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Advances in Physiology Education Dec 2023This is a memoir of my experiences in learning and teaching Physiology. It begins in 1962 when I entered the University of Washington as a medical student and began...
This is a memoir of my experiences in learning and teaching Physiology. It begins in 1962 when I entered the University of Washington as a medical student and began research in a physiology laboratory, which led to a Ph.D. degree in Physiology and Biophysics to go with my M.D. degree in 1968. At this time, both groups of students participated in the same physiology course containing both lectures and laboratories. After postdoctoral research at the NIH and in Cambridge, UK, in 1973 I joined the faculty of the Department of Physiology, University of California, San Francisco where I participated in the teaching of medical students and graduate students for nearly 15 years. By this time, the teaching of medical and graduate students had largely separated. In 1987, I moved to the University of Michigan as Professor and Chair of Physiology where my role in teaching was organizational as well as participatory for the next 35 years. In this work, I compare the teaching of medical students as well as graduate students and focus on how it has changed over this 60-year period. Over this time both medical and graduate Ph.D. education have become more integrative. Medical education is now taught in organ blocks rather than courses, and I participated in organizing the teaching of the gastrointestinal block. At Michigan, there is no longer a separate medical school class in Physiology, and graduate students enter a combined, "Program in Biomedical Science" for a year before choosing a mentor and department. Teaching remains an important part of the career of academic physiologists. It is important for schools offering the Ph.D. to provide instruction and experience in teaching. The American Physiology Society has developed new programs to assist teachers and many universities have centers on learning and teaching.
Topics: Humans; Faculty; Education, Medical; Students, Medical; Education, Graduate; Mentors; Teaching; Physiology
PubMed: 37498551
DOI: 10.1152/advan.00094.2023 -
Seminars in Perinatology Nov 2023Simulation is a cornerstone of training in neonatal clinical care, allowing learners to practice skills in a safe and controlled environment. Competency-based assessment... (Review)
Review
Simulation is a cornerstone of training in neonatal clinical care, allowing learners to practice skills in a safe and controlled environment. Competency-based assessment provides a systematic approach to evaluating technical and behavioral skills observed in the simulation environment to ensure the learner is prepared to safely perform the skill in a clinical setting. Accurate assessment of competency requires the creation of tools with evidence of validity and reliability. There has been considerable work on the use of competency-based assessment in the field of neonatology. In this chapter, we review neonatal simulation-based training, examine competency-based assessment tools, explore methods to gather evidence of the validity and reliability, and review an evidence-based approach to competency-based assessment using simulation.
Topics: Infant, Newborn; Humans; Reproducibility of Results; Clinical Competence; Simulation Training; Neonatology; Computer Simulation
PubMed: 37748942
DOI: 10.1016/j.semperi.2023.151823 -
Health Literacy Research and Practice Oct 2023Suboptimal provider-parent communication contributes to poor parent comprehension of pediatric discharge instructions, which can lead to adverse outcomes. Residency is a...
OBJECTIVE
Suboptimal provider-parent communication contributes to poor parent comprehension of pediatric discharge instructions, which can lead to adverse outcomes. Residency is a critical window to acquire and learn to utilize key communication skills, potentially supported by formal training programs or visual reminders. Few studies have examined resident counseling practices or predictors of counseling quality. Our objectives were to (1) examine pediatric resident counseling practices and (2) determine how formal training and presence of discharge templates with domain-specific prompts are associated with counseling.
METHODS
We conducted a cross-sectional survey of a convenience sample of residents in the American Academy of Pediatrics Section on Pediatric Trainees. Outcomes included resident self-report of frequency of (1) counseling in domains of care and (2) use of health literacy-informed counseling strategies (pictures, demonstration, Teach Back, Show Back) (6-point scales; frequent = ). Predictor variables were (1) formal discharge-related training (e.g., lectures) and (2) hospital discharge instruction template with space for individual domains. Logistic regression analyses, utilizing generalized estimating equations when appropriate to account for multiple domains (adjusting for resident gender, postgraduate year), were performed.
KEY RESULTS
Few residents ( = 317) (13.9%) reported formal training. Over 25% of residents infrequently counsel on side effects, diagnosis, and restrictions. Resident reported use of communication strategies was infrequent: drawing pictures (24.1%), demonstration (15.8%), Teach Back (36.8%), Show Back (11.4%). Designated spaces in instruction templates for individual domains were associated with frequent domain-specific counseling (adjusted odds ratio [aOR] 4.1 [95% confidence interval: 3.5-4.8]). Formal training was associated with frequent Teach Back (aOR 2.6 [1.4-5.1]) and Show Back (aOR 2.7 [1.2-6.2]).
CONCLUSIONS
Lack of formal training and designated space for domain-specific instructions are associated with suboptimal counseling at discharge by pediatric residents. Future research should focus on determining the best mechanisms for teaching trainees communication skills and optimizing written instruction templates to support verbal counseling. [].
Topics: Child; Humans; United States; Patient Discharge; Cross-Sectional Studies; Communication; Parents; Hospitals
PubMed: 37812910
DOI: 10.3928/24748307-20230918-01 -
The Clinical Teacher Oct 2023Development, implementation and evaluation of a simulation curriculum is time and resource intensive. Limited faculty time and training are cited as primary barriers to...
BACKGROUND
Development, implementation and evaluation of a simulation curriculum is time and resource intensive. Limited faculty time and training are cited as primary barriers to adopting simulation into medical education. Near-peer teaching is a potential solution to manage the increased teaching demands that occur with simulation use.
APPROACH
In 2022, we implemented a near-peer simulation curriculum for teaching junior physical medicine and rehabilitation (PM&R) residents high-acuity low-opportunity events commonly seen on the inpatient rehabilitation unit. The curriculum was taught by senior residents to supplement faculty lectures. Senior residents completed facilitator training on simulator logistics, debriefing and formative assessment.
EVALUATION
Residents completed an end-of-course questionnaire evaluating teaching effectiveness and perceived knowledge acquisition. All items were scored on a 5-point Likert-type scale. Learners rated their near-peers as having good clinical teaching effectiveness (mean [SD], 4.66[0.38]). Senior residents (n = 6) disclosed feeling knowledgeable about the topics they instructed (baseline 3.9[3.2-4.4]; after 4.6[4.1-4.9]; p = 0.19), and junior residents (n = 6) felt they gained knowledge and improved their ability to manage patients as a result of the near-peer curriculum (baseline 2.4[2.3-2.5]; after 3.9[3.5-4.2]; p = 0.005).
IMPLICATIONS
This educational programme is an example of how near-peer teaching can be used in simulation. Our simulation curriculum taught by near-peers was valued by learners as well taught and educational. Research is needed that directly compares the effectiveness of near-pear teaching to faculty instruction. We hope that by sharing our work, educators will feel inspired to use near-peer teachers for simulation instruction when faculty availability for teaching is scarce.
Topics: Humans; Curriculum; Faculty; Educational Status; Computer Simulation; Education, Medical
PubMed: 37632300
DOI: 10.1111/tct.13645 -
Development (Cambridge, England) Oct 2023Nutritional and metabolic cues are integral to animal development. Organisms use them both as sustenance and environmental indicators, fueling, informing and influencing...
Nutritional and metabolic cues are integral to animal development. Organisms use them both as sustenance and environmental indicators, fueling, informing and influencing developmental decisions. Classical examples, such as the Warburg effect, clearly illustrate how genetic programs control metabolic changes. However, the way that nutrition and metabolism can also modulate or drive genetic programs to instruct developmental trajectories is much more elusive, owing to several difficulties including uncoupling permissive and instructive functions. Here, we discuss recent advancements in the field that highlight the developmental role of nutritional and metabolic cues across multiple levels of organismal complexity.
Topics: Animals; Nutritional Physiological Phenomena
PubMed: 37260408
DOI: 10.1242/dev.200623 -
Advances in Physiology Education Sep 2023In the field of anatomy education, the debate over the superiority of learning with or without human donors is decades long and ongoing. Arguments for or against the use... (Review)
Review
In the field of anatomy education, the debate over the superiority of learning with or without human donors is decades long and ongoing. Arguments for or against the use of human donors in anatomy education vary, depending on the healthcare discipline. Physical therapy programs have been particularly resistant to the trend away from the use of human donors. In this personal view, I present my history of anatomy education and how my perspectives on teaching and learning anatomy have changed dramatically throughout my teaching experiences. The purpose of this article is to support instructors who are creating anatomy courses for all healthcare trainees without donors, inspire those teaching with donors to incorporate other methods of instruction and evaluation, challenge educators to examine their own biases surrounding anatomy education, and provide recommendations for developing an anatomy course without human donors. Included in this article is the perspective of a practicing physical therapist who learned through human dissection and has assisted me in the development and management of the human anatomy course in our physical therapy curriculum. This article provides an overview of how to design an anatomy course without anatomical donors for doctor of physical therapy students and includes recommendations for instructors who need to reduce or eliminate anatomical donors from their anatomy curriculum.
Topics: Humans; Anatomists; Anatomy; Cadaver; Curriculum; Dissection; Education, Medical, Undergraduate; Educational Status; Learning; Students, Medical; Teaching
PubMed: 37141435
DOI: 10.1152/advan.00004.2023 -
BMC Medical Education Jul 2023Situation, background, assessment, and recommendation (SBAR) has been extensively used in clinical and nursing education. A structured communication program increases...
BACKGROUND
Situation, background, assessment, and recommendation (SBAR) has been extensively used in clinical and nursing education. A structured communication program increases effective communication, positivity, and education satisfaction during inter-professional collaboration among nursing students. This systematic review aimed to identify and synthesize evidence on the effectiveness of SBAR-based simulation training for nursing students.
METHODS
A research protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. The protocol for this study was registered in PROSPERO (CRD42021234068). Eight bibliographical databases were searched for studies published between 2001 and 2021, using relevant search terms. Searches were conducted in PubMed, Embase, Cumulative Index to Nursing and Allied Health, and Cochrane Central Register of Controlled Trials for literature in English, and DBpia, Research Information Sharing Service, Korean Studies Information Service System, and Korea Institute of Science and Technology Information for literature in Korean. After screening titles, abstracts, and full-text papers, pertinent data were extracted, and critical appraisals of the retrieved studies were performed. Data were analyzed using the framework approach, and the findings were presented in a narrative summary. The Effective Public Health Practice Project "Quality Assessment Tool for Quantitative Studies" was used to assess the quality of the included studies.
RESULTS
Twelve studies were included: 3 randomized controlled trials and 9 quasi-experimental studies. Two overarching themes were noted, namely communication clarity and critical thinking. The results of six out of 12 studies produced significant results in favor of SBAR-based simulation in terms of communication clarity. Divergent results were obtained regarding communication ability, critical thinking, confidence, learning self-efficacy, and attitude toward patient safety. The results of these studies highlight that communication clarity ultimately leads to positive results in terms of nursing students' behaviors related to patient safety.
CONCLUSIONS
This review provides a comprehensive update of the literature on the effectiveness of SBAR-based nursing simulation programs for nursing students. These programs were found to have positive learning outcomes because of clear and concise communication. Further studies on the effectiveness of various learning outcomes derived from SBAR-based programs are required.
Topics: Humans; Communication; Education, Nursing; Learning; Simulation Training; Students, Nursing
PubMed: 37452348
DOI: 10.1186/s12909-023-04495-8 -
Current Urology Reports Nov 2023Surgical simulation has become a cornerstone for the training of surgical residents, especially for urology residents. Urology as a specialty bolsters a diverse range of... (Review)
Review
PURPOSE OF REVIEW
Surgical simulation has become a cornerstone for the training of surgical residents, especially for urology residents. Urology as a specialty bolsters a diverse range of procedures requiring a variety of technical skills ranging from open and robotic surgery to endoscopic procedures. While hands-on supervised training on patients still remains the foundation of residency training and education, it may not be sufficient to achieve proficiency for graduation even if case minimums are achieved. It has been well-established that simulation-based education (SBE) can supplement residency training and achieve the required proficiency benchmarks.
RECENT FINDINGS
Low-fidelity modules, such as benchtop suture kits or laparoscopic boxes, can establish a strong basic skills foundation. Eventually, residents progress to high-fidelity models to refine application of technical skills and improve operative performance. Human cadavers and animal models remain the gold standard for procedural SBE. Recently, given the well-recognized financial and ethical costs associated with cadaveric and animal models, residency programs have shifted their investments toward virtual and more immersive simulations. Urology as a field has pushed the boundaries of SBE and has reached a level where unexplored modalities, e.g., 3D printing, augmented reality, and polymer casting, are widely utilized for surgical training as well as preparation for challenging cases at both the residents, attending and team training level.
Topics: Humans; Internship and Residency; Education, Medical, Graduate; Urology; Curriculum; Robotic Surgical Procedures; Clinical Competence; Simulation Training; Computer Simulation
PubMed: 37736826
DOI: 10.1007/s11934-023-01178-1 -
Rhode Island Medical Journal (2013) Oct 2023Robotic surgery continues to revolutionize the field of urologic surgery, and thus it is crucial that graduating urologic surgery residents demonstrate proficiency with...
Robotic surgery continues to revolutionize the field of urologic surgery, and thus it is crucial that graduating urologic surgery residents demonstrate proficiency with this technology. The large learning curve of utilizing robotic technology limits resident immediate participation in real-life robotic surgery, and skill acquisition is further challenged by variable case volume. Robotic simulation offers an invaluable opportunity for urologic trainees to cultivate strong foundational skills in a non-clinical setting, ultimately leading to both competence and operative confidence. Several different simulation technologies and robotic assessment protocols have been developed and demonstrate validity in several domains. However, despite their demonstrable utility, there is no formal robotic curricula within US urologic surgery residencies. In this article, we will review the current state of robotic simulation training in urologic surgery and highlight the importance of its widespread utilization in urologic surgery residency training programs.
Topics: Humans; Robotic Surgical Procedures; Clinical Competence; Robotics; Urologic Surgical Procedures; Computer Simulation; Internship and Residency; Curriculum; Simulation Training
PubMed: 37768162
DOI: No ID Found