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Biomedical subjects

Rachel B Levine

Publications and source records attributed to Rachel B Levine.

8 recordsLinked to original sources
PubMed2005

Costs and funding for published medical education research.

CONTEXT: The Institute of Medicine has called for increased rigor of education research and funding to support educational innovation. However, funding for medical education research is scarce. The costs of conducting studies in medical education and how such research is currently funded have not been systematically evaluated. OBJECTIVES: To determine how medical education research studies that were recently published were funded and to approximate the costs of conducting these studies. DESIGN, SETTING, AND PARTICIPANTS: We conducted a cross-sectional survey of first authors of medical education studies published from September 1, 2002, to December 31, 2003. Original medical education research studies conducted at US institutions and published in 13 prominent peer-reviewed journals were included. MAIN OUTCOME MEASURES: For each study we measured duration, percentage of the authors' total work commitment ("percentage effort") devoted to the study, resources used and their costs, attainment of funding, and the first author's estimated cost of conducting the study. The cost of each study was calculated by multiplying the percentage effort of each author for the duration of the study by the national median salary for each author, according to specialty and academic rank, and then adding the costs of resources used. RESULTS: Responses were received from authors of 243 (84%) of 290 identified medical education studies. The median calculated cost of conducting the 243 studies was 24,471 dollars (interquartile range [IQR], 11,531 dollars-63 808 dollars). The median authors' estimate of study cost was 10,000 dollars (IQR, 4000 dollars-25 000 dollars). Some funding was obtained for 72 (29.6%) of the studies. Of studies that were funded, the median amount of funding was 15,000 dollars (IQR, 5000 dollars-66,500 dollars). The median calculated cost of funded studies was 37,315 dollars (IQR, 18,731 dollars-82,393 dollars). Private foundation grants were the most common funding source (n = 30 [41.7%]). Factors independently associated with attaining funding were training in grant writing (odds ratio, 2.05; 95% confidence interval, 1.11-3.79) and number of medical education studies published by the first author (odds ratio, 2.4; 95% confidence interval, 1.24-4.63). CONCLUSIONS: The majority of published medical education research is not formally funded, and the studies that do receive support are substantially underfunded. To realize the Institute of Medicine's directive and to improve the quality of medical research, policy reform that increases funding for medical education scholarship will likely be required.

Costs and Cost Analysis↗
PubMed2005

Completing a scholarly project during residency training. Perspectives of residents who have been successful.

BACKGROUND: Resident research has potential benefits and scholarly activity is an internal medicine residency training requirement. This study sought to learn about the resources needed and the barriers to performing scholarly work during residency from residents who had been successful. METHODS: A questionnaire was delivered to 138 internal medicine residents presenting their work at the 2002 American College of Physicians-American Society of Internal Medicine annual session. Residents were asked to comment on why they had participated in a scholarly project, the skills and resources needed to complete the project, as well as the barriers. Comparisons were made between residents who presented a research abstract and those who exhibited a clinical vignette. RESULTS: Seventy-three residents (53%) completed the questionnaire. Thirty-nine residents presented a clinical vignette and 34 displayed a research abstract. Residents participated in research for a variety of reasons, including intellectual curiosity (73%), career development (60%), and to fulfill a mandatory scholarly activity requirement at their residency program (32%). The most common barriers were insufficient time (79%), inadequate research skills (45%), and lack of a research curriculum (44%). Residents who had presented research abstracts devoted more time (median, 200 vs 50 hours; P<.05) to their project than those who exhibited clinical vignettes. Sixty-nine percent of residents thought research should be a residency requirement. CONCLUSIONS: The majority of respondents reported that their scholarly project was a worthwhile experience despite considerable barriers. Teaching research skills more explicitly with a focused curriculum and providing adequate protected time may enable residents to be successful.

Biomedical Research↗
PubMed2005

Resident research and scholarly activity in internal medicine residency training programs.

OBJECTIVES: 1) To describe how internal medicine residency programs fulfill the Accreditation Council for Graduate Medical Education (ACGME) scholarly activity training requirement including the current context of resident scholarly work, and 2) to compare findings between university and nonuniversity programs. DESIGN: Cross-sectional mailed survey. SETTING: ACGME-accredited internal medicine residency programs. PARTICIPANTS: Internal medicine residency program directors. MEASUREMENTS: Data were collected on 1) interpretation of the scholarly activity requirement, 2) support for resident scholarship, 3) scholarly activities of residents, 4) attitudes toward resident research, and 5) program characteristics. University and nonuniversity programs were compared. MAIN RESULTS: The response rate was 78%. Most residents completed a topic review with presentation (median, 100%) to fulfill the requirement. Residents at nonuniversity programs were more likely to complete case reports (median, 40% vs 25%; P=.04) and present at local or regional meetings (median, 25% vs 20%; P=.01), and were just as likely to conduct hypothesis-driven research (median, 20% vs 20%; P=.75) and present nationally (median, 10% vs 5%; P=.10) as residents at university programs. Nonuniversity programs were more likely to report lack of faculty mentors (61% vs 31%; P<.001) and resident interest (55% vs 40%; P=.01) as major barriers to resident scholarship. Programs support resident scholarship through research curricula (47%), funding (46%), and protected time (32%). CONCLUSIONS: Internal medicine residents complete a variety of projects to fulfill the scholarly activity requirement. Nonuniversity programs are doing as much as university programs in meeting the requirement and supporting resident scholarship despite reporting significant barriers.

Adult↗
PubMed2005

Factors associated with citation of internal medicine residency programs for lack of scholarly activity.

BACKGROUND: The Accreditation Council for Graduate Medical Education requires that residents demonstrate scholarly activity prior to completion of training. PURPOSE: To determine which factors are associated with program citation for failure to comply with the Residency Review Committee (RRC) scholarly activity requirement for internal medicine residencies. METHODS: All 391 internal medicine residency program directors were surveyed in March 2002. Data were collected on program characteristics and factors (research curriculum, research director, faculty mentors, protected time for research, funding, and presence of a mandatory research requirement) that have been associated with successful resident research. Multiple logistic regression analysis identified factors associated with citation. RESULTS: The response rate was 78%. Ten percent of respondents report having been cited for lack of demonstration of scholarly activity. Factors that reduced the odds of citation were being a university-based program, odds ratio (OR) 0.13, 95% confidence interval (CI) 0.03-0.54, p = .005; having a greater number of residents, OR 0.95, 95% CI 0.93-0.98, p = .001; and having funding to support resident scholarship, OR 0.39, 95% CI 0.17-0.91, p = .03. Using multiple logistic regression analysis, having designated funding for resident scholarship was the only factor independently associated with a decreased odds of citation, OR 0.27, 95% CI 0.10-0.72, p = .009. CONCLUSIONS: To improve compliance with the RRC requirement for scholarly activity and avoid citation, residency programs may wish to consider devoting more resources, particularly money, to support resident scholarly activity.

Accreditation↗
PubMed2004

Teaching the teachers: national survey of faculty development in departments of medicine of U.S. teaching hospitals.

OBJECTIVE: To determine the prevalence, topics, methods, and intensity of ongoing faculty development (FD) in teaching skills. DESIGN: Mailed survey. PARTICIPANTS: Two hundred and seventy-seven of the 386 (72%) U.S. teaching hospitals with internal medicine residency programs. MEASUREMENTS: Prevalence and characteristics of ongoing FD. RESULTS: One hundred and eight teaching hospitals (39%) reported ongoing FD. Hospitals with a primary medical school affiliation (university hospitals) were more likely to have ongoing FD than non-university hospitals. For non-university hospitals, funding from the Health Resources Services Administration and >50 house staff were associated with ongoing FD. For university hospitals, >100 department of medicine faculty was associated. Ongoing programs included a mean of 10.4 topics (standard deviation, 5.4). Most offered half-day workshops (80%), but 22% offered > or =1-month programs. Evaluations were predominantly limited to postcourse evaluations forms. Only 14% of the hospitals with ongoing FD (5% of all hospitals) had "advanced" programs, defined as offering > or =10 topics, lasting >2 days, and using > or =3 experiential teaching methods. These were significantly more likely to be university hospitals and to offer salary support and/or protected time to their FD instructors. Generalists and hospital-based faculty were more likely to receive training than subspecialist and community-based faculty. Factors facilitating participation in FD activities were supervisor attitudes, FD expertise, and institutional culture. CONCLUSIONS: A minority of U.S. teaching hospitals offer ongoing faculty development in teaching skills. Continued progress will likely require increased institutional commitment, improved evaluations, and adequate resources, particularly FD instructors and funding.

Data Collection↗
PubMed2004

Outcomes of a national faculty development program in teaching skills: prospective follow-up of 110 medicine faculty development teams.

BACKGROUND: Awareness of the need for ambulatory care teaching skills training for clinician-educators is increasing. A recent Health Resources and Services Administration (HRSA)-funded national initiative trained 110 teams from U.S. teaching hospitals to implement local faculty development (FD) in teaching skills. OBJECTIVE: To assess the rate of successful implementation of local FD initiatives by these teams. METHODS: A prospective observational study followed the 110 teams for up to 24 months. Self-reported implementation, our outcome, was defined as the time from the training conference until the team reported that implementation of their FD project was completely accomplished. Factors associated with success were assessed using Kaplan-Meier analysis. RESULTS: The median follow-up was 18 months. Fifty-nine of the teams (54%) implemented their local FD project and subsequently trained over 1,400 faculty, of whom over 500 were community based. Teams that implemented their FD projects were more likely than those that did not to have the following attributes: met more frequently (P=.001), had less turnover (P=.01), had protected time (P=.01), rated their likelihood of success high (P=.03), had some project or institutional funding for FD (P=.03), and came from institutions with more than 75 department of medicine faculty (P=.03). The cost to the HRSA was $22,033 per successful team and $533 per faculty member trained. CONCLUSIONS: This national initiative was able to disseminate teaching skills training to large numbers of faculty at modest cost. Smaller teaching hospitals may have limited success without additional support or targeted funding.

Education, Medical, Continuing↗
PubMed2003

A systematic review of resident research curricula.

PURPOSE: To review in a systematic manner the published curricula for training house officers in research. METHOD: Articles were identified by searching the Medline, Educational Resources Information Center, and Science Citation Index databases, educational Web sites, and bibliographies of captured articles, and by contacting experts who had developed resident research curricula. Demographic information, curriculum development steps, educational strategies, evaluation methods, and outcomes were abstracted. RESULTS: The search identified 41 articles describing curricula. The most common curricular objectives were to increase house officers' research productivity and improve their critical appraisal skills. Only one curriculum was designed with the goal of producing academic physicians. Among many instructional methods, conducting research projects, exposing learners to role models or mentors, and providing house officers with multiple opportunities to present their work were common. Only 27 articles (66%) articulated goals or objectives, and 11 included (27%) needs assessments. Evaluation methods were often rudimentary, frequently limited to learners' self-assessments or authors' anecdotal reports. Five (12%) reported pre-post-intervention testing of learners' knowledge. No curricula were evaluated as prospective pretest-posttest controlled trials. A minority of articles reported costs, obstacles encountered, or modifications made in the curriculum. CONCLUSION: Successful educational interventions should incorporate needs assessments, clearly defined learning objectives, and evaluation methods. While many curricula for resident research exist, the lack of detailed developmental information and meaningful evaluations hinders educators interested in adopting these curricula.

Attitude of Health Personnel↗