Academic medicine : journal of the Association of American Medical Colleges
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Multicenter Study
Development, implementation, and dissemination of the I-PASS handoff curriculum: A multisite educational intervention to improve patient handoffs.
Patient handoffs are a key source of communication failures and adverse events in hospitals. Despite Accreditation Council for Graduate Medical Education requirements for residency training programs to provide formal handoff skills training and to monitor handoffs, well-established curricula and validated skills assessment tools are lacking. Developing a handoff curriculum is challenging because of the need for standardized processes and faculty development, cultural resistance to change, and diverse institution- and unit-level factors. ⋯ They describe resources, activities, and outputs, and report preliminary learner outcomes using data from resident and faculty evaluations of the I-PASS Handoff Curriculum: 96% of residents and 97% of faculty agreed or strongly agreed that the curriculum promoted acquisition of relevant skills for patient care activities. They also share lessons learned that could be of value to others seeking to adopt a structured handoff curriculum or to develop large-scale curricular innovations that involve redesigning firmly established processes. These lessons include the importance of approaching curricular implementation as a transformational change effort, assembling a diverse team of junior and senior faculty to provide opportunities for mentoring and professional development, and linking the educational intervention with the direct measurement of patient outcomes.
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Comparative Study
Competencies and frameworks in interprofessional education: a comparative analysis.
Health professionals need preparation and support to work in collaborative practice teams, a requirement brought about by an aging population and increases in chronic and complex diseases. Therefore, health professions education has seen the introduction of interprofessional education (IPE) competency frameworks to provide a common lens through which disciplines can understand, describe, and implement team-based practices. Whilst an admirable aim, often this has resulted in more confusion with the introduction of varying definitions about similar constructs, particularly in relation to what IPE actually means. ⋯ They are the Interprofessional Capability Framework (United Kingdom), the National Interprofessional Competency Framework (Canada), the Core Competencies for Interprofessional Collaborative Practice (United States), and the Curtin University Interprofessional Capability Framework (Australia). The authors highlight the need for further discussion about establishing a common language, strengthening ways in which academic environments work with practice environments, and improving the assessment of interprofessional competencies and teamwork, including the development of assessment tools for collaborative practice. They also argue that for IPE frameworks to be genuinely useful, they need to augment existing curricula by emphasizing outcomes that might be attained only through interprofessional activity.
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To quantify the relative prevalence of traditional (education, research, service) and emerging (prevention, diversity, primary care, distribution, cost control) themes in medical school mission statements. ⋯ The traditional themes of education, research, and service dominate medical school mission statements. DO-granting and community-based medical schools, however, more often have incorporated the emerging themes of primary care and distribution. Although including emerging themes in a mission statement does not guarantee tangible results, omitting them suggests that the school has not embraced these issues. Without the engagement of established medical schools, the national health care problems represented by these emerging themes will not receive the attention they need.
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Comparative Study
A tale of two cities: understanding the differences in medical professionalism between two Chinese cultural contexts.
To compare stakeholders' constructs of medical professionalism in two Chinese cultural contexts. ⋯ The resemblance between the Chinese and Taiwanese frameworks in the prominence of morality and integrity suggests the influence of Confucianism. The exclusively Chinese articulations of teamwork, health promotion, and economic considerations appear to derive from social, political, and economic factors unique to Mainland China. This study demonstrates the dynamic influence of cultural values, social history, and health care systems on the construction of medical professionalism frameworks and calls for further research to adapt global frameworks to fit specific local contexts.
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Although resident-as-teacher programs bring postgraduate trainees' teaching skills to a minimum threshold, intensive, longitudinal training is lacking for residents who wish to pursue careers in medical education. The authors describe the development, implementation, and preliminary assessment of the novel track for future clinician-educators that they introduced in the internal medicine residency program at Beth Israel Deaconess Medical Center in 2010. ⋯ Although these preliminary data are promising, data will be collected over the next several years to explore whether the additional curricular time, faculty time, and costs and potential expansion to other institutions are justified.