A case tracking system with electronic medical record integration to automate outcome tracking for radiologists.

Radiologists make many diagnoses, but only sporadically get feedback on the subsequent clinical courses of their patients. We have created a web-based application that empowers radiologists to create and maintain personal databases of cases of interest. This tool integrates with existing information systems to minimize manual input such that radiologists can quickly flag cases for further follow-up without interrupting their clinical work. We have integrated this case-tracking system with an electronic medical record aggregation and search tool. As a result, radiologists can learn the outcomes of their patients with much less effort. We intend this tool to aid radiologists in their own personal quality improvement and to increase the efficiency of both teaching and research. We also hope to develop the system into a platform for systematic, continuous, quantitative monitoring of performance in radiology.

Use of unstructured parent narratives to evaluate medical student competencies in communication and professionalism.

OBJECTIVE: Medical education programs across the country are now required to conduct meaningful assessments of trainees' competencies, although uniform standards for conducting these evaluations have yet to be established. In 1999, the Indiana University School of Medicine introduced a comprehensive competency-based undergraduate curriculum. The overall goal of the curriculum is to make medical students' day-to-day experiences of training a source of learning about professionalism, communication, and aspects of medicine beyond factual knowledge. We sought to examine free-text comments by parents of pediatric inpatients as substrate for competency evaluation and feedback for third-year students on their pediatrics rotation. METHODS: The study was conducted from June 2001 to February 2004. Parents of hospitalized children completed a short medical student evaluation form that included 2 questions inviting free-text response. We used narrative analysis, a qualitative research technique, to describe both the content and meaning of the parents' responses. RESULTS: We collected 573 evaluations with narrative comments about 412 students. The most common aspect of medical student performance commented on by parents related to communication (53.8%). The next most common narrative comment was some form of affirmation of the student as a health care professional (26.0%). Other themes included establishing context for the comment, perceptions of the health care system, criticizing medical student performance, perceptions of the role of medical students, physical approach to the patient, expression of humility by the student, holistic approach to the patient, physical appearance of the student, superlative description of student, and advocating for the patient. Multiple themes were identified in 232 narrative comments (40.4%). Examples of each theme are provided. CONCLUSIONS: Family members of pediatric inpatients are a valuable source of information about medical student performance in at least 2 of the Accreditation Council for Graduate Medical Education competency areas (Communication and Professionalism). Themes identified in this study could be used to inform the design of a comprehensive 360-degree student evaluation strategy.

Teaching patient communication skills to medical students: a review of randomized controlled trials.

Tools to examine the effects of teaching interventions across a variety of studies are needed. The authors perform a meta-analysis of 24 randomized controlled trials evaluating the effects of teaching on medical students' patient communication skills. Study quality is rated using a modified Jadad score, and standardized mean difference effect size (d) measures are calculated. Fifteen of 24 studies have sufficient data for analysis. Students' ability to establish rapport improves after teaching. The effects are large when the teaching intervention was small group discussion (n = 5) or giving structured feedback on a student-patient interview (n = 6). A similar effect of teaching is seen on student data gathering skills (n = 5). Teaching medical students patient communication skills using small group discussion or providing feedback on a student-patient interview results in improvement in student performance.