Military medicine
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At the request of then-Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, Defense Health Horizons (DHH) examined options for shaping Graduate Medical Education (GME) in the Military Health System (MHS) in order to achieve the goals of a medically ready force and a ready medical force. ⋯ Graduate Medical Education (GME) is vital to produce the future physician workforce and medical leadership of the MHS. It also provides the MHS with clinically skilled manpower. Graduate Medical Education (GME) research sows the seeds for future discoveries to improve combat casualty care and other priority objectives of the MHS. Although readiness is the MHS's top mission, GME is also vital to meeting the other three components of the quadruple aim (better health, better care, and lower costs). Properly managed and adequately resourced GME can accelerate the transformation of the MHS into an HRO. Based on our analysis, DHH believes that there are numerous opportunities for MHS leadership to strengthen GME so it is more integrated, jointly coordinated, efficient, and productive. All physicians emerging from military GME should understand and embrace team-based practice, patient safety, and a systems-oriented focus. This will ensure that those we prepare to be the military physicians of the future are prepared to meet the needs of the line, to protect the health and safety of deployed warfighters, and to provide expert and compassionate care to garrisoned service members, families, and military retirees.
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The U.S. Military Health System (MHS) pioneered the use of telehealth in deployed environments in the early 1990s. However, its use in non-deployed environments historically lagged behind that of the Veterans Health Administration (VHA) and comparable large civilian health systems, due to administrative, policy, and other obstacles that slowed or blocked its expansion in the MHS. A report was prepared in December 2016, which summarized past and then-present telehealth initiatives in the MHS; described the obstacles, opportunities, and policy environment; and provided three possible courses of action for expansion of telehealth in deployed and non-deployed settings. ⋯ This review serves as a snapshot in time of the steps leading to telehealth expansion before 2017, which helped to set the stage for later use of telehealth in behavioral health initiatives and as a response to coronavirus disease 2019. The lessons learned are ongoing and further research is expected to inform additional development of telehealth capability for the MHS.
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Brain injury often impacts the visual system. Diagnosis and treatment of visual system problems related to brain injury is a field with less settled science and more variation in practice than most specialty fields. Most optometric brain injury residency programs are in federal clinics (VA and DoD). A consensus core curriculum has been created that will allow some consistency while facilitating program strengths. ⋯ In a relatively new subspeciality without a firm foundation of settled science, a common curriculum will help provide a common framework to facilitate clinical and research progress in this field. The process sought out expertise and community building to help improve the adoption of this curriculum. This core curriculum will provide a framework for educating optometric residents in the diagnosis, management, and rehabilitation of patients with visual sequelae because of brain injury. It is intended to ensure that appropriate topics are covered while allowing for flexibility according to each program's strengths and resources.
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The desire to measure faculty's teaching productivity has led many medical school departments to create academic productivity metrics and evaluation systems to track clinical and/or nonclinical teaching efforts. The authors investigated these metrics and their impact on teaching productivity and quality in the literature. ⋯ Setting metrics and measurement of teaching seems to have had a generally positive effect on amounts of teaching; however, their impacts on the quality of teaching are less clear. The diversity of metrics reported makes it difficult to generalize the impact of these teaching metrics.