scholarly journals Training the Gastroenterologist of the Future: A Different Mix of Knowledge, Skills and Attitudes in Needed

2003 ◽  
Vol 17 (10) ◽  
pp. 607-611
Author(s):  
Claude C Roy
Keyword(s):  
United States ◽  
Problem Solving ◽  
Medical Practice ◽  
Training Programs ◽  
Clinical Skills ◽  
Quality Care ◽  
The United States ◽  
Evidence Based ◽  
Intellectual Content ◽  
The Future

In the United States, the declining interest of residents in gastroenterology is thought to be the result of the specialty being too procedure driven and not intellectually challenging. It is clear that the growth of technology and excessive demands for procedures have forced the curtailing of clinic time, erosion of clinical skills, distraction from scholarly pursuits and a decrease in the intellectual content of our training programs. In order to attract the ’best and the brightest’ and to better prepare gastroenterologists for the future, trainees will require more knowledge and experience in nutrition, genetics and the evaluative sciences. Furthermore, they need to realize that the main responsibility of clinicians is problem solving. This can be learned only through personal clinical experience and teaching by clinicians with good analytical and intuitive skills. Quality care requires the integration of the needs, means and preferences of patients with evidence-based medical practice. Finally, new physicians should be imbued with the concept that an empathic relationship with patients is crucial for the accurate collection of information and plays an important therapeutic role.

scholarly journals Nephrology Fellows’ and Program Directors’ Perceptions of Hospital Rounds in the United States

2020 ◽  
Vol 15 (4) ◽  
pp. 474-483
Author(s):  
Suzanne M. Boyle ◽  
Keshab Subedi ◽  
Kurtis A. Pivert ◽  
Meera Nair Harhay ◽  
Jaime Baynes-Fields ◽  
...  
Keyword(s):  
United States ◽  
Patient Care ◽  
Training Programs ◽  
Clinical Skills ◽  
Care Delivery ◽  
Clinical Skill ◽  
Program Directors ◽  
The United States ◽  
Early Morning ◽  
Attending Rounds

Background and objectivesHospital rounds are a traditional vehicle for patient-care delivery and experiential learning for trainees. We aimed to characterize practices and perceptions of rounds in United States nephrology training programs.Design, setting, participants, & measurementsWe conducted a national survey of United States nephrology fellows and program directors. Fellows received the survey after completing the 2019 National Board of Medical Examiners Nephrology In-Training Exam. Program directors received the survey at the American Society of Nephrology’s 2019 Nephrology Training Program Directors’ Retreat. Surveys assessed the structure and perceptions of rounds, focusing on workload, workflow, value for patient care, and fellows’ clinical skill-building. Directors were queried about their expectations for fellow prerounds and efficiency of rounds. Responses were quantified by proportions.ResultsFellow and program director response rates were 73% (n=621) and 70% (n=55). Most fellows (74%) report a patient census of >15, arrive at the hospital before 7:00 am (59%), and complete progress notes after 5:00 pm (46%). Among several rounding activities, fellows most valued bedside discussions for building their clinical skills (34%), but only 30% examine all patients with the attending at the bedside. Most directors (71%) expect fellows to both examine patients and collect data before attending-rounds. A majority (78%) of directors commonly complete their documentation after 5:00 pm, and for 36%, after 8:00 pm. Like fellows, directors most value bedside discussion for development of fellows’ clinical skills (44%). Lack of preparedness for the rigors of nephrology fellowship was the most-cited barrier to efficient rounds (31%).ConclusionsHospital rounds in United States nephrology training programs are characterized by high patient volumes, early-morning starts, and late-evening clinical documentation. Fellows use a variety of prerounding styles and examine patients at the beside with their attendings at different frequencies.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_03_17_CJN.10190819.mp3

scholarly journals Opposition to Pharmacist Contraception Services: Evidence for Rebuttal

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 176
Author(s):  
Madeline Mitchell ◽  
Courtney Stauffenberg ◽  
Veronica Vernon ◽  
Cortney M. Mospan ◽  
Allie Jo Shipman ◽  
...  
Keyword(s):  
United States ◽  
Healthcare Professionals ◽  
Training Programs ◽  
The United States ◽  
Safety Training ◽  
Pharmacy Students ◽  
Evidence Based ◽  
Training Cost ◽  
Preventative Services ◽  
Fragmentation Of Care

Pharmacist contraception services are growing across the United States. Several states have authorized pharmacists to prescribe contraception, and the interest in other states continues to grow. Opposition to these practices exists and centers on discussions related to safety, training, cost, and fragmentation of care. We review these arguments and provide evidence refuting these concerns. Pharmacist-prescribed contraception increases access to care, and patients express interest in utilizing this service at the pharmacy. Pharmacists follow evidence-based recommendations. Counseling on preventative services and referral to other providers is part of contraception care by pharmacists. Training programs have been developed to equip both pharmacy students and pharmacists with the knowledge, skills, and tools needed to successfully provide these services. This article can serve as a guide for pharmacists and advocates when discussing pharmacist-prescribed contraception with policymakers, patients, and other healthcare professionals.

Conclusion: From the Edges Toward the Middle

2019 ◽  
pp. 509-510
Author(s):  
J. Lloyd Michener ◽  
Brian C. Castrucci ◽  
Don W. Bradley ◽  
Craig W. Thomas ◽  
Edward L. Hunter
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Professionals ◽  
Training Programs ◽  
The United States ◽  
Lessons Learned ◽  
What Works ◽  
The Future

This chapter concludes the book and looks to the future. The teams and partnerships for health are clearly underway across the United States. From this point on, health care professionals and other agencies will all need to incorporate lessons learned and practices adopted into training programs, for all the health and related disciplines. Rather than learn what makes a difference in health, the aim should be to discover and then teach what makes a difference for some, and what works better for others. Training would be best carried out in teams, so the skills of teamwork and partnership are not just ideas, but practiced skills. The chapter concludes with this thought: health is something we can achieve together, but that no person or group can achieve alone.

scholarly journals P071: Content of clinical informatics in international training standards for emergency medicine specialists

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S82-S82
Author(s):  
B. R. Holroyd ◽  
M. S. Beeson ◽  
T. Hughes ◽  
L. Kurland ◽  
J. Sherbino ◽  
...  
Keyword(s):  
United States ◽  
Emergency Medicine ◽  
Medical Education ◽  
Graduate Medical Education ◽  
The United States ◽  
Clinical Informatics ◽  
Evidence Based ◽  
Graduate Medical ◽  
The Future ◽  
Training Standards

Introduction: The field of Clinical Informatics (CI) and specifically the electronic health record, has been identified as a key facilitator to achieve a sustainable evidence-based healthcare system for the future. International graduate medical education programs have been challenged to ensure their trainees are provided with appropriate skills to deliver effective and efficient healthcare in an evolving environment. This study explored how international Emergency Medicine (EM) specialist training standards address training in relevant areas of CI. Methods: A list of categories of CI competencies relative to EM was developed following a thematic review of published references documenting CI curriculum and competencies. Publically available, published documents outlining core content, curriculum and competencies from international organizations responsible for specialty graduate medical education and/or credentialing in EM for the United States, Canada, Australasia, the United Kingdom and Europe. These EM training standards were reviewed to identify inclusion of topics related to the relevant categories of CI competencies. Results: A total of 23 EM curriculum documents were included in the thematic analysis. Curricula content related to critical appraisal/evidence based medicine, leadership, quality improvement and privacy/security were included in all EM curricula. The CI topics related to fundamental computer skills, computerized provider order entry and patient-centered informatics were only included in the EM curricula documents for the United States and were absent for each other organization. Conclusion: There is variation in the CI related content of the international EM specialty training standards which were reviewed. Given the increasing importance of CI in the future delivery of healthcare, organizations responsible for training and credentialing specialist emergency physicians must ensure their training standards incorporate relevant CI content, thus ensuring their trainees gain competence in essential aspects of CI.

AGA Institute Future Trends Committee Report: The Future of Gastroenterology Training Programs in the United States

2008 ◽  
Vol 135 (5) ◽  
pp. 1764-1789.e2 ◽  
Author(s):  
Timothy C. Wang ◽  
Fabio Cominelli ◽  
David E. Fleischer ◽  
James M. Gordon ◽  
Robert M. Glickman ◽  
...  
Keyword(s):  
United States ◽  
Training Programs ◽  
The United States ◽  
Committee Report ◽  
Future Trends ◽  
The Future

440: Barriers to the Practice of Evidence Based Urology in the United States

2007 ◽  
Vol 177 (4S) ◽  
pp. 147-148
Author(s):  
Philipp Dahm ◽  
Hubert R. Kuebler ◽  
Susan F. Fesperman ◽  
Roger L. Sur ◽  
Charles D. Scales ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Evidence Based

Gendered differences in emigration and mobility perspectives among European researchers working abroad

2014 ◽  
Vol 7 (1) ◽  
pp. 33-41 ◽  
Author(s):  
Elisabeth Scheibelhofer
Keyword(s):  
United States ◽  
Qualitative Research ◽  
Qualitative Study ◽  
Social Relations ◽  
The United States ◽  
Research Strategy ◽  
The Future ◽  
Highly Skilled

This paper focuses on gendered mobilities of highly skilled researchers working abroad. It is based on an empirical qualitative study that explored the mobility aspirations of Austrian scientists who were working in the United States at the time they were interviewed. Supported by a case study, the paper demonstrates how a qualitative research strategy including graphic drawings sketched by the interviewed persons can help us gain a better understanding of the gendered importance of social relations for the future mobility aspirations of scientists working abroad.

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