Biomedical subjects

Marcy E Rosenbaum

Publications and source records attributed to Marcy E Rosenbaum.

11 recordsLinked to original sources

PubMed2006

Using patient-generated cases to teach students skills in responding to patients' emotions.

Responding to patients' emotions has been identified as a core skill in medical interviewing. To give medical students realistic practice in responding to patients' emotions, an exercise was initiated in which simulated patient (SP) cases were developed in collaboration with SPs. Small groups were visited by two SPs, who portray emotional scenarios based on symptoms for which they had previously sought a doctor's care or considered seeking care. SPs also identified circumstances that would provoke emotional reactions for their case. Students and facilitators rated this activity highly. Benefits included more realistic case portrayals, less training time for SPs and more efficient use of SPs.

Education, Medical, Undergraduate↗

PubMed2006

Increasing departmental and college-wide faculty development opportunities through a teaching scholars program.

The University of Iowa Teaching Scholars Program was initiated in 1999 at the University of Iowa Carver College of Medicine (CCOM) with the overall goal of promoting leadership in faculty development related to teaching skills. Specific goals of this program are (1) to promote the development of a cadre of faculty members who have the skills to implement faculty development within their departments and the CCOM; (2) to increase departmental involvement in faculty development efforts; (3) to increase resources available for dissemination of college-wide faculty development efforts; and (4) to acknowledge the extra effort faculty put into developing their skills and knowledge in medical education and in providing continuing education to their faculty colleagues. All clinical and basic science departments in the CCOM are given the opportunity to have a faculty member participate in the program. Unlike other programs reported in the literature, competitive decisions for program participation are made at the departmental level. The three-year program combines monthly meetings and other activities to train faculty to provide faculty development in teaching skills. Each scholar develops and implements a project to address departmental faculty development needs as well as needs of other departments in the CCOM. To date (2006), 50 faculty members from 19 different departments have participated in the program with an average of 12 scholars per class. The program has resulted in a substantial increase in departmental and college-wide faculty development programming and has had a positive impact on individual scholars' teaching skills and leadership roles.

Curriculum↗

PubMed2005

Using reflection activities to enhance teaching about end-of-life care.

BACKGROUND: While reflection on experiences and attitudes related to death can be an important component of learning to care for the dying, opportunities within the medical school curriculum to promote learner reflection are often limited. OBJECTIVE: To describe implementation and evaluation of activities in an end-of-life curriculum to promote self-reflection and student concerns and thoughts revealed through reflection exercises. DESIGN: Within a lecture-based course on end-of-life care, second-year medical students participated in four activities to promote self-reflection, including: (1) visualizing their own deaths; (2) documenting their experiences with death; (3) writing essays reacting to course content; and (4) participating in physician-led small group sessions. MEASUREMENTS: Student reaction essays and small group evaluations. RESULTS: Qualitative analysis of student reaction essays (2002-2004; total, n = 522) revealed nine major themes in student concerns and thoughts related to caring for the dying. These included: (1) expressing emotions; (2) personal grief and emotional detachment; (3) communicating effectively; (4) spending enough time; (5) feeling ill-prepared to deal with death; (6) losing a loved one; (7) shifting emphasis from curing to caring; (8) listening to patients and respecting their decisions and (9) previous negative end-of-life experiences. Analysis of essays and evaluations assessed the impact of the various reflection activities and demonstrated that these activities allowed students to critically examine and discuss their experiences and concerns regarding providing end-of-life care. CONCLUSIONS: A variety of activities can be incorporated successfully into a largely didactic curriculum to promote student reflection on their attitudes and concerns related to end-of-life care, thereby laying an important foundation for their future practice in caring for the dying. In addition, analysis of student reflection essays can serve as an important curriculum evaluation tool.

Curriculum↗

PubMed2005

In their own words: presenting the patient's perspective using research-based theatre.

INTRODUCTION: In this paper we describe the development of a performance piece based on patients' stories of interacting with health care providers, its introduction into the curriculum to dramatise the patient's perspective on health care, and the evaluation of student responses. METHODS: The piece, entitled In Their Own Words, was created from transcripts of interviews with authors who wrote about their experiences of illness. Over the past 4 years, students have performed the piece as a dramatic reading as part of a required course for Year 1 medical students. RESULTS: Analysis of the students' written reflections identified 5 major themes describing what students learned from the performance piece. These themes were: illness evokes emotions and providers must address both the physical and emotional needs of their patients; patients want health care providers to listen well and to understand patients' perspectives; providers' words and gestures profoundly affect patients; patients do not want to be defined, identified or treated as only their symptoms or illnesses, and information and conditions that clinicians consider routine can be very distressing for patients. DISCUSSION: These themes identified in the students' comments represent critical concepts that health care providers must understand so that they can build therapeutic relationships with their patients. Thus, In Their Own Words is an effective tool for increasing students' awareness of patients' experiences of illness, which is a key aspect of learning to provide effective patient-centred care. Presenting patients' stories through dramatic readings represents an innovative approach to incorporating the patient's perspective into medical education.

Communication↗

PubMed2005

Outcomes of a teaching scholars program to promote leadership in faculty development.

BACKGROUND: Provision of adequate opportunities for faculty to receive training in teaching skills requires persons with faculty development expertise to provide this training. PURPOSE: In this study, we examined outcomes of a teaching scholars program (TSP) aimed at promoting leaders in faculty development in teaching skills in individual departments and throughout the institution. METHOD: A 3-year TSP, established in 1999, combines monthly meetings and other activities to train faculty representing departments throughout the College of Medicine to provide faculty development in teaching skills. Analysis of program participants' curriculum vitae was conducted to compare preprogram and postprogram faculty development activities. RESULTS: There was substantial increase in program participants' facilitation of teaching skills workshops and development of teaching improvement systems within their home departments. Participants also facilitated an increased number of college-wide workshops. Secondary outcomes included increases in educational leadership positions and education-related presentations and publications. CONCLUSION: The TSP is a successful local model for increasing the resources available for teaching improvement.

Curriculum↗

PubMed2005

Using a peer evaluation system to assess faculty performance and competence.

BACKGROUND AND OBJECTIVES: Identification of reliable methods to evaluate the newly mandated American Board of Medical Specialties (ABMS)/Accreditation Council for Graduate Medical Education (ACGME) competencies of the board-certified physician is in its early stages. In this study, we evaluated a comprehensive faculty peer evaluation system designed to assess the six competencies as well as faculty performance in their primary departmental roles and teaching. METHODS: Using a one-page form containing 19 items, all faculty members evaluated all other faculty within a single department. Annual individual faculty reviews included discussion of these aggregated evaluations. RESULTS: The reliabilities for the ACGME competency subscales ranged from .61 to .79. While overall scores were relatively high, there was variability across faculty. Factor analysis demonstrated that evaluation items load onto three scales. The first relates to clinical practice and teaching, the second to departmental citizenship, and the third to research. An item related to systems-based practice loaded on none of the factors. Research faculty outscored other faculty on the items reflecting research skills. Faculty who had primary administrative responsibility scored higher than other faculty on measures related to role within the department. No differences in subgroup scores for clinical skills were observed. CONCLUSIONS: Using a method in which all faculty evaluate each other can result in objective, reliable measures of faculty performance.

Accreditation↗

PubMed2004

Answering physicians' clinical questions: obstacles and potential solutions.

OBJECTIVE: To identify the most frequent obstacles preventing physicians from answering their patient-care questions and the most requested improvements to clinical information resources. DESIGN: Qualitative analysis of questions asked by 48 randomly selected generalist physicians during ambulatory care. MEASUREMENTS: Frequency of reported obstacles to answering patient-care questions and recommendations from physicians for improving clinical information resources. RESULTS: The physicians asked 1,062 questions but pursued answers to only 585 (55%). The most commonly reported obstacle to the pursuit of an answer was the physician's doubt that an answer existed (52 questions, 11%). Among pursued questions, the most common obstacle was the failure of the selected resource to provide an answer (153 questions, 26%). During audiotaped interviews, physicians made 80 recommendations for improving clinical information resources. For example, they requested comprehensive resources that answer questions likely to occur in practice with emphasis on treatment and bottom-line advice. They asked for help in locating information quickly by using lists, tables, bolded subheadings, and algorithms and by avoiding lengthy, uninterrupted prose. CONCLUSION: Physicians do not seek answers to many of their questions, often suspecting a lack of usable information. When they do seek answers, they often cannot find the information they need. Clinical resource developers could use the recommendations made by practicing physicians to provide resources that are more useful for answering clinical questions.

Adult↗

PubMed2004

Teaching medical students and residents skills for delivering bad news: a review of strategies.

Although delivering bad news is something that occurs daily in most medical practices, the majority of clinicians have not received formal training in this essential and important communication task. A variety of models are currently being used in medical education to teach skills for delivering bad news. The goals of this article are (1) to describe these available models, including their advantages and disadvantages and evaluations of their effectiveness; and (2) to serve as a guide to medical educators who are initiating or refining curriculum for medical students and residents. Based on a review of the literature and the authors' own experiences, they conclude that curricular efforts to teach these skills should include multiple sessions and opportunities for demonstration, reflection, discussion, practice, and feedback.

Education, Medical↗

PubMed2002

Teaching delivery of bad news using experiential sessions with standardized patients.

BACKGROUND: Delivering bad news is a difficult task that is important to address in medical education. PURPOSE: This study evaluated the impact of an experiential educational intervention using multiple standardized patient scenarios on medical students' comfort with delivering difficult news. METHODS: In small groups, 3rd-year medical students practiced communicating bad news within the context of five different patient scenarios. During 1999 and 2000, surveys were administered to 341 students before and 4 weeks and 1 year after the program. Students rated comfort level in discussing bad news, terminal illness, hospice, and dying with patients. RESULTS: A significant one standard deviation change was observed in students' self-reported comfort in communicating bad news after the educational program. The intervention was highly rated, especially the encounters with standardized patients and observation of others. CONCLUSIONS: Experiential education using multiple standardized patient scenarios is a successful model for increasing student comfort in responding to difficult clinical communication tasks.

Communication↗

PubMedDate not supplied

Academic physicians and complementary and alternative medicine: an institutional survey.

In order to assess attitudes, awareness, and behavior related to complementary and alternative medicine (CAM) among academic physicians, a questionnaire study was conducted with faculty in one of the largest teaching hospitals in the United States. The survey assessed attitudes toward and awareness of 11 CAM therapies in regard to patient usage and usefulness. The majority of respondents believed that only 20% or less of their patients used CAM. Respondents varied widely on level of knowledge/awareness of specific CAM therapies. Those who were more knowledgeable were more likely to perceive CAM as useful and to have recommended more therapies. The modalities respondents noted as knowing the least about were deemed the least useful. Limited knowledge of most CAM therapies and limited awareness of patient CAM use points to the need for continuing education efforts for physicians, focusing on CAM.

Adult↗

PubMedDate not supplied

Empirically identified goals for the management of unexplained symptoms.

BACKGROUND AND OBJECTIVES: Effective management of patients with medically unexplained symptoms may be influenced by physicians' goals. This study's objective was to identify physicians' goals for managing primary care patients with unexplained symptoms. METHODS: This was a qualitative study of patients and clinicians from primary care clinics in Iowa and Illinois. Interviews were conducted with 47 patients who had unexplained symptoms and the 36 primary care clinicians who managed them. The interviews were transcribed and coded independently by two investigators. Categories for coding responses were derived from the data and the literature. RESULTS: Eleven goals were identified and grouped into four classes based on whether they were disease centered, patient centered, society centered, or clinician centered. The three goals most commonly held by patients were patient centered: clinician support (62%), functional improvement (45%), and patient coping (43%). The most common clinician goals were symptom alleviation (38%), patient coping (32%), and functional improvement (30%). Only one clinician (2%) cited making the patient feel supported as a goal. CONCLUSIONS: The goals of clinician support and patient coping appear to have value to patients beyond being means for achieving symptom alleviation. Although receiving physician support is an important goal for patients, it was not a commonly recognized goal by physicians. Clearly identified management goals may improve the care of patients with medically unexplained symptoms and help clinicians achieve greater satisfaction with the management of these patients.

Adaptation, Psychological↗