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Biomedical subjects

Lloyd F Novick

Publications and source records attributed to Lloyd F Novick.

At least 19 recordsLinked to original sources
PubMed2003

Measuring orientation to population-based prevention.

BACKGROUND: Assessing orientation to population-based preventive alternatives is useful in the evaluation of preventive medicine curricula. METHODS: An instrument was developed using hypothetical situations describing a health issue that could be encountered by a primary care physician. Options to be selected were in three categories: (1) treatment, (2) clinical prevention, or (3) population-based prevention. Respondents allocated 900 points among alternatives for nine situations (100 points per situation). Pilot testing of the instrument was implemented, comparing the responses of public health physicians with two groups (Syracuse and Baltimore) of family medicine physicians. RESULTS: For the overall instrument, the scores on the population scale and population-treatment differential showed statistically significant differences between the public health physicians and both groups of family medicine physicians (p<0.01). For medical students taught the Case-Based Series in Population-Oriented Prevention (C-POP), there was an overall increase in the population scale (p<0.0001) and the population-treatment differential (p<0.0004). CONCLUSIONS: The development of a scenario-based tool to assess changes in population-based prevention orientation shows preliminary promise for future evaluation efforts involving preventive medicine curricula.

Clinical Competence↗
PubMed2003

Evaluation of a preventive medicine curriculum: incorporating a case-based approach.

BACKGROUND: Evaluating the acquisition of skills in prevention is an increasing priority in prevention education. Assessment instruments were developed to measure student skills before and after an education intervention at State University of New York (SUNY)-Upstate Medical University. METHODS: The evaluation method used three testing instruments that measure preventive medicine skills. We selected three surrogate topics, each their own instrument: sexually transmitted disease, lead toxicity, and ischemic heart disease. All three instruments measure four key preventive medicine skills areas: (1) using and interpreting data sources; (2) measuring disease frequency, including incidence and prevalence; (3) making inferences and identifying bias in data presentations; and (4) identifying appropriate study design and screening tests. Second-year medical students were assessed before and after our preventive medicine course in spring 2002, using our evaluative instruments. RESULTS: Before and after instruction analysis, overall, and by skills area tested revealed a significant increase in student preventive medicine skills (p< or =0.001) in all four categories. On conclusion of the case-based curriculum, students were also asked to rate the cases. The majority (60%) of the students thought the cases were of value to their medical education, and 58% believed that they added to their skills in population prevention. CONCLUSIONS: These instruments can measure change in preventive medicine skills before and after a course in preventive medicine.

Consumer Behavior↗
PubMed2003

Case-based teaching in preventive medicine: rationale, development, and implementation.

The importance of prevention teaching is increasingly recognized in medical education, but its implementation in medical school curricula is hampered by its cross-specialty nature, lack of curricular time, and perception as a topic of less importance than the traditional basic and clinical sciences. The Case-Based Series in Population-Oriented Prevention (C-POP) was developed to address national objectives for prevention education in a format that recognizes the students' abilities and preferences for case-based learning. This series uses small-group discussion cases that can be adapted to a variety of settings and instructor capabilities. These cases guide the learners from a specific clinical problem to the broader clinical and population-based prevention issues for the topic. The cases were developed with the use of local health department scenarios and data and have been taught and refined in a number of settings. As part of the curriculum development project, evaluation tools that examined prevention skills and orientation were developed and tested. With its emphasis on small-group learning, clinical relevance, and adaptability to a variety of learner and instructor needs, the C-POP project effectively integrates prevention concepts into medical education.

Curriculum↗
PubMed2003

Community health assessment.

This case-community health assessment-is one of a series of teaching cases in the Case-Based Series in Population-Oriented Prevention (C-POP). It has been developed for use in medical school and residency prevention curricula. The complete set of cases is presented in this supplement to the American Journal of Preventive Medicine. Community health assessment is key to understanding the health problems and priorities of a population. This case outlines a process by which the participants can complete a health assessment of a community using indicator-based methods. Students construct a set of health indicators from a variety of domains, evaluate problems, and report on the health priorities for a community. The students relate identified health issues to underlying behavioral risk factors.

Community Health Services↗
PubMed2003

Outbreak of tuberculosis in a homeless men's shelter.

This case-tuberculosis in a homeless men's shelter-is one of a series of teaching cases in the Case-Based Series in Population-Oriented Prevention (C-POP). It has been developed for use in medical school and residency prevention curricula. The complete set of cases is presented in this supplement to the American Journal of Preventive Medicine. Tuberculosis presents a significant public health challenge. In this teaching case, medical students are given information about four cases of active tuberculosis that occurred over a short period of time in residents of a homeless men's shelter. The students then walk through the steps that a local health department takes to identify and screen those individuals at risk for transmission of tuberculosis during an outbreak. During this process, they learn skills in epidemiology (such as defining "epidemic" and distinguishing uses for incidence and prevalence) as well as in population-based prevention of tuberculosis. Finally students discuss health policy as it relates to the control and prevention of tuberculosis.

Curriculum↗
PubMed2003

Racial and ethnic disparity in low birth weight in Syracuse, New York.

This case-racial and ethnic disparity in low birth weight-is one of a series of teaching cases in the Case-Based Series in Population-Oriented Prevention (C-POP). It has been developed for use in medical school and residency prevention curricula. The complete set of cases is presented in this supplement to the American Journal of Preventive Medicine. Low birth weight is a leading cause of infant mortality. Unfortunately, despite declining rates of infant mortality, racial and ethnic disparities in both low birth weight and infant mortality rates persist. In this teaching case, a clinical vignette is used to draw attention to this public health priority in Syracuse, New York. Students learn essential epidemiology skills such as identifying limitations of sources of data and calculating relative risks, using the example of low birth weight. In performing these skills, students also identify etiologies for such disparity. Finally, students discuss interventions that, when implemented, may decrease infant mortality rates.

Curriculum↗
PubMed2003

Sexually transmitted disease in adolescents.

This case-sexually transmitted diseases in adolescents-is one of a series of teaching cases in the Case-Based Series in Population-Oriented Prevention (C-POP). It has been developed for use in medical school and residency prevention curricula. The complete set of cases is presented in this supplement to the American Journal of Preventive Medicine. Sexually transmitted diseases (STDs) are common among adolescents. This case focuses on the population-based prevention of STDs. The case begins with clinical, diagnostic, and laboratory management of an adolescent female diagnosed with gonorrhea. Students then examine how the diagnosis of an STD can be used as an opportunity to provide preventive care and counseling on safer sexual behaviors. Questions addressing HIV testing and counseling are included in this section. Students proceed to explore how the diagnosis and reporting of an STD calls for interaction, such as partner notification, between clinical providers and public health departments. Finally, students are provided with actual information from local focus groups on attitudes and behaviors of high-risk adolescents. At the conclusion of the case, they are asked to interpret the data and formulate strategies to decrease gonorrhea rates in the community.

Adolescent↗
PubMed2003

Future applications of case-based teaching in population-based prevention.

The Case-Based Series in Population-Oriented Prevention (C-POP) introduced in this supplement to the American Journal of Preventive Medicine provides a set of tools to integrate clinical- and community-based prevention into interactive teaching cases. These cases, which address recommended core competencies in prevention education, have been taught to both medical students and preventive medicine residents. Initial experience with the cases indicates that this method is a promising tool to enhance prevention education in medical schools and primary care residencies. Because prevention education is essential in other fields, such as public health and nursing, extension of this approach to other professional schools is possible. Such extension is feasible because the cases are designed to be adaptable for different levels of education, flexible to be tailored to local situations, and expandable to accommodate changes in the field. In addition, the cases can be made accessible to all educators through a national library and in interactive web-based format. This article describes how the C-POP series can be used to strengthen prevention education for a wide audience of physician and nonphysician learners.

Computer-Assisted Instruction↗
PubMed2003

Bicycle helmet effectiveness in preventing injury and death.

This case--bicycle helmet effectiveness--is one of a series of teaching cases in the Case-Based Series in Population-Oriented Prevention (C-POP). It has been developed for use in medical school and residency prevention curricula. The complete set of cases is presented in this supplement to the American Journal of Preventive Medicine. This case examines the cost-effectiveness of three interventions to increase utilization of bicycle helmets to avert head injuries in individuals aged 18 years and under in Onondaga Count NY. Students are initially presented with data on head injuries, hospitalization, and death related to bicycle use. They then appraise a published study on the effectiveness of bicycle helmets in averting head injury. Finally, students work in groups to determine the cost-effectiveness of each intervention by calculating implementation costs and the specific number of head injuries averted associated with intervention. The three interventions are legislative, school, and community-based campaigns to increase helmet use. Students are provided with budget estimates and assumptions needed to complete the exercise. Cost-effectiveness analysis, cost-benefit analysis, and related concepts are discussed, including provider versus societal perspectives and importance of sensitivity analysis.

Adolescent↗
PubMed2003

Adolescent suicide prevention.

This case-prevention of adolescent suicide-is one of a series of teaching cases in the Case-Based Series in Population-Oriented Prevention (C-POP). It has been developed for use in medical school and residency prevention curricula. The complete set of cases is presented in this supplement to the American Journal of Preventive Medicine. This teaching case examines the issue of prevention of adolescent and young adult suicide both at an individual and at a population or community level, using data from the Onondaga County Health Department. In the first section of the case, students are asked to determine whether five deaths related to falling or jumping at a local shopping mall should be considered to be suicidal deaths. Students then develop skills in the reporting as well as in the epidemiology of adolescent suicidal deaths in Onondaga County. As the case progresses, students analyze the results of a local surveillance study of suicidal attempts and ideation. The case concludes with students evaluating a hypothetical screening study intended to reduce the risk of suicidal death and discussing a research design to examine the effectiveness of this prevention strategy.

Adolescent↗
PubMedDate not supplied

Examining public health financing in New York State: a methodology for evaluating local and national public health data.

Historically, there has been little national, standardized data collection on the financing of public health. In part this is due to the diverse way in which local public health is organized and funded. The lack of consistent financial data to adequately evaluate performance severely limits the ability of policy makers to set standards for improving quality. However, even in the absence of such data and analysis, policies have been established by local, state, and national governments to reduce public health funding, while at the same time, placing additional responsibilities on local public health. In an effort to understand fiscal trends for local health departments in New York State, the New York State Association of County Health Officials conducted a survey in December 2002 that collected data on spending and funding sources from calendar year 2000 to calendar year 2002. The survey instrument presents a model for state and local public health departments to evaluate their own resources/needs and to promote information exchange within and between localities. With limited resources, local public health officials must make difficult choices about their programs. By encouraging localities to collect uniform financial data sets, public health will be better suited to support its case for stable and sufficient funding.

Data Collection↗
PubMedDate not supplied

A case exercise in public health preparedness: a community outbreak of influenza-like illness.

Public health emergency preparedness has been a priority of local and state health departments as well as other community partners for several years. This article provides a tool for teaching a wide audience of learners the essential steps in training for a disease outbreak. This teaching case involves an investigation of and the community's response to an outbreak of influenza-like illness. Students learn skills in surveillance and hypothesis generation with regard to the outbreak. During the exercise, the learners are divided into teams to develop a response plan. The teams include Command and Coordination, Public Communication, Hospitals and Health Care Providers, Emergency Management and Public Safety, and Public Health. While the teams are developing their response plan, the etiology of the outbreak becomes clear. Once the etiology is known, each of the teams then develops an action plan to minimize the impact of the outbreak.

Disaster Planning↗