with a 4 week intern block dedicated to core topics in PC; is reinforced in precepting and subsequent blocks; and has a weekly EPIC conference where these topics are deepened and extended. EPIC Block: The overarching themes throughout the 4 weeks focus on understanding and practice of core skills: workshops/precepting on time management, efficient use of EHR, obtaining best practices, consultation, how one learns best, practice in the medical home and engaging community resources. Week 1 focuses on diabetes, and introduces the pillars: psychosocial medicine, evidence-based practice, and systems-based policy awareness and skill. The second week focuses on hypertension. The last 2 weeks introduce 7 common, high-risk high gain conditions from smoking to hepatitis B. Teaching methods combine group learning and reflective written exercises!
EMBASE:71297542
ISSN: 0884-8734
CID: 783112
Speed dating as an innovative method for helping medical students learn about internal medicine training and careers [Meeting Abstract]
NEEDS AND OBJECTIVES: Despite an increasing need for physicians trained in Internal Medicine (IM), the number of medical students entering residencies in IM has declined. Misconceptions about careers in IM, pay differentials between disciplines, student debt and work hours are thought to contribute to this decline. We developed an "IM Speed Dating Event" to increase first year medical student's awareness of the breadth and richness of IM training and careers. SETTING AND PARTICIPANTS: Faculty members from each Division within the Department of Medicine at our institution were asked to participate to emphasize the diversity of careers paths after IM training. Medical Students were recruited via email, flyers and word-of-mouth. Over 3 years of the event (2009-2011), 51 medical students participated (14-19/year). DESCRIPTION: This "speed dating" event was structured so that students rotated, in timed, five-minute blocks, speaking to a total of 10 faculty. Faculty members were organized to optimize diversity of disciplines to which students were exposed. Students asked questions about faculty members' career and training paths, current roles/responsibilities, work life, and work/life balance. The event was very informal, easy to set up and organize, and the speed dating format encouraged friendly, compelling and direct, but brief, discussions. EVALUATION: All 51 participants (n=18 in 2009, 19 in 2010, and 14 in 2011), completed a pre-event anonymous assessment of their attitudes toward and understanding of IM residency and career pathways and practices as well as their specialty and career intentions. After the event, 47 completed an evaluation of the "Speed Dating" event including listing 3 things they learned and the degree to which the event led them to become more interested in exploring IM. Pre-event assessment results suggest that medical students are quite unsure about IM careers (e.g., 45% reported being not sure whether faculty within IM Departments have all done IM residencies and 58% rep!
EMBASE:71297584
ISSN: 0884-8734
CID: 783102
CAN WE MEASURE AGENDA SETTING AND BALANCING PRIORITIES IN ENCOUNTERS AND ARE THESE SKILLS INDEPENDENT? [Meeting Abstract]
ISI:000208812700185
ISSN: 0884-8734
CID: 4449572
