PubMed Health⌕ Search

Biomedical subjects

Barbara Barzansky

Publications and source records attributed to Barbara Barzansky.

9 recordsLinked to original sources
PubMed2005

Educational programs in US medical schools, 2004-2005.

CONTEXT: The educational environment affects the outcomes of medical education, including the characteristics and distribution of medical school graduates. OBJECTIVE: To report the status of variables related to medical education that represent areas that recently have been in flux or have potential impact on health care delivery. DESIGN, SETTING, AND PARTICIPANTS: Descriptive survey study comparing selected results of the Liaison Committee on Medical Education Annual Medical School Questionnaire between 2004-2005 and 1994-1995. The questionnaire was sent to the deans of all 125 LCME-accredited medical schools. Response rate was 100% in both years. MAIN OUTCOME MEASURES: Overall trends between 1994-1995 and 2004-2005 in the size and composition of the medical school faculty, the numbers of medical school applicants and students, requirements for passage of the US Medical Licensing Examination, medical student work hours, the use of computers in the educational program, the geographic pipeline from entry to medical school to entry to graduate medical education, and the educational background of medical school deans. RESULTS: The number of full-time faculty members increased from 90 016 in 1994-1995 to 119 025 in 2004-2005 (a 32% increase) while the number of medical students remained constant at about 67 000. In 2004-2005, 11% of medical school deans held MD and PhD degrees, 6% held MD and MBA degrees, 4% held MD and MPH degrees, and 2% held an MD and another degree (such as JD). In 2004-2005, 68% of all first-year medical students were residents of the state in which the medical school is located and a mean of 43% of 2005 graduates remained in the same state as the medical school for graduate medical education; results were similar in 1995. In 2004-2005, 58 schools (46%) required students to have their own computers and 35 (28%) to have their own personal digital assistants. In 2004-2005, night call was less common in the family medicine, internal medicine, pediatrics, and psychiatry clerkships compared with 1994-1995. CONCLUSIONS: Although most students remain in their home state for medical school, most students leave the medical school state for residency. Factors external to the medical school, such as funding mechanisms and regulations from the public and private sectors, may be having an impact on faculty size and composition, and on the geographic pipeline of students into medical school and residency training.

Clinical Clerkship↗
PubMed2004

Educational programs in US medical schools, 2003-2004.

CONTEXT: US medical schools continue to change their organizational structures, staffing patterns, and educational programs. OBJECTIVE: To review the status of US medical school educational programs in the 2003-2004 academic year, compared with 1993-1994. DATA SOURCES: The Liaison Committee on Medical Education (LCME) Annual Medical School Questionnaire for 2003-2004 and the Association of American Medical Colleges Directory of American Medical Education for the years 1983-1984, 1993-1994, and 2003-2004. DATA SYNTHESIS: The number of full-time faculty members in the 126 LCME-accredited medical schools increased from 90 975 in 1993-1994 to 114 549 in 2003-2004 (+26%), whereas the number of enrolled students remained essentially unchanged (66 453 in 1993-1994 and 67 166 in 2003-2004). In 2003-2004, 48% of medical school deans held another title at the medical center or university level, such as vice president for health affairs. There are 94 medical schools that have a comprehensive clinical examination using the standardized patient/objective structured clinical examination format; 59 schools require students to pass this examination for graduation. As of spring 2004, 58 schools will require students in the class of 2005 to pass the new US Medical Licensing Examination Step 2 Clinical Skills examination. CONCLUSIONS: The role of the medical school dean has expanded over time and is associated with the creation of a discrete administrative structure for the educational program. The number of full-time medical school faculty continues to increase, whereas the number of enrolled students remains steady. Considerable variability exists among medical schools in their use of standardized clinical evaluations.

Adult↗
PubMed2004

Comparison of accreditation practices and standards of US schools of medicine and veterinary medicine.

There are 126 medical education programs leading to the MD degree in the United States, and 16 in Canada, that are accredited by the Liaison Committee on Medical Education (LCME). This article summarizes the current policies and procedures used by the LCME and traces their historical development. The external factors that have acted to influence accreditation in the United States, such as recognition of accreditation agencies by the US Department of Education, are then described. Finally, comparisons are drawn between the accreditation systems for medical education and veterinary medical education programs.

Accreditation↗
PubMed2004

Evaluation of the UME-21 initiative at 18 medical schools between 1999 and 2001.

BACKGROUND: This study evaluated the processes of curricular change and the initial outcomes of the Undergraduate Medical Education for the 21st Century (UME-21) project at 18 schools. METHODS: Site visits were conducted at eight partner schools in 1999 and 2001. Written proposals, progress reports, and final reports of 18 schools were reviewed. Senior medical students' responses to questionnaires, including the annual Association of American Medical Colleges Graduation Questionnaire and a UME-21 supplemental graduation questionnaire, were analyzed. RESULTS: There was variation among the schools in the curriculum at baseline, in the structure of the UME-21 innovation that was introduced, and in the process of implementation. There was an increase in seniors' ratings of instruction in the newer areas of evidencebased medicine, quality assurance, and cost-effectiveness in relation to national norms between 1999 and 2001. There was less impact on the more traditional content areas of ethics, patient communications, prevention, and leadership skills. CONCLUSIONS: The circumstances of the national evaluation introduced many methodological complexities, some of which could have been avoided if planning for evaluation had started earlier. However, the evaluation revealed that even modest funding directed toward specific curricular goals can produce measurable change and can have effects that extend beyond the initial scope of the project.

Clinical Clerkship↗
PubMed2003

Educational programs in US medical schools, 2002-2003.

CONTEXT: To better provide medical students with the knowledge, skills, attitudes, and values they will need as physicians, US medical schools continue to make ongoing changes to their staffing and curricula. OBJECTIVE: To review the status of US medical education in the 2002-2003 academic year, compared with 1997-1998. DATA SOURCES: The Liaison Committee on Medical Education (LCME) Annual Medical School Questionnaire, the Association of American Medical Colleges (AAMC) Databook, and the AAMC Data Warehouse: Applicant Matriculant File. Data evaluated included those on medical school faculty, applicants, and students; curriculum hours devoted to new multidisciplinary or nontraditional subject areas (eg, cultural diversity, evidence-based medicine, medical ethics, medical informatics); and methods used to evaluate student learning. DATA SYNTHESIS: The number of full-time faculty members in the 126 LCME-accredited medical schools increased from 96 773 in 1997-1998 to 109 526 in 2002-2003 (+13.2%). The number of applicants entering decreased from 43 016 in 1997-1998 to 33 625 in 2002-2003 (-21.8%). The number of enrollees remained virtually unchanged from 1997-1998 (66 748) to 2002-2003 (66 677). Most medical schools have incorporated new subject areas into their curricula, although time devoted to these areas varies across schools. Schools typically use written examinations (National Board of Medical Examiners subject tests and/or internally prepared examinations) to assess factual knowledge, and observations by faculty members and residents to assess clinical skills. Use of standardized methods (eg, an objective structured clinical examination [OSCE]) to assess clinical skills is variable; 82 schools use a final third- or fourth-year comprehensive OSCE; 53 require a passing OSCE score for graduation. CONCLUSIONS: While the number of applicants to US medical schools has continued to decline, student numbers are constant. The number of full-time faculty members has increased. Schools are incorporating new subject areas into their curricula, and the use of standardized methods of assessing clinical skills, while variable, is generally increasing.

Adult↗
PubMed2003

Sleep, fatigue, and medical training: setting an agenda for optimal learning and patient care.

The difficult issues surrounding discussions of sleep, fatigue, and medical education stem from an ironic biologic truth: physicians share a common physiology with their patients, a physiology that includes an absolute need for sleep and endogenous circadian rhythms governing alertness and performance. We cannot ignore the fact that patients become ill and require medical care at all times of the day and night, but we also cannot escape the fact that providing such care requires that medical professionals, including medical trainees, be awake and functioning at times that are in conflict with their endogenous sleep and circadian physiology. Finally, we cannot avoid the reality that medical education requires long hours in a constrained number of years. Solutions to the problem of sleep and fatigue in medical education will require the active involvement of numerous parties, ranging from trainees themselves to training program directors, hospital administrators, sleep and circadian scientists, and government funding and regulatory agencies. Each of these parties can be informed by previous laboratory and field studies in a variety of operational settings. including medical environments. Education regarding the known effects of sleep. circadian rhythms, and sleep deprivation can help to elevate the general level of discourse and point to potential solutions. Empiric research addressing the effects of sleep loss on patient safety, education outcomes, and resident health is urgently needed: equally important are the development and assessment of innovative countermeasures to maximize performance and learning. Addressing the economic realities of any changes in resident work hours is an essential component of any discussion of these issues. Finally, work-hour regulations may serve as one component of improved sleep and circadian health for medical trainees. but they should not be seen as substitutes for more original solutions that rely less on enforcement and more on collaboration. By working together to address the problems of sleep and fatigue in its own trainees, the medical field can provide a valuable legacy to patients and to future generations of healthcare providers--a legacy or optimal medical education, healthy doctors, and healthy patients.

Education, Medical↗
PubMed2002

Educational programs in US medical schools, 2001-2002.

We used data mainly from the 2001-2002 Liaison Committee on Medical Education Annual Medical School Questionnaire, which had a 100% response rate, to describe the status of US medical education programs. In 2001-2002, the number of full-time medical school faculty members was 104 949, a 2.4% increase from 1999-2000. The 34,859 applicants for the class entering in 2001 represented a 9.5% decrease from the number of applicants in 1999-2000. There were 2 applicants for every acceptance, and the academic qualifications of medical students entering in 2001 were unchanged from 1999. Women comprised 47.8% of entering students in 2001, and 13.1% were members of underrepresented minority groups. Of all first-year students, 67% were in-state residents. Most medical schools had mandatory required night call during at least some required clinical clerkships, but only 17 had formal policies on medical student work hours. In 74 schools (60%), medical students were required to pass Steps 1 and 2 of the United States Medical Licensing Examination to advance or graduate.

Curriculum↗
PubMed2002

Sleep loss and fatigue in residency training: a reappraisal.

Reduced sleep time is commonplace for many interns and residents. Recent studies, however, suggest that sleep loss and fatigue result in significant neurobehavioral impairments in healthy young adults. We reviewed studies addressing the effects of sleep loss on cognition, performance, and health in surgical and nonsurgical residents. We describe the effectiveness of countermeasures for sleepiness, including recent work-hour restrictions. A more complete understanding of the issues of sleep loss during residency training can inform innovative strategies to minimize the effects of sleepiness and fatigue on patient care and resident safety.

Clinical Competence↗