Defining Their Own Success: Scholars' Views After a Faculty Development Program.

OBJECTIVE: Educator roles in medicine are expanding yet career paths and definitions of successful careers are not uniformly agreed upon. Educator success from their own perspective has not been broadly explored as these studies usually occur from the institutional or organizational viewpoint. This study examined the impact of a national educational faculty development program (FDP) for academic pediatricians on educators' self-description of their own professional and personal success. METHODS: This was a cross-sectional, qualitative study of FDP alumni between 2019-2021. Interviews explored participants perspectives on their professional success, and supports and barriers. Using an iterative process, thematic analysis of the data identified 6 themes. RESULTS: Fourteen scholars were interviewed. All felt they were successful citing both outcome and impact measures categorized into 6 themes: personal attributes, adequate resources and barriers, foundational skill development, experiencing strong mentoring and networking, engaging, and being connected to a community of practice and self-identifying as a medical educator. To view the data holistically, a model incorporating 3 frameworks was developed. CONCLUSIONS: These educators viewed themselves as successful academic educators. While papers, promotions and positions were important, educators viewed impact in mentoring and collaborations with others, along with acquired expertise and an expanded viewpoint of the field and themselves as equally important. Educators and leaders could use these elements for their own self-assessment and support, FDP development and enhancement, and for investment in programs and faculty educators.

An Annotated Bibliography of Key Studies in Medical Education in 2020: Applying the Current Literature to Educational Practice and Scholarship.

Pediatric medical educators, with their multitude of responsibilities, may have difficulty staying abreast with both medical education and specialty specific medical literature. The body of medical literature is growing at an exponential rate. This annotated bibliography serves as a summary of highlighted medical education literature in the year 2020. The purpose was to identify manuscripts which have the potential to significantly influence a pediatric medical educator's practice. The authors reviewed abstracts from 14 medical education and specialty journals using a two-staged review process. Each stage of review was completed by 2 different authors. A total of 1861 abstracts were reviewed and ultimately 15 key manuscripts were identified. The authors grouped the manuscripts into 6 core domains: diversity and inclusion, faculty development, feedback, learner development, mentorship, and teaching skills. Condensed summaries of each medical education manuscript likely to influence educational practice are provided by the authors in this annotated bibliography.

An Annotated Bibliography of Key Studies in Medical Education in 2019: Applying the Current Literature to Educational Practice and Scholarship.

Pediatric medical educators have the dual challenge of remaining up-to-date in the field of pediatrics and in the field of medical education. Due to the volume of information published in these 2 fields it can be nearly impossible to remain current in both fields of practice. To facilitate interpretation of the most recent medical education research, the authors conducted an annotated bibliography of medical education literature published in 2019. The purpose of this annotated bibliography was to identify manuscripts which had the potential to significantly influence a pediatric educator's practice. Using a 2-staged review process, the authors reviewed abstracts from 13 medical education and specialty journals. All reviews were independently completed by 2 different reviewers for each journal in both stages. A total of 4700 abstracts were reviewed and 17 key manuscripts were identified. The authors grouped the key manuscripts into 6 core themes: bedside teaching, learning climate, bias, learner autonomy, learner in trouble, and resident competency. This annotated bibliography provides the authors' condensed summary of the medical education manuscripts most likely to influence educational practices for the busy pediatric medical educator.

An Annotated Bibliography of Key Studies in Medical Education in 2018: Applying the Current Literature to Pediatric Educational Practice and Scholarship.

Pediatric educators desire to and should strive to incorporate current educational methods and ideas into their professional practices. The overwhelming volume of medical education literature makes this difficult. This article provides an overview of 18 key articles from the 2018 literature that the authors considered impactful for the field of pediatric medical education. The author group has extensive combined leadership experience and expertise across the continuum of pediatric medical education and used an iterative, staged process to review 2270 abstracts from 13 medical education-related journals. This process aimed to identify a subset of articles that were most relevant to educational practice and scholarship and most applicable to pediatric medical education. Author pairs independently reviewed and scored abstracts and reached consensus to identify the abstracts that best met these criteria. Selected abstracts were discussed using different author pairs to determine the final articles included in this review. The 18 articles selected are summarized. The results showed a cluster of studies related to assessment, learner education and teaching, communication, and culture and climate. This review offers a summary for educators interested in remaining knowledgeable and current regarding the most relevant and valuable information in the field of medical education.

Top Medical Education Studies of 2016: A Narrative Review.

Education, like clinical medicine, should be based on the most current evidence in the field. Unfortunately, medical educators can be overwhelmed by the sheer volume and range of resources for this literature. This article provides an overview of 15 articles from 2016 that the authors consider the top articles in the field of pediatric medical education. The 7 authors, all medical educators with combined leadership and expertise across the continuum of pediatric medical education, used an iterative 3-stage process to review more than 6339 abstracts published in 2016. This process was designed to identify a small subset of articles that were most relevant to educational practices and most applicable to pediatric medical education. In the first 2 stages, pairs of authors independently reviewed and scored abstracts in 13 medical education-related journals and reached consensus to identify the articles that best met these criteria. In the final stage, all articles were discussed using a group consensus model to select the final articles included in this review. This article presents summaries of the 15 articles that were selected. The results revealed a cluster of studies related to observed standardized clinical encounters, self-assessment, professionalism, clinical teaching, competencies/milestones, and graduate medical education management strategies. We provide suggestions on how medical educators can apply the findings to their own practice and educational settings. This narrative review offers a useful tool for educators interested in keeping informed about the most relevant and valuable information in the field.

Evaluation of a Speed Mentoring Program: Achievement of Short-Term Mentee Goals and Potential for Longer-Term Relationships.

OBJECTIVE: Speed mentoring provides brief mentoring and networking opportunities. We evaluated 1) a national speed mentoring program's ability to encourage in-person networking and advice-sharing, and 2) 2 potential outcomes: helping mentees achieve 3-month goals, and fostering mentoring relationships after the program. METHODS: An outcome approach logic model guided our program evaluation. Sixty mentees and 60 mentors participated. Each mentee met with 6 mentors for 10 minutes per pairing. At the program, mentees created goals. At 3 months, mentors sent mentees a reminder e-mail. At 4 months, participants received a Web-based survey. RESULTS: Forty-two (70%) mentees and 46 (77%) mentors completed the survey. Participants reported the program allowed them to share/receive advice, to network, to provide/gain different perspectives, and to learn from each other. Mentors as well as mentees identified shared interests, mentor-mentee chemistry, mentee initiative, and mentor approachability as key qualities contributing to ongoing relationships. Many mentor-mentee dyads had additional contact (approximately 60%) after the program and approximately one-third thought they were likely to continue the relationship. Goal-setting encouraged subsequent mentor-mentee contact and motivated mentees to work toward attaining their 3-month goals. The mentors aided mentees goal attainment by providing advice, offering support, and holding mentees accountable. CONCLUSIONS: A national speed mentoring program was an effective and efficient way to establish national connections, obtain different perspectives, and receive advice. Goal-setting helped mentees in achieving 3-month goals and fostering mentoring relationships outside of the program. These elements continue to be a part of this program and might be valuable for similar programs.

Diagnostic errors in primary care: lessons learned.

BACKGROUND: Diagnostic errors occur more commonly than other kinds of errors, they are more likely to harm patients, and they are more likely to be preventable. Little is known about the presenting complaints, initial (incorrect) diagnoses, and physicians' personal lessons learned related to diagnostic errors. METHODS: In 2009 and 2010, we invited a random sample of 200 family physicians, 200 general internists, and 200 general pediatricians practicing in Iowa to describe an important diagnostic error using a 1-page, mailed questionnaire. The data were analyzed using quantitative and qualitative methods. RESULTS: The response rate was 34% (202 of 600 physicians). Common presenting complaints included abdominal pain (n = 27 of 202 patients, 13%); fever (n = 19; 9%); and fatigue (n = 15, 7%). Common initial (incorrect) diagnoses included benign viral infections (n = 35, 17%); musculoskeletal pain (n = 21, 10%); and chronic obstructive pulmonary disease/asthma (n = 13, 6%). The 202 responding physicians described 254 personal lessons learned, which we used to develop a taxonomy of 24 generic lessons. Three common lessons were: (1) consider diagnosis X in patients presenting with symptom Y (n = 37 lessons, 15%; eg, "Any discomfort above the umbilicus may be coronary artery disease."); (2) look beyond the initial, most obvious diagnosis (n = 26 lessons, 10%); and (3) be alert to atypical presentations of disease (n = 24 lessons, 9%). CONCLUSIONS: In this study, diagnostic errors often were preceded by common symptoms and common, relatively benign initial diagnoses. The lessons learned often involved various aspects of broadening the differential diagnosis.

PediatricEducation.org

Página dedicada a educação médica continuada com conteúdo voltado para área da pediatria. Apresenta informações sobre os responsáveis, objetivos educaionais, links.

An evaluation of pediatric residency education in conveying immunization knowledge.

BACKGROUND: The Accreditation Council of Graduate Medical Education now requires all pediatric residency training programs assess medical knowledge competency. PURPOSE: The goal of this project was to determine whether pediatric residency training using patient-based/experiential teaching made residents competent in the area of immunization knowledge or whether additional teaching strategies might need to be developed. METHODS: Cross-sectional and longitudinal study designs were used to determine improvement in immunization knowledge on a multiple-choice quiz over the 3 years of residency training. RESULTS: Both the cross-sectional and longitudinal data showed a statistically significant improvement in performance between residency training Years 1 and 2 but not between Years 2 and 3 on the quiz. This statistically significant relationship by year of training was seen despite the modest reliability of the short quiz and the sample size. CONCLUSIONS: This study shows that pediatric residency education using patient-based/experiential teaching is effective in teaching first year residents about immunization knowledge but is not as effective for 2nd- and 3rd-year residents. Other instructional methods such as computer-based cases could be employed during the 2nd and 3rd years.

Formative evaluation of a pediatric digital library's educational content and comparison to national curricular standards.

BACKGROUND: U.S. medical education has undergone numerous regulatory changes; to maintain educational consistency and quality, these changes must be met with innovative educational methods. AIM: A formative evaluation of a pediatric digital library (PDL) documenting its content and comparing it to 3 national medical education curricula was performed. METHODS: The PDL's weekly cases are written using templates based on specific educational constructs. Cases (N = 150) were evaluated in November 2007. Data was tabulated by age group, specialty, symptom/presentation and disease/problem. Curriculum maps were developed from 3 national curricula and topics were mapped to one or more equivalent PDL topics. Data was tabulated for total national curriculum topics, mapped PDL topics and weekly cases. RESULTS: The cases covered 100% of all pediatric age groups (N = 9) and specialties (N = 42). They covered 85% of the symptoms/problems (N = 127) and 37.2% of the diseases/problems (N = 707). Although the PDL was not explicitly designed to meet these national curricula standards, >80% of the topics in these curricula were covered. CONCLUSIONS: The PDL broadly covered national curricular standards and represents an unstructured pediatric curriculum. It offers a complementary and alternative educational method of medical education for educators and learners at all stages of professional development.

Initial experiences in radiology e-learning.

The use of two different educator-centric learning management systems (LMSs), Moodle and Manila, for radiology e-learning was formatively evaluated and the implications of the future use of LMSs in radiology education were explored. NeuroRAD, a neuroradiologic digital library and learning community, is implemented with Moodle, one of the most popular open-source educator-centric LMSs. Pediatric-Education.org, a pediatric digital library and learning community, is implemented with Manila, a commercial educator-centric LMS. Quantitative and qualitative analyses of these LMSs were performed with World Wide Web server log file statistical programs and user-submitted comment forms. In 2005, NeuroRAD was used by 9959 visitors, who read 98,495 pages of information, whereas PediatricEducation .org was used by 91,000 visitors, who read 186,000 pages of information. Visitors represented a wide spectrum of medical learners and used the sites to answer clinical questions; to prepare for lectures, conferences, and informal teaching sessions; and to stay up-to-date and prepare for examinations. Early results indicate that radiology learning communities can be implemented with educator-centric LMSs relatively easily and at low cost by radiologists with minimal computer expertise, and can find receptive and appreciative audiences. Online radiology learning communities could play a significant role in providing education to radiologists the world over throughout their careers.

Delivering biodefense continuing education to military medical providers by allowing a biodefense educational curriculum to unfold in practice.

A challenge today is how to deliver initial and continuing education on biodefense to military medical providers in a manner that can be integrated into their workflow and lifestyle. A summative evaluation of a prototypical biodefense digital library (BDL) and learning collaboratory was performed. The BDL posted daily links to biodefense news stories from January 2004 to December 2005. Four evaluations were completed, that is, content evaluation, curriculum comparison with a biodefense graduate program, usage evaluation, and impact factor analysis. News stories (N = 678) came from a broad range of authoritative national and international news sources (N = 178). News stories covered all of the categories in the required and elective formal biodefense graduate program courses. The BDL was consistently displayed on the first page of the top three Internet search engines, meaning that it was among the top 10 authoritative Internet sites on biodefense. Presenting biodefense news stories to busy military medical providers in an organized chronological fashion produces an unstructured biodefense educational curriculum that unfolds in practice and becomes an educational resource that is ultimately well regarded and may be efficient to use.

Promoting health and improving health care in a cost-effective manner through a military digital library.

OBJECTIVE: The Virtual Naval Hospital (VNH) is a digital library designed to meet the information needs of U.S. Navy medical professionals. The goal of this study was to determine whether the VNH promoted health and improved patient care in a cost-effective manner. DESIGN AND MEASUREMENTS: An economic analysis determining the costs and benefits from the perspective of the U.S. Navy was conducted. As part of this analysis, medical professionals were surveyed from February to August 2000. RESULTS: Respondents used the VNH for a variety of professional activities (average, 8.2 h/wk). Respondents (70%) thought that VNH usage improved patient care. Medical providers thought it improved their diagnosis (70%) and treatment (60%). Respondents stated that the VNH affected 81 medical evacuations and 668 sick-in-quarter days. Overall content satisfaction was 94%. The VNH had a net savings of $143,848/yr and a cost/benefit ratio of 55.9%. CONCLUSIONS: The VNH has a beneficial impact on the Navy's health care system by improving health promotion and patient care and by being economically cost-effective.

The Virtual Naval Hospital: the digital library as knowledge management tool for nomadic patrons.

OBJECTIVE: To meet the information needs of isolated primary care providers and their patients in the US Navy, a digital health sciences library, the Virtual Naval Hospital, was created through a unique partnership between academia and government. METHODS: The creation of the digital library was heavily influenced by the principles of user-centered design and made allowances for the nomadic nature of the digital library's patrons and the heterogeneous access they have to Internet bandwidth. RESULTS: The result is a digital library that has been in operation since 1997, continues to expand in size, is heavily used, and is highly regarded by its patrons. CONCLUSIONS: The digital library is dedicated to delivering the right information at the right time to the right person so the right decision can be made, and therefore the Virtual Naval Hospital functions as a knowledge-management system for the US Navy Bureau of Medicine and Surgery.

A randomized controlled trial of an information prescription for pediatric patient education on the Internet.

BACKGROUND: Information prescriptions (IPs) are prescriptions of specific, evidence-based information to manage health problems. OBJECTIVE: To determine whether a pediatrician-provided IP would change parents' attitudes/behaviors about using Internet health information resources. DESIGN, SETTING, AND PARTICIPANTS: We conducted a randomized controlled trial of parents visiting an academic general pediatric practice. Both groups received a preintervention paper survey and a telephone survey 2 to 3 weeks after their clinic visit. The intervention group was offered computer training and received the IP and training summary handout. RESULTS: Final groups included 100 control and 97 intervention subjects. Of all parents, 68.0% had used the Internet in the past 6 months for health information and 52.8% used it for children's health information. The intervention group used the Internet more for general health information (P =.05) and child health information (P<.001) than the control group. At follow-up, 51 (66.2%) of 77 Internet information resources used by the intervention group were prescribed by the pediatricians. Parents who used the IP (31 [32%] of 97 intervention parents) used the Internet for general health information (P<.001) and child health information (P =.001) more than nonusers. Compared with nonusers, IP users were more likely to state they would use the IP again in the future (P =.02) and had already recommended the IP to family or friends more than nonusers (P =.001). CONCLUSIONS: Parents of children in pediatric practices commonly use the Internet for general and children's health information. In this study, IPs were associated with specific parental attitude and behavior changes resulting in increased Internet utilization for general and child health information and for specific high-quality information resources. Pediatricians can implement IPs in their office.

A pediatric digital storytelling system for third year medical students: the virtual pediatric patients.

BACKGROUND: Computer-based patient simulations (CBPS) are common, effective, instructional methods for medical students, but have limitations. The goal of this project was to describe the development of a CBPS designed to overcome some of these limitations and to perform an online evaluation. METHODS: In 1996, patients and families experiencing a common pediatric problem were interviewed, photographed and a chart review completed. A digital storytelling template was developed: 1. patient's story, evaluation and clinical course, 2. problem-based approach to the evaluation, and 3. discussion of disease process. The media was digitized and placed onto the Internet. The digital stories and a 10-question online survey were pilot tested. Online survey responses were collected from 1999-2003. Overall use of the digital stories was measured by computer server logs and by the number of hyperlinks to the CBPS. RESULTS: Eight stories were created using this system. Over 4.5 years, 814,148 digital story pages were read by 362,351 users. Hyperlink citations from other websites to the CBPS were 108. Online survey respondents (N = 393) described the overall quality as excellent or very good (88.4%). The stores were clearly written (92%) at an appropriate level (91.4%). Respondents felt they could begin to evaluate a similar case presentation (95.4%), and would remember the case in the future (91%). CONCLUSIONS: A new type of CBPS, the digital storytelling system, has been developed and evaluated which and appears to be successful in overcoming some of the limitations of earlier CBPS by featuring patient's stories in their own words, by focusing on problems rather than diseases, and by having stories that are quick for students to work through.

The child's voice: understanding the contexts of children and families today.

Children and families live and grow in a different social context than 15 years ago. The purpose of this report was to explore contemporary themes for improved contextual understanding of children and families today and their relationship to providing optimal pediatric dental care. Twelve themes were discussed using research studies and clinical expertise from the viewpoints of a pediatric psychologist and pediatrician. It was concluded that enhanced communication and partnership building improves comprehension and compliance with dental treatment. Furthermore, diagnosing the child and family within the immediate local context is central to developing and accomplishing an effective dental treatment plan.

An analysis of patient care questions asked by pediatricians at an academic medical center.

BACKGROUND: General pediatricians' information needs are not presently well characterized in the literature. OBJECTIVE: To characterize the patient care information needs of academic medical center pediatricians by collecting and classifying questions generated in clinical settings, allowing pediatric educators and authors to more effectively meet the needs of pediatricians. METHODS: A semistructured telephone survey of pediatric residents and faculty at a midwestern US academic medical center over two 6-month periods. The main outcome measures were number of questions asked, age ranges, pediatric subspecialties, and generic question types. RESULTS: A total of 607 pediatrician questions were collected. The infant age range generated the most questions (34.1%), and other age groups were almost equally distributed. The most common pediatric specialties were pharmacology (34.1%), infectious diseases (9.1%), neurology/neurosurgery (5.1%), allergy/pulmonary (4.6%), and neonatology (4.6%). The most common generic questions asked were "What is the dosage of drug X?" (18.0%), "What is the treatment for condition X?" (15.2%), and "What is condition X?" (13.5%). There were qualitative differences between resident and faculty groups. CONCLUSIONS: The information needs of academic medical center pediatricians can be assessed and potentially serve as a foundation for the development of common and digital educational information resources. Resident and faculty groups showed some qualitative differences. Pediatricians need drug-dosing information; clear condition definitions, including manifestation and clinical course descriptions; and physical finding and laboratory testing information. Educators and authors should highlight information concerning pharmacology and infectious diseases when developing educational and information resources.

An evaluation of information-seeking behaviors of general pediatricians.

OBJECTIVE: Usage of computer resources at the point of care has a positive effect on physician decision making. Pediatricians' information-seeking behaviors are not well characterized. The goal of this study was to characterize quantitatively the information-seeking behaviors of general pediatricians and specifically compare their use of computers, including digital libraries, before and after an educational intervention. METHODS: General pediatric residents and faculty at a US Midwest children's hospital participated. A control (year 1) versus intervention group (year 2) research design was implemented. Eligible pediatrician pools overlapped, such that some participated first in the control group and later as part of the intervention. The intervention group received a 10-minute individual training session and handout on how to use a pediatric digital library to answer professional questions. A general medical digital library was also available. Pediatricians in both the control and the intervention groups were surveyed using the critical incident technique during 2 6-month time periods. Both groups were telephoned for 1- to 2-minute interviews and were asked, "What pediatric question(s) did you have that you needed additional information to answer?" The main outcome measures were the differences between the proportion of pediatricians who use computers and digital libraries and a comparison of the number of times that pediatricians use these resources before and after intervention. RESULTS: A total of 58 pediatricians were eligible, and 52 participated (89.6%). Participant demographics between control (N = 41; 89.1%) and intervention (N = 31; 70.4%) were not statistically different. Twenty pediatricians were in both groups. Pediatricians were slightly less likely to pursue answers after the intervention (94.7% vs 89.2%); the primary reason cited for both groups was a lack of time. The pediatricians were as successful in finding answers in each group (95.7% vs 92.7%), but the intervention group took significantly less time (8.3 minutes vs 19.6 minutes). After the intervention, pediatricians used computers and digital libraries more to answer their questions and spent less time using them. CONCLUSION: This study showed higher rates of physician questions pursued and answered and higher rates of computer use at baseline and after intervention compared with previous studies. Pediatricians who seek answers at the point of care therefore should begin to shift their information-seeking behaviors toward computer resources, as they are as effective but more time-efficient.