Academic medicine : journal of the Association of American Medical Colleges
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Despite mandates from accreditation bodies for programs to ensure procedural competence, standardized measures do not exist to assess residents' skills in performing central venous catheter (CVC) insertion. The objective of the present study was to develop an instrument to assess residents in subclavian (SC) CVC insertion, to set performance standards, and to validate the tool using performance data. ⋯ The authors were able to create and validate a consensus-driven procedural assessment tool with data-driven standards for basic proficiency and competence that faculty can use to assess residents as they perform CVC insertion.
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Randomized Controlled Trial
The development of an independent rater system to assess residents' competence in invasive procedures.
To design an independent rater (IR) direct observation system to monitor invasive procedures performed by residents in the hospital setting. ⋯ Recent innovations in procedural training with partial task simulation trainers necessitate developing methods to measure skills transfer from the simulator to the clinical setting. This description of a nonphysician IR direct observation system for CVC insertion offers a feasible tool that may be generalized to monitoring other invasive procedures.
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Peer assessment of teaching can improve the quality of instruction and contribute to summative evaluation of teaching effectiveness integral to high-stakes decision making. There is, however, a paucity of validated, criterion-based peer assessment instruments. The authors describe development and pilot testing of one such instrument and share lessons learned. ⋯ The authors describe the importance of faculty involvement in determining a cohesive set of criteria to assess lectures. They discuss how providing evidence that a peer assessment instrument is credible and reliable increases the faculty's trust in feedback. The authors point to the need for proper peer rater training to obtain high interrater agreement measures, and posit that once such measures are obtained, reliable and accurate peer assessment of teaching could be used to inform the academic promotion process.
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To examine relationships between pharmaceutical representatives and obstetrician-gynecologists and identify factors associated with self-reported reliance on representatives when making prescribing decisions. ⋯ Physicians' interactions with industry and their familiarity with guidelines vary by practice setting, perhaps because of more restrictive policies in university settings, professional isolation of private practice, or differences in social norms. Prescribing samples may be associated with physicians' use of information from sales representatives more than is merited by the physicians' own beliefs about the value of pharmaceutical representatives.
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Grand rounds are a time-honored continuing medical education activity that is intended to keep doctors current and competent. In addition, health care leaders and medical educators often rely on grand rounds to change physician behavior and improve patient outcomes. However, the extent to which grand rounds programs are consistent with evidence-based educational practices is unknown. ⋯ This study has identified important opportunities for improving a specific grand rounds program and for researching similar examples of this common, traditional educational forum for physicians.