Teaching and learning in medicine
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Randomized Controlled Trial Clinical Trial
Simulation-based training of internal medicine residents in advanced cardiac life support protocols: a randomized trial.
Internal medicine residents must be competent in Advanced Cardiac Life Support (ACLS) for board certification. ⋯ Performance improved significantly after simulator training. No improvement was detected as a function of clinical experience alone. The educational program was rated highly.
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Airway management skills are a vital part of emergency medicine training. Mastery of these skills requires didactic, model, and real-patient experiences. Practice with the use of relevant models greatly enhances these skills. ⋯ Combined results across all procedures showed that 94.8% believed the deer head models to be excellent, very good, or good models for demonstrating the techniques (range of favorable responses across all techniques was 87.5% to 98.8%). Deer heads serve as good to excellent aids for practicing advanced airway management skills. They are readily available and free of cost. This model should be considered in airway skills training.
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The Accreditation Council for Graduate Medical Education is shifting its focus from a structure and process system of graduate medical education to one that is outcomes based, requiring all residents in training to achieve competence in six broad domains and presenting educators with the challenge of evaluation. ⋯ Web-based portfolio assessment provides an ideal venue for the evaluation of competence and has the ability to provide educators with a research infrastructure to practice evidence-based education.
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Residency programs must prepare physicians to practice in the current health care environment. This mandate is reflected in 3 of the 6 competency domains now required by the Accreditation Council for Graduate Medical Education: systems-based practice, interpersonal skills and communication, and practice-based learning and improvement. ⋯ The use of several practical, scientifically sound, and specific methods for assessing residents' competency in care management are recommended. Assessment instruments will need to be flexible enough to adapt to the rapid changes in the health care delivery system and terminology.