By William Rayburn, MD
This column provides a list of insightful publications on topics of interest to teaching faculty and professionals in CME/CPD.
Current Listings | Winter 2021
Health Care Professionals' Reflections on Their Learning as Spiritual Generalists and Integration Into Practice
Meeting spiritual needs of patients is important for quality health care. This interdisciplinary, simulation-based workshop involved 211 participants. Questionnaires before and after the workshop confirmed that the workshop offered clinically applicable value in meeting spiritual generalists, appreciating spirituality/religion and its role in health care, and interfacing with chaplaincy. A subsample who completed delayed post surveys at 3 to 9 months reported making clinical practice changes by improved spiritual screening, recognition of spiritual distress and referral to chaplaincy.
(Thiel M, Luff D, Kerr E, Robinson M, Meyer E. J Contin Edu Health Prof. 2020; 28. Doi: 10.1098/CEH.0000000000000318) PMID: 33136759
Can the recruitment of senior transitioning clinician educators enhance the number and quality of resident observations? Thinking outside the-box
The Accreditation Council for Graduate Medical Education’s Next Accreditation System has mandated direct observation by faculty of trainee performance. Most faculty perceive that they have limited time to observe trainees’ achievement of competency in an efficient and effective manner. Hiring more faculty is not feasible or a priority, and faculty development programs have not been universally effective to enhance observations. The author proposes recruiting the enlarging pool of senior clinician educators who are either retired or transitioning retirement to play a much-needed role in teaching at an academic health center.
(Greenberg L. Teach Learn Med 2020; 25: 1-6. Doi:10.1080/10401334.2020.1801442) PMID: 32841577
Impact of Educational Format on Learner Commitment to Change and Satisfaction
The value proposition of CME lies in its ability to elicit change in learners so new knowledge and skills are used to improve patient outcomes. The authors analyzed post activity learner evaluations of 9 educational formats produced by the American Academy of Family Physicians between 2015 and 2017. Education that was interactive and leveraged elements of social learning theory produced the greatest commitment to change the score. By contrast, satisfaction scores were not significantly different between formats.
(Bird GC, Kozakowski SM, Mullins A, Campbell E. J Contin Educ Health Prof 2020; 40: 207-210. Doi: 10.1097/CEH.0000000000000301) PMID: 32898121
Health Professions Educators’ System-oriented Roles as Educational Advocate, Quality Improver, and Broker
This qualitative study was intended to ask health professionals about their educational roles besides teaching and student support. Results of surveys and interviews revealed three strategic dimensions: 1) educational advocacy, aimed at championing education at different levels and parts of the educational system and building educational capacity, 2) educational quality improvement, focused on shifting narratives about education and educational change in health service settings and leveraging educational evidence, and 3) educational brokerage, oriented at connecting clinical and educational communities to build trust and consensus.
(Kumar K, School A. J Contin Educ Health Prof 2020; 40: 176-181. Doi: 10.1097/CEH.0000000000000309) PMID: 32898119
Regional Education on Endoscopic Surgery Using a Teleconference System with High-quality Video via the Internet: Saga Surgical Videoconferences
Effective education is needed for unskilled surgeons, especially at low-volume institutions. This report describes establishing local remote teleconferences by combining the use of a general web conferencing system and a synchronized remote video playback system about endoscopic surgery (ES). Fourteen teleconferences involved viewing an uncut video of ES that had been performed at one of the institutions. The procedure was discussed frankly, and expert surgeons advised improvements. This system was of low initial cost and offered easy participation and high-quality videos.
(Manabe T, Takasaki M, Ide T, et al. BMC Med Educ 2020; 200: 329. Doi: 10.1186/s12909-020-02215-0) PMID: 32972399
Twelve Tips for Being an Effective Clinical Skills Peer Teacher
Most clinical skills teaching is delivered through peer teachers (other students) rather than over-qualified physicians. Teaching benefits both the learner and teacher through an informal and improved learning atmosphere. Peer teaching by students is invaluable in cultivating teaching skills. This article outlines 12 tips, with a paragraph about each tip, as to how students can be effective and successful in teaching clinical skills. Practical guidance was gathered from faculty reflecting on their roles and the wider literature on peer teaching in clinical skills.
(Niaz H, Mistry J. Med Tech 2020; Nov 2; 1-6. Doi: 10.1080/0142159X.2020.1841130) PMID: 33136451
What are We Really Talking About? An Organizing Framework for Types of Consultation and Their Implications for Physician Communication
Consultations between providers on an outpatient or inpatient basis is one of the most frequent means of interdisciplinary communication and learning. In this Perspective, the authors propose an organizing framework of 7 types of consultations, which apply broadly across disciplines: ideal consults, obligatory consults, procedural consults, S.O.S. consults, confirmatory consults, inappropriate consults, and curbside consults. Descriptions of this framework may help practitioners to be more productive, efficient, and collegial about patient care, which may facilitate improved work satisfaction and enhanced learning.
(Hale AJ, Freed JA, Alston K, Ricotta D. Acad Med 2019; 94: 809-812. Doi: 10.10971ACM.000000000000002659) PMID: 30768469
Incorporating Physician Input into a Maintenance of Certification (MOC) Examination: a Content Validity Tool
Periodic MOC examinations are intended to evaluate whether physicians have maintained competence and are current in the knowledge and judgment requires for practice in their discipline. Each MOC exam comprises multiple-choice questions or case-based clinical vignettes. This study presents results from the cardiovascular disease MOC blueprint review. Responses from 441 review participants were analyzed to better address clinically relevant content. The blueprint review garnered more detailed and valuable feedback from the physician community about the relevance of topics and their frequency seen in practice.
(Poniatowski P, Dougosh J, Baranowski R, et al. Acad Med 2019; 94: 1369-1375. Doi: 10.1097/ACM.0000000000002727) PMID: 31460935
Teaching Clinical Handover with ISBAR
Clinical handover is a critical core skill that needs to be taught to health professionals of all stages of experience and disciplines. Use of a structured, standardized framework for handover improves patient outcomes The ISBAR (Introduction, Situation, Background, Assessment, Recommendation) framework provides a standardized approach to communication in any complex clinical environment. The purpose of this review is to highlight key elements of effective clinical handover, and to explore teaching techniques that aim to ensure the framework is embedded in practice.
(Burgess A, van Diggele C, Roberts C, Mellis C. BMC Med Educ 2020; 20 (Suppl 2): 459 doi: 10.1186/s12909-020-02285-0) PMID: 33272274.
How to Conduct Cost and Value Analyses inHealth Professions Education: AMEE Guide No. 139
Despite much talk about the growing demand for accountability and transparency in health care costs, education is lacking about the use of cost and value analyses. This guide from the Association for Medical Education in Europe (AMEE) introduces key concepts, methods, and literature that will enable novices in economics to conduct simple cost and value analyses, hold informed discussions with economic specialists, and undertake further learning on more advanced economic topics. Key steps include defining the economic research question, identifying an appropriate economic study design, and carefully identifying, quantifying, and pricing the cost ingredients.
(Foo J, Cook D, Tolsgaard, et al. Med Teacher Doi: 10.1080/0142159X.2020.1838466) PMID: 33280483
William Rayburn, MD, MBA is an emeritus distinguished professor, chair of obstetrics and gynecology, and associate dean at the University of New Mexico School of Medicine, Albuquerque, NM and a clinical professor of obstetrics and gynecology and graduate studies at the Medical University of South Carolina, Charleston, SC.