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Biomedical subjects

Craig L Gjerde

Publications and source records attributed to Craig L Gjerde.

6 recordsLinked to original sources

Teaching patient-centered tobacco intervention to first-year medical students.

The University of Wisconsin's Tobacco Intervention Basic Skills curriculum (TIBS) was inaugurated to begin training 147 first-year medical students in skills for promoting health behavior change. Learning activities included lecture, demonstration, reading, quiz, role-play exercises, and standardized patient interviews. After TIBS, the 69 students who provided pre- and postintervention data exhibited more therapeutic attitudes and increased knowledge and self-confidence in applying TIBS skills. Two months later, 52% of the 109 posttest respondents had applied TIBS in clinical settings, often for behaviors other than tobacco use. We conclude that medical students can gain from early training on promoting behavior change.

Adult↗

Teaching of medical informatics in UME-21 medical schools: best practices and useful resources.

OBJECTIVES: Information-based decision making is important to modern medical practice. This report identifies learning objectives, teaching innovations, and student outcomes for teaching medical informatics (MI) in medical schools that participated in the Undergraduate Medical Education for the 21st Century (UME-21) curriculum project. METHODS: Project reports by the UME-21 schools were analyzed, and curricular content was classified in terms of the five categories for MI literacy adapted from the Medical School Objectives Project. Student self-assessments of adequacy of exposure to MI were reviewed. RESULTS: Teaching methods included demonstrations, lectures, small-group tutorials, hands-on labs, and task-based assignments. The curriculum was taught during the first 3 years of medical school with medical librarians participating. Content examples in the five categories of medical literacy were: "Role of the Lifelong Learner" (accessing, evaluating, and using information and databases), "Role of Clinician" (obtaining patient information, using decision support), "Role of Educator/Learner/Communicator" (accessing information for patient education, student-teacher communication, studying Web-based cases, making presentations, accessing on-line course information), "Role of Researcher/Evaluator" (documenting patient encounters), and "Role of Manager" (using drug formularies and clinical guidelines). Seniors exposed to the UME-21 curriculum reported higher levels of exposure to MI than did untrained seniors 2 years earlier; however, seniors at non-UME-21 schools reported equally high levels. CONCLUSIONS: UME-21 schools developed creative materials for teaching students to use computers for learning, communication, and searching for information. Outcome measures suggest that MI has become an important curriculum topic in most medical schools.

Computer Literacy↗

A weekend program model for faculty development with primary care physicians.

BACKGROUND: Medical teachers are expected to be proficient at teaching students and residents about the changing health care system. The University of Wisconsin established a faculty development fellowship program to better prepare clinical teachers in family medicine, general pediatrics, and general internal medicine. This paper describes our fellowship program, presents data on program accomplishments, and discusses what we have learned. METHODS: We developed a year-long series of five weekend workshops. A core group of faculty provided 2- to 4- hour sessions on topics including evidence-based medicine, physician leadership, advocacy, doctor-patient communication, quality, technology tools, and teaching skills. Evaluation data were used to shape the program, make improvements, and assess impact. Fellows self-assessed their ability to perform skills at the beginning and ending of the year; paired t tests were used to compare these changes. RESULTS: Attendance and program completion rates were more than 94% for the 84 fellows taught over 6 years. Individual sessions and the overall program were well-rated by fellows. Participants reported improvements in targeted skills; statistical analyses confirmed many significant pre-post improvements. LESSONS LEARNED: To obtain high ratings, faculty must apply adult learning and active learning principles; lectures were not well tolerated. Initial technology skills were often low; computer labs needed many helpers. Participants needed extensive faculty support on their projects. It facilitated coordination and learning to have a core group of fellowship faculty who did most of the teaching. Graduates have become enthusiastic recruiters for new fellows. Our 5-weekend program has proven to be an effective faculty development model.

Adult↗

Collaborating to integrate curriculum in primary care medical education: successes and challenges from three US medical schools.

BACKGROUND AND OBJECTIVES: Traditional medical school department-based clerkship structures can lead to redundancy and/or gaps in curriculum, inefficient administrative systems, and academic isolation for clerkship directors. This paper describes the approaches, successes, and challenges three institutions experienced when implementing an interdepartmental collaboration to create an integrated primary care clerkship experience. METHODS: Each school combined family medicine, ambulatory pediatrics, and ambulatory medicine into contiguous clerkship blocks. In all institutions, each clerkship maintained certain distinct features while the integrated aspects contained longitudinal curriculum of certain primary care topics. RESULTS: Evaluations by students demonstrated favorable responses to the new content and integrated methods of teaching, as did results of the Association of American Medical Colleges graduation survey. Faculty at each institution reported that their multidisciplinary approach has stimulated important educational collaborations, many of which require an economy of scale not often achievable within a single clerkship. These included innovative evaluation/documentation efforts; centralization of administrative tasks; enhanced recruitment, retention, and development of community-based faculty; an increase in the active core group of local and national primary care leaders; and an increase in scholarly activities. The collaborations have not occurred without challenges, primarily in the need for identifying sustainable resources for these and future collaborative educational endeavors. CONCLUSIONS: The benefits involved in developing an integrated primary care experience include expansion of curriculum content and methods, as well as enhancement of collegial support and resources to community-based and academic faculty. These integrations do, however, bring added challenges, time, and costs to traditional independent clerkships.

Ambulatory Care↗

Career influence of an international health experience during medical school.

BACKGROUND AND OBJECTIVES: International health (IH) experiences are popular among medical students and may influence career choices. The International Health Fellowship Program (IHFP) consisted of preparatory coursework and field experience in a developing country. We conducted a survey 4-7 years later to assess the career influence of IHFP participation. METHODS: Fellows completed a questionnaire regarding training, practice setting, patient population, further international work, and knowledge and attitudes about IH. RESULTS: Surveys were completed by 42 (70%) fellows; 31% spend most of their time working with underserved populations, 67% have been involved in community health projects, 74% practice primary care, 29% have an MPH degree, 57% have done further work in developing countries, while 90% named one or more barriers to further IH experiences. Knowledge and attitudes about IH were largely retained. Most fellows (67%) believed the IHFP influenced their careers. CONCLUSIONS: Most fellows felt that IHFP participation had a positive influence on their careers. While a causative relationship cannot be inferred, fellows demonstrate a strong preference to work with underserved populations and engage in community service activities. Compared with US physicians, IHFP fellows are more likely to practice primary care and obtain MPH degrees. Medical schools that seek to produce graduates with these qualities should make efforts to increase quality IH opportunities for their students.

Career Choice↗

Toward the development of advocacy training curricula for pediatric residents: a national delphi study.

BACKGROUND: Training in child advocacy is now required in pediatric residency program curricula. No national consensus exists regarding the content of such advocacy training. OBJECTIVE: To identify an operational definition of advocacy, as well as knowledge, skills, and attitude objectives for advocacy training in pediatric residency programs. METHODS: Professionals experienced in pediatric advocacy and training (n = 53) were invited to participate in a sequence of surveys to define the content of a pediatric residency advocacy curriculum that would result in acquisition of appropriate knowledge, skills, and attitudes related to advocacy for children. Three rounds of surveys were distributed, collected, and analyzed using a modified Delphi technique, in which the results from an antecedent survey were used to refine responses in a subsequent survey. RESULTS: Participants (n = 36), comprising a group of experienced leaders with diverse training and experience in child advocacy and resident education, created a consensus definition for advocacy. They initially identified 179 possible objectives for advocacy curricula. Through the iterative process of the Delphi technique, 32 of those objectives were identified as necessary for inclusion in a child advocacy curriculum for pediatric residents. CONCLUSIONS: Using a modified Delphi technique, a group of experienced leaders in pediatric advocacy were able to reach consensus on an operational definition of child advocacy and a set of objectives for a resident advocacy curriculum. Programs may use these findings to assist in developing an advocacy curriculum based on their own faculty assets and community resources.

Adult↗