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David C Leach

Publications and source records attributed to David C Leach.

11 recordsLinked to original sources
PubMed2005

In search of coherence: a view from the Accreditation Council for Graduate Medical Education.

The Conjoint Committee on Continuing Medical Education has developed a position paper, a set of recommendations, and next steps in the reform of continuing medical education (CME). The Accreditation Council for Graduate Medical Education (ACGME) sets standards for and accredits residency programs in graduate medical education and is not directly involved with CME. This article offers a perspective about the Conjoint Committee's recommendations from the executive director of the ACGME. It is a personal rather than an organizational perspective. Each of the 7 recommendations of the Conjoint Committee offers some opportunity for the ACGME and identifies issues that confront medical educators and accreditors at earlier stages of the formation of physicians. The Conjoint Committee's report also exposes the painful reality that organized medicine is almost hopelessly fragmented at a time when it is important to work together. Earlier efforts to produce a more coherent system of professional oversight have failed, but several emerging realities now may make possible what was not before. These include a common language for the competencies needed to practice medicine, common metrics of competence, technologic advances in learning portfolios, conceptual advances about the use of data on physician competence, and an inexorable focus on improvement of patient care. The possibility of patient-centered rather than profession-centered oversight is emerging. The most profound consequence of the Conjoint Committee's work may be a new organizational model, based on readily available data, that enhances trust. If so, a radical transformation of the accreditation of medical education will follow.

Accreditation↗
PubMed2003

Short and versatile route to a key intermediate for lactacystin synthesis.

[reaction: see text] A key intermediate 14 for the synthesis of lactacystin 1 has been constructed in four steps and 33% overall yield. The key steps involve cyclization of a suitably functionalized glutamic acid derivative and concomitant alkylation of the resulting beta,beta-diketoester system, C-acylation of the cyclic alpha-amidoketone 9, and decarboxylbenzylation of 12. Alkylation of a related beta,beta-diketoester 5 was additionally achieved with several electrophiles.

Acetylcysteine↗
PubMed2003

Professionalism: identifying current themes.

PURPOSE OF REVIEW: This review analyzes the literature on medical professionalism in order to inform further study, educational activity, and reflective practice for all phases of a physician's professional development from medical school through practice. RECENT FINDINGS: Several themes emerged from an analysis of the writing about medical professionalism during the past year. A number of authors attempted to identify concrete behaviors associated with attributes and characteristics used to define professionalism. These behaviors in turn became the focus of teaching and assessment activities primarily conducted with medical students and residents. Educators who attempted to assess professionalism achieved some modest success in reporting valid and reliable results of their efforts. Each of these activities points to a systemic component of professionalism that includes five broad categories of relationships in which physicians engage. All five categories are important to understanding and acting on the values and attitudes required by professionalism in medicine. SUMMARY: Competence to practice medicine includes the ability of physicians to demonstrate professionalism in all the relationships in which they engage. The attributes and characteristics used to define professionalism contribute to recognizing the behaviors that should be apparent not only in the physician-to-patient relationship which is at its core, but also in relationships with other physicians, colleagues in the health care system, society, and oneself. All these relationships must be appropriately aligned with the values and attitudes that form a collective understanding of professionalism that has emerged within the profession.

Journal Article↗
PubMed2002

Building and assessing competence: the potential for evidence-based graduate medical education.

The Accreditation Council for Graduate Medical Education (ACGME) has recently begun to use educational outcome measures as an accreditation tool. This long-term initiative offers the potential for building knowledge about effective educational interventions and ultimately for using time-variable educational models. This article reviews the progress of the ACGME initiative and plans of the initiative and explores the broader implications of competency. In addition to knowledge and skills the product of a good educational program is a physician who habitually exercises good clinical judgments. Skill sets and accountability proceed along a continuum that is outlined. Crucial is the development of a community committed to discerning and obeying the truth about the effectiveness of educational interventions.

Accreditation↗