Biomedical subjects

Marianna B Shershneva

Publications and source records attributed to Marianna B Shershneva.

5 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↗

PubMed2005

Education through telemedicine networks: setting quality standards.

Quality standards for educational programming have received limited attention in telemedicine. We selected five sets of standards from the distance education literature established by: (1) the American Council on Education; (2) the American Distance Education Consortium; (3) the Council of Regional Accrediting Commissions; (4) the Distance Education and Training Council; (5) the Innovations in Distance Education Project. The standards were reviewed to determine the purposes they were intended to serve and the process by which they were established. The content of the five sets of standards were summarized around the 'four commonplaces' of education: learner, teacher, curriculum and context. Four major findings emerged. First, none of the sets of standards addresses all of the issues that are potentially relevant to telemedicine education; all emphasize certain topics while neglecting others. Second, there are some important aspects of telemedicine that are not addressed at all, such as patient confidentiality. Third, the standards generally provide a framework for defining high quality in distance education, leaving to those at the local level the task of deciding how a standard applies in their setting. Finally, the standards reviewed have many elements that could potentially apply to telemedicine education. Setting quality standards for education through telemedicine requires a systematic approach and a means for continuous improvement of those standards.

Education, Distance↗

PubMed2005

Learning to use learning resources during medical school and residency.

OBJECTIVES: This study (1) examined the natural history of learning to use learning resources by medical students and residents and (2) considered whether that history is consistent with the ways in which physicians approach their learning tasks. METHODS: The authors conducted and analyzed thirty-two open-ended interviews of first-year and third-year medical students and first-year and senior residents in internal medicine, family medicine, or pediatrics. RESULTS AND DISCUSSION: Learning to use learning resources occurs at the same time as learning done to address instructional and clinical problems that physicians-in-training face, with all kinds of learning following well-documented stages. Skills for using resources are developed gradually and by overcoming barriers such as time constraints and existing habits. CONCLUSIONS: Implications of the natural history of learning to use learning resources can be employed by librarians and medical teachers to facilitate self-directed learning for physicians-in-training. Specific recommendations are provided.

Adult↗

PubMed2004

Setting quality standards for web-based continuing medical education.

Continuing medical education (CME) on the Internet has grown steadily over the past several years. However, the quality of Web-based CME has received limited attention in the medical literature, and there have been few attempts to articulate quality standards. This article describes five sets of standards published in the distance education literature and explores whether the standards might be used to inform and enhance approaches to designing and delivering Web-based CME programs. Standards synthesize practical knowledge, best practices, and research findings. They vary in their perspectives on quality, fall short of being comprehensive, and convey many elements that apply to Web CME. We conclude that published standards in the distance education literature can provide valuable guidance to Web CME providers, and there is a clear need for additional research into questions about what works in Web-based education and why.

Education, Distance↗

PubMed2002

Use of theory to interpret elements of change.

Actions useful in reducing unacceptable variation in physicians' clinical activities have been identified through critical reviews of randomized controlled trials, and, from them, Richard Grol proposed six elements of effective change for mounting programs to improve clinical practice. The elements include consideration of the complex reality of clinical practice, attention to the designated change, analysis of the target group and setting, mixed interventions to address needs, and a plan of action. Although empirically based, the elements lack a theoretical underpinning that explains why the elements work. This article interprets the elements using theories separately advanced by Dewey, Slotnick, and Wenger to suggest ways for understanding what studies have shown.

Attitude of Health Personnel↗