Biomedical subjects

Lori L Bakken

Publications and source records attributed to Lori L Bakken.

8 recordsLinked to original sources

PubMed2006

A model of teaching-learning transactions in generalist-specialist consultations.

INTRODUCTION: A new paradigm in continuing medical education is characterized by emphasis on physicians' learning in practice. Consistent with this paradigm, our study examined a subset of clinical practice--generalist-specialist consultations--from an educational perspective. METHODS: We applied the grounded-theory method with semistructured interviews. Ten primary care physicians and 9 internal medicine subspecialists were interviewed regarding their approaches to learning and teaching during generalist-specialist consultations. RESULTS: Based on 48 formal and informal consultations reported by physicians, we developed a theory of teaching-learning transactions in generalist-specialist consultations. DISCUSSION: As a teaching-learning transaction, the mutual learning process in generalist-specialist consultations involves 3 components: needs assessment, dialogue, and sufficiency. Providers of continuing medical education may use the proposed theoretical framework to help clinicians and health care organizations analyze and enhance educationally valuable interactions at the interface of primary and secondary care.

Education, Medical, Continuing↗

PubMed2006

Viewing clinical research career development through the lens of social cognitive career theory.

Issues such as, over commitment, insufficient time, and lack of funding, threaten physicians' entry and sustainability in a research career pathway. Social cognitive career theory is presented as a conceptual framework to critically examine the limitations of the National Institutes of Health's (NIH) efforts to promote the career development of physician-scientists. Special attention is given to the unique challenges of promoting this career pathway for women and underrepresented minorities. The authors propose enhanced recommendations for the career development of physician-scientists and research questions for future studies and program development aimed at advancing the nation's efforts to promote clinical research.

Biomedical Research↗

PubMed2005

Who are physician-scientists' role models? Gender makes a difference.

PURPOSE: To determine for educational purposes whether differences exist in the role models physician-scientists-in-training or in their early years of career development envision when they self-assess their abilities to perform clinical research. METHOD: A 35-item clinical research self-efficacy questionnaire was administered to 251 health care professionals who attended programs at the University of Wisconsin-Madison from 2002-2004. Three questions were included to determine the sex, role, and qualities of the expert that are envisioned by participants. Frequency distributions were computed for each response and variables were compared by gender using chi-square analysis and Fisher exact test. RESULTS: Ninety-five physicians-in-training and junior faculty physicians responded to the questionnaire. Seventy-one percent of female and 95% of male respondents reported their envisioned experts to be male. The most frequently reported role of the envisioned expert was that of a mentor who was a faculty member in the respondent's own department (72% women, 60% men). The three most frequently reported qualities of the envisioned expert were "multiple publications," "scientific knowledge," and "supportiveness." However, women more frequently reported "communication skills" and "problem-solving abilities" than did men. This difference was statistically significant and largely due to the frequency of qualities selected by women whose envisioned expert was female. CONCLUSIONS: The results of this study emphasized the importance of a role model's gender in the career development of physician-scientists.

Adult↗

PubMed2005

Survey of the impact of National Institutes of Health clinical research curriculum awards (K30) between 1999 and 2004.

BACKGROUND: This report summarizes a survey conducted in 2004 by the Association of Clinical Research Training Program Directors' Evaluation Committee. The purpose of this survey was to determine the early capacity of the 59 National Institutes of Health (NIH) K30 programs (funded between 1999 and 2004) to produce clinical investigators trained in core skills required in clinical research. METHODS: In July 2004, a 37-item Web-based survey was distributed to institutions funded by the NIH K30 award mechanism. Frequencies and proportions were computed for each categorical response, and means were calculated for nominal responses using SPSS, version 11.5 (SPSS, Chicago, IL). Items 7 (funding year) and 8 (recruitment year) were cross-tabulated to ascertain the tempo at which programs were able to establish their enrolment processes. RESULTS: Forty-five of the 59 programs funded by the K30 award (76%) responded to this survey. The average number of active trainees in each program is 32. Women constitute 53% of active trainees, and 22% of them are underrepresented minorities. Ninety-six percent of active trainees have medical degrees. The average number of graduates over the 5-year funding period is 18. Of the graduates, 50% are women and 17% are underrepresented minorities. Fifty-six percent of them earned certificates, 44% earned master of science degrees, and 13% earned other degrees. Sixty-one percent of K30 program graduates have some extramural funding to support their research. The average number of publications per trainee for all trainees (active and graduate) is 2.3. CONCLUSION: The K30 program has been a catalyst at multiple US institutions for improving the pedagogy for clinical research training. It has successfully fulfilled the mandate set forth by the 1998 NIH Director's Panel on Clinical Research (Nathan Report).

Biomedical Research↗

PubMed2004

An academic writing needs assessment of English-as-a-second-language clinical investigators.

INTRODUCTION: Academic writing for publication is competitive and demanding for researchers. For the novice English-as-a-second-language (ESL) researcher, the pressure to publish compounds the difficulties of mastering the English language. Very few studies have used ESL graduate and post-graduate students as academic writing research subjects. The purpose of this project was to assess the learning needs of ESL clinical investigators regarding academic writing for English scholarly publication. METHOD: A qualitative evaluation approach was used to examine the gap between the current and desired proficiency level for the academic writing of ESL clinical investigators. We considered the perspectives of seven ESL clinical investigators plus three mentors and three writing instructors. Semi-structured questions were asked. Field notes were organized using a field-work recording system. They were analyzed using the constant comparative method. RESULTS: ESL clinical investigators do not accurately perceive their writing deficiencies. They have little knowledge of criteria for academic writing and they are influenced by their prior English learning experiences in their home culture, which engender passive attitudes toward seeking appropriate writing resources. Adequate time is especially needed to develop successful writing skills. DISCUSSION: Four basic steps are recommended to guide program planners in developing ESL writing activities for professional learning: (1) recognize discrepancies, (2) establish clear standards and performance criteria for scholarly writing, (3) develop individual plans, and (4) organize long-term writing assistance.

Education, Medical, Continuing↗

PubMed2003

Gender differences among physician-scientists in self-assessed abilities to perform clinical research.

PURPOSE: To examine gender differences in physicians' self-assessed abilities to apply knowledge and skills in six core competencies for success as a clinical investigator. METHOD: A written questionnaire containing 35 learning objectives was administered to physicians involved in a clinical-research training program at the University of Wisconsin-Madison. Between 2000 and 2002, 57 postgraduate trainees (49% women) completed the questionnaire; 40 of the 57 completed the questionnaire a second time after a four-day intensive workshop in clinical research. The main outcome measure was gender differences in ratings for each question answered. RESULTS: Before the workshop, women physicians rated their abilities lower than men rated their own abilities on 22 of 35 learning objectives and women were significantly lower in rating their ability to spend sufficient time developing and advancing their own area of scientific knowledge and research. After the workshop, women rated themselves lower than men rated themselves on 33 of 35 objectives, with significant differences in seven. Women did not rate themselves significantly higher than men rated themselves on any of the 35 objectives assessed. CONCLUSION: Women physicians consistently rated their abilities to perform or apply knowledge and skills related to clinical research lower than men rated themselves, and a traditional training venue exacerbated these gender differences. This previously unexplored gender difference in self-perceived competency may indicate an additional barrier women face in academic career development and suggests that educational programs incorporate learning activities that address gender differences when training physicians for careers in clinical research.

Biomedical Research↗

PubMed2002

Role of experience and context in learning to diagnose Lyme disease.

INTRODUCTION: A recent review of research in continuing medical education suggests that scholarship should be integrated with practice so that practical problems can be addressed with theoretically derived yet applicable solutions. This project develops a theory describing how physicians learn and formulate decisions in the context of diagnosing Lyme disease in order that educational programs can be designed to improve accuracy in diagnosis of this disease. METHODS: A qualitative study using grounded theory methodology was performed to explore the learning process of physicians when diagnosing Lyme disease. Nine physicians were interviewed, and the interview transcripts were coded into categories to form a theory about how physicians learn in practice. RESULTS: Patient-physician interactions initiate the learning process by setting a context for which physicians frame a problem according to familiarity. Repetitive, similar, and counter-experiences, combined with cognitive knowledge, contribute to that framework and influence how the problem is framed along a continuum of familiarity. Furthermore, these experiences serve as information that influences diagnostic decisions and physicians' behaviors. DISCUSSION: For teaching and learning, cases and examples should include sufficient variety, repetition, and counterexperiences that allow a physician to appropriately recognize and categorize a patient's signs and symptoms into a disease category. Resources for information should be readily available and current. Preceptors and physician colleagues should provide timely feedback on diagnostic accuracy, and case studies should be presented with contextual elements that facilitate the diagnosis of Lyme disease.

Clinical Competence↗

PubMed2002

An evaluation plan to assess the process and outcomes of a learner-centered training program for clinical research.

In 1994, the National Center for Research Resources' Committee on Addressing Career Paths for Clinical Research reported that insufficient training in research methods, inadequate mentoring, and inappropriate timing of training presented major barriers to the development of clinical researchers. The National Institutes of Health responded to the need for additional training programs by supporting 57 institutions through the Clinical Research Curriculum Award (K30) Program. The ability to assess the success of these programs depends on the nature and extent of their evaluation plans. Evaluation plans for clinical research training programs should include means of assessing both process and outcomes of a program's implementation in its formative and summative stages. This article describes the University of Wisconsin-Madison's Clinical Investigator Preparatory Program and an evaluation plan that incorporates process and outcome assessments based on a theoretical framework of adult and professional education.

Adult↗