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Biomedical subjects

Richard J Olson

Publications and source records attributed to Richard J Olson.

6 recordsLinked to original sources

Structured journal club as a tool to teach and assess resident competence in practice-based learning and improvement.

PURPOSE: To describe the use of the journal club as a tool to teach and assess competency in practice-based learning (PBL) and improvement among residents in ophthalmology. DESIGN: Interventional case series. PARTICIPANTS: Ophthalmology residents. SETTING: Three academic ophthalmology residency programs in the United States. METHODS: A survey was performed of self-assessed skills in PBL among residents in ophthalmology training before and after the implementation of a structured review checklist during a traditional resident journal club. The survey had 5 domains, including (A) appraise and assimilate evidence, (B) read a journal article critically, (C) use a systematic and standardized checklist, (D) apply knowledge of study designs and statistical methods, and (E) maintain a self-documented written record of compliance. The respondents scored their ability (range, 1-5). RESULTS: The use of a structured journal club tool was associated with a statistically significant improvement in self-assessed ability in all 5 domains. CONCLUSIONS: Although validity, reliability, and long-term efficacy studies are necessary, the structured journal club is one method of teaching and assessing resident competency in PBL and improvement.

Clinical Competence↗

Long-term outcome of pediatric aphakic glaucoma.

PURPOSE: To determine the long-term outcome in pediatric patients with aphakic glaucoma. METHODS: A retrospective analysis of 130 patients diagnosed with aphakic glaucoma between 1969 and 2004 was performed. A total of 36 patients (55 eyes) were included in this study after excluding those who had cataract extraction after age 10 and those patients with other ocular conditions, systemic syndromes, traumatic cataracts, congenital glaucoma, or inadequate follow-up (less than 1 year). Outcome variables studied included visual acuity, number of medication changes required over the course of the follow-up, maximum number of medications used at a time for more than 6 months to control intraocular pressures, and surgical interventions required. Mean follow-up period was 18.7 years (range, 6.9-35 years). RESULTS: At the time of last follow-up, 54.5% of the patients had visual acuity 20/40 or better, 34.5% had 20/50 to 20/200, and 11% had acuity worse than 20/200. During the course of follow-up, 34% required 1 to 2 medication changes for controlling glaucoma, 33% required 3 to 5 medication changes, and 33% required 6 or more medication changes. Thirty-six percent of the eyes required a maximum of 1 to 2 medications for more than 6 months during the course of follow-up, 33% required 3, and 31% required 4 or more medications for controlling intraocular pressure. Of the 55 eyes, 15 eyes (27%) required surgical intervention. Six of the 15 eyes (40%) required 1 surgery, 8 eyes (53%) required 2 to 3 surgeries, and 1 eye (7%) required 4 to 6 surgeries. CONCLUSION: Patients with glaucoma after pediatric cataract surgery can have a good visual outcome although multiple medications and surgical interventions may be required to control the glaucoma.

Adolescent↗

User-centered development of a Web-based preschool vision screening tool.

Although amblyopia is most successfully treated when detected in early childhood, many preschool-aged children are not being screened. This project explored the delivery of Web-based vision screenings, integrated with patient education, to parents and children, aged 3 to 6 years. Through a user-centered design methodology involving requirements gathering, iterative prototype development, and usability testing, a highly usable screening Website was created. Interviewing and testing parents and children in the home were essential in gathering accurate data about environments where the tool would actually be used. Frequent iterations of designing, testing, and modifying the tool were useful in identifying and correcting usability problems. Usability goals were set early in the project, and in the final phase a satisfaction questionnaire was administered to participants. Twenty-one out of 22 final usability objectives were achieved and the feasibility of Web-based vision screening was demonstrated.

Amblyopia↗

Using the Journal Club to teach and assess competence in practice-based learning and improvement: a literature review and recommendation for implementation.

The traditional journal club has historically been used to teach residents about critically reading and reviewing the literature in order to improve patient care. The Accreditation Council for Graduate Medical Education competencies mandate requires that ophthalmology residency programs both teach and assess practice-based learning and improvement. A systematically conducted review of the literature regarding the use of the journal club in resident medical education was performed to define specific recommendations for implementation of a journal club tool. Selected best practices for a successful journal club were gleaned from the existing medical literature. These include the following: 1) the use of a structured review checklist, 2) explicit written learning objectives, and 3) a formalized meeting structure and process. The journal club might prove to be an excellent tool for the assessment of competencies like practice-based learning which may be difficult to assess by other means. Future study is necessary to determine if journal club can improve educational outcomes and promote lifelong competence in practice-based learning.

Clinical Competence↗