Advances in medical education and practice
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Studying the effect of drugs on humans, clinical pharmacologists play an essential role in many academic medical and research teams, within the pharmaceutical industry and as members of government regulatory entities. Clinical pharmacology fellowship training programs should be multidisciplinary and adaptable, and should combine didactics, applied learning, independent study, and one-on-one instruction. ⋯ The purpose of this article is to provide information for academic clinicians and researchers interested in designing a similar program, for professionals in the field of clinical pharmacology who are already affiliated with a fellowship program and may benefit from supplemental information, and for clinical researchers interested in clinical pharmacology who may not be aware that such training opportunities exist. This article provides the details of a recently accredited program, including design, implementation, accreditation, trainee success, and future directions.
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Review
Clinical performance feedback and quality improvement opportunities for perioperative physicians.
Clinical performance feedback is an important component of the ongoing development and education of health care practitioners. For physicians, feedback about their clinical practice and outcomes is central to developing both confidence and competence at all stages of their medical careers. Cultural and financial infrastructures need to be in place, and the concept of feedback needs to be readily embraced and encouraged by clinical leadership and other stakeholders. ⋯ Anesthesiologists and other perioperative physicians are identifying specialty-specific indicators that can be used when creating a broader quality improvement agenda. Placing a more immediate formal feedback strategy that focuses on goal-oriented behavior is rapidly becoming a mainstay. Physicians may use their individual feedback reports for reflection and designing personal development plans as lifelong learners and leaders in improving patient care.
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A review of the literature was conducted to analyze the impact of simulation-based training for direct and video laryngoscopy (VL) skills for health care professionals and health care students. ⋯ This review suggests that simulation-based training is one effective way to teach VL skills. VL allows for a higher success rate, faster response time, and a decrease in the number of attempts by health care students and health care professionals under the conditions based on the eleven studies reviewed.
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For years, undivided attention during the presurgical "timeout" has been utilized as a precaution to ensure patient safety. The information relayed during the timeout is presented in a confirmatory nature rather than a delegation of new information. However, it is a standard of practice in which all members of the operating theater provide their full and undivided attention. Standards of patient care should be contiguous throughout the preoperative, perioperative, and postoperative stages of surgery. In this manner, it is expected that the same undivided attention afforded during the timeout should be maintained when transferring the patient to the postanesthesia care unit. ⋯ Focus is on the quantity of information that can be recalled by the transferring nurse, and whether or not undivided attention affects the outcome. Analysis focuses on suggestions to better improve patient safety and recovery when being transferred in an anesthetic setting. The practice of patient handover should be standardized to better improve the safety and quality of medical care.
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As the health care delivery landscape changes, medical schools must develop creative strategies for preparing future physicians to provide quality care in this new environment. Despite the growing prominence of the patient-centered medical home (PCMH) as an effective model for health care delivery, few medical schools have integrated formal education on the PCMH into their curricula. Incorporating the PCMH model into medical school curricula is important to ensure that students have a comprehensive understanding of the different models of health care delivery and can operate effectively as physicians. ⋯ Students who participate in the WCCC gain hands-on experience in coordinating care, providing continuity of care, addressing issues of accessibility, and developing quality and safety metrics. The WCCC experience provides an integrative model that links service-learning with education on health care delivery in a primary care setting. The authors propose that adoption of this approach by other student-run clinics provides a substantial opportunity to improve medical education nationwide and better prepare future physicians to practice within this new model of health care delivery.