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Biomedical subjects

Mark R Bagg

Publications and source records attributed to Mark R Bagg.

4 recordsLinked to original sources

Levels of medical care in the global war on terrorism.

Trauma care for military personnel injured in Iraq has become increasingly sophisticated. There are five levels, or echelons, of care, each progressively more advanced. Level I care provides immediate first aid at the front line. Level II care consists of surgical resuscitation provided by highly mobile forward surgical teams that directly support combatant units in the field. Level III care is provided through combat support hospitals--large facilities that take time to become fully operational but offer much more advanced medical, surgical, and trauma care, similar to a civilian trauma center. Level IV care is the first echelon at which definitive surgical management is provided outside the combat zone. Level V care is the final stage of evacuation to one of the major military centers in the United States, where definitive stabilization, reconstruction, or amputation of the injured extremity is performed.

Delivery of Health Care↗

Measuring medical education and curriculum during orthopedic surgical residency.

BACKGROUND: Evaluating residency programs requires objective assessment tools, but few are readily available. The purpose of this study was to measure education by correlating resident test scores with several measurements of educator performance. MATERIALS AND METHODS: The study group included residents and educators from a single residency program. We performed a retrospective analysis of scores from the Orthopaedic In-Training Examination collected during a 6-year period. Resident examination scores were indexed by dividing program averages by national averages to determine yearly score trends and then were correlated with educator attendance and teaching hours. Subspecialty scores were ranked to gauge residency strengths and weaknesses. Teaching hours devoted to subspecialties were compared with test scores to measure curricular emphases and to appraise teaching efficiency. RESULTS: Yearly average examination scores were proportional to national averages (P < 0.001). However, of 3436 possible educator-score associations, only 15 scores correlated highly (r > 0.9) with educators, and only 26 were significant (P < 0.05). Trend analysis put subspecialty scores in yearly perspective. Ranking was inaccurate until scores were indexed to the national average. In 2002, the distribution of 238 teaching hours ranged from 4 to 48 h for subspecialties, and 9 of 12 subspecialties were emphasized disproportionately to the examination. Teaching efficiency varied more than 10-fold by subspecialty. CONCLUSIONS: The creation of a score index helped to identify and address imbalances between teaching hours devoted to subspecialties and resident needs as evidenced by low In-Training examination scores. The present study improved educator accountability by correlating measurements of teaching and learning.

Curriculum↗