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Biomedical subjects

Jesse C Crosson

Publications and source records attributed to Jesse C Crosson.

4 recordsLinked to original sources
PubMed2004

Evaluating the effect of cultural competency training on medical student attitudes.

BACKGROUND AND OBJECTIVES: Developing skills for taking care of patients from a wide variety of backgrounds is a growing area of importance in medical education. Incorporating cultural competency training into undergraduate medical education is an accreditation requirement. Although there are an increasing number of such curricula reported in the literature, there has been little evaluation of their effectiveness. We describe a new undergraduate cultural competency curriculum, the reliability of an instrument for assessing student attitudes in this area, and the effects of our curriculum on student attitudes. METHODS: Two introductory clinical medicine courses focused on the importance of providing culturally competent care to all patients. The courses used problem-based learning and a history-taking mnemonic to teach students to assess patients' perspectives. The authors verified the reliability of the Health Beliefs Attitudes Survey (HBAS) and used it to determine changes in students' attitudes on issues relating to cultural competency. RESULTS: The HBAS reliably measured four cultural competency concepts. Student attitudes regarding the importance of assessing patient opinions and determining health beliefs improved significantly following the courses. CONCLUSIONS: The method used here to teach students cultural competency skills early in medical school positively affects student attitudes on cultural competency issues.

Adult↗
PubMedDate not supplied

Implementing an electronic medical record in a family medicine practice: communication, decision making, and conflict.

PURPOSE: Electronic medical record (EMR) systems offer substantial opportunities to organize and manage clinical data in ways that can potentially improve preventive health care, the management of chronic illness, and the financial health of primary care practices. The functionality of EMRs as implemented, however, can vary substantially from that envisaged by their designers and even from those who purchase the programs. The purpose of this study was to explore how unique aspects of a family medicine office culture affect the initial implementation of an EMR. METHODS: As part of a larger study, we conducted a qualitative case study of a private family medicine practice that had recently purchased and implemented an EMR. We collected data using participant observation, in-depth interviews, and key informant interviews. After the initial data collection, we shared our observations with practice members and returned 1 year later to collect additional data. RESULTS: Dysfunctional communication patterns, the distribution of formal and informal decision-making power, and internal conflicts limited the effective implementation and use of the EMR. The implementation and use of the EMR made tracking and monitoring of preventive health and chronic illness unwieldy and offered little or no improvement when compared with paper charts. CONCLUSIONS: Implementing an EMR without an understanding of the systemic effects and communication and the decision-making processes within an office practice and without methods for bringing to the surface and addressing conflicts limits the opportunities for improved care offered by EMRs. Understanding how these common issues manifest within unique practice settings can enhance the effective implementation and use of EMRs.

Communication↗
PubMedDate not supplied

Social network analysis as an analytic tool for interaction patterns in primary care practices.

PURPOSE: Social network analysis (SNA) provides a way of quantitatively analyzing relationships among people or other information-processing agents. Using 2 practices as illustrations, we describe how SNA can be used to characterize and compare communication patterns in primary care practices. METHODS: Based on data from ethnographic field notes, we constructed matrices identifying how practice members interact when practice-level decisions are made. SNA software (UCINet and KrackPlot) calculates quantitative measures of network structure including density, centralization, hierarchy and clustering coefficient. The software also generates a visual representation of networks through network diagrams. RESULTS: The 2 examples show clear distinctions between practices for all the SNA measures. Potential uses of these measures for analysis of primary care practices are described. CONCLUSIONS: SNA can be useful for quantitative analysis of interaction patterns that can distinguish differences among primary care practices.

Decision Making↗