Academic medicine : journal of the Association of American Medical Colleges
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To explore what contributions to scholarship teacher-clinician faculty list in the portfolios that they use as evidence for promotion. ⋯ The academic culture at Harvard Medical School has shifted from promotion based solely on original scholarship to promotion based on a broad array of educational contributions. The faculty, as they seek promotion, create portfolios that list written scholarship, teaching, and service at the local, regional, and national levels and at all ranks of promotion.
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This essay describes the development, implementation, and evaluation of a theory-based faculty development program for physician-educators in medicine and pediatrics at The Cleveland Clinic. The program comprises a 12-hour course (focused on skills in precepting, bedside teaching, leading small-group discussions, giving lectures, designing curricula, and giving effective feedback); onsite coaching of teaching (on wards, in outpatient clinics, or in formal lectures); and innovative projects in clinical medical education. ⋯ The evaluation of the program includes satisfaction ratings, self-assessment of teaching competencies, and independent ratings of teaching effectiveness by the participants' trainees (medical students, residents, and fellows). The program is rated highly, shows significant improvements in teaching skills as measured by both participants' self assessments and independent ratings by participants' trainees, and is ongoing.
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In 1997, the University of New Mexico Health Sciences Center ("the Center") created a managed care plan ("the Plan") for its uninsured patients who were county residents. The Plan's features include pooling the resources of existing county safety-net providers, enrolling patients with primary care providers at easily accessible neighborhood-based clinics, and investing in social support services, case management, and 24-hour telephone triage. After two years of the Plan's operation, the utilization of ambulatory care services by Plan enrollees, the number of discharges per 1,000 enrollees from the Center-affiliated University Hospital, and the number of hospital days per 1,000 enrollees had all dropped significantly (p < .001 for all). ⋯ The replacement of unpaid hospital days with paying patients is estimated to have yielded over $695,000 in additional revenues per year. The authors conclude that managing the care of uninsured patients in an academic health center can reduce ambulatory care and inpatient utilization and reduce the cost of care. To achieve these favorable outcomes requires the organization of services to meet the unique needs of the uninsured and underserved population.
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The aging of the U. S. population has led many organizations to call for an increase in the amount of clinical geriatrics training in medical education. ⋯ They then defined the core knowledge, attitudes, and skills students must develop to care for older people. This article summarizes these core competencies, which medical educators may find useful in developing new curricula on aging or in evaluating existing curricula.