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1.
Acad Med ; 2019 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-31738214

RESUMEN

Infertility is more prevalent in female physicians than in the U.S. general population. While pregnancy and its potential medical and career development consequences among physicians have been explored in the literature, infertility and its consequences remain understudied and unaddressed. Fertility issues are important for all physicians hoping to start families, including male physicians, transgender physicians, single physicians, and physicians with same-sex partners.Infertility has numerous physical, emotional, and financial consequences and may have a negative impact on physician well-being. Options to preserve fertility (such as egg, embryo, and sperm cryopreservation) are available, yet physicians may not be aware of or have the financial ability to make use of such resources. Physician reproductive health, including the ability to build a family if and when a physician chooses, is a vital aspect of well-being. The risks and consequences of infertility and the management of fertility should be studied and addressed from policy and advocacy standpoints.The authors, who have experienced and sought treatment for infertility, bring attention to the challenges around both physician infertility and preservation of fertility. They propose three strategies to address physician infertility: increasing fertility education and awareness starting at the undergraduate medical education level and continuing throughout training and practice; providing insurance coverage for and access to fertility assessment and management; and offering support for those undergoing fertility treatments. The authors believe that implementing these suggestions would make a significant positive impact on trainees and practicing physicians and help build a health care workforce that is healthy and well physically, emotionally, and financially.

2.
Acad Med ; 94(9): 1289-1292, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31460917

RESUMEN

Academic medical centers (AMCs) are transforming to improve their care delivery and learning environments so that they build a culture that fosters high-value care. However, AMCs struggle to create learning environments where trainees are part of the reason for institutional success and their initiatives have high impact and are sustainable. The authors believe that AMCs can reach these goals if they codevelop strategic priorities and provide infrastructure to support alignment between the missions of health delivery systems and graduate medical education (GME).They outline four steps for AMCs and policy makers to create an infrastructure that supports this alignment to deliver value-based care. First, AMCs can align strategic priorities between delivery systems and educators by creating a common understanding of why initiatives require priorities within the health care system. Second, AMCs can support alignment with data from multiple sources that are reliable, valid, and actionable for trainees. Third, resident initiatives can create sustained impact by linking trainees to the institutional staff and infrastructure supporting value improvement efforts. Fourth, incentive payment programs through medical education could augment current system incentives to propel further alignment between education and delivery systems. The authors support their recommendations with concrete examples from emerging models created by GME and health delivery system leaders at AMCs across the country.

3.
Sleep ; 42(11)2019 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-31310317

RESUMEN

STUDY OBJECTIVES: Although sleep disturbance is common in acutely ill patients during and after a hospitalization, how hospitalization affects sleep in general medicine patients has not been well characterized. We describe how sleep and activity patterns vary during and after hospitalization in a small population of older, predominately African American general medicine patients. METHODS: Patients wore a wrist accelerometer during hospitalization and post-discharge to provide objective measurements of sleep duration, efficiency, and physical activity. Random effects linear regression models clustered by subject were used to test associations between sleep and activity parameters across study days from hospitalization through post-discharge. RESULTS: We recorded 404 nights and 384 days from 54 patients. Neither nighttime sleep duration nor sleep efficiency increased from hospitalization through post-discharge (320.2 vs. 320.2 min, p = 0.99; 74.0% vs. 71.7%, p = 0.24). Daytime sleep duration also showed no significant change (26.3 vs. 25.8 min/day, p = 0.5). Daytime physical activity was significantly less in-hospital compared to post-discharge (128.6 vs. 173.2 counts/min, p < 0.01) and increased 23.3 counts/min (95% CI = 16.5 to 30.6, p < 0.01) per hospital day. A study day and post-discharge period interaction was observed demonstrating slowed recovery of activity post-discharge (ß 3 = -20.8, 95% CI = -28.8 to -12.8, p < 0.01). CONCLUSIONS: Nighttime sleep duration and efficiency and daytime sleep duration were similar in-hospital and post-discharge. Daytime physical activity, however, was greater post-discharge and increased more rapidly during hospitalization than post-discharge. Interventions, both in hospital and at home, to restore patient sleep and sustain activity improvements may improve patient recovery from illness.

4.
Chest ; 156(5): 1022-1030, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31352036

RESUMEN

Nearly 50% of physicians report symptoms of clinical burnout. Occupational factors and personal health play substantial roles in physician burnout. The role of sleep in physician burnout is not well understood. Burnout is at epidemic levels in health care, with research suggesting nearly one in two physicians experience clinical burnout as defined according to the Maslach Burnout Index. Sleep deprivation, burnout, and clinician health are intricately intertwined. The relation between sleep deprivation and burnout is not only suggested in hypothetical models but also confirmed in observational studies of workers of all types. Models describing the relation between burnout and sleep suggest as potential causative mechanisms of sleep disturbances the following: (1) a chronic depletion of energy stores; or (2) activation of the hypothalamic-pituitary-adrenal axis and increasing levels of bodily stress. Sleep deprivation and burnout are widespread in health-care workers, affecting not only nurses but also medical students, physicians-in-training, and practicing physicians. Although sleep deprivation is associated with clinical burnout, direct studies showing that sleep extension can improve burnout recovery are lacking. Early detection and early intervention to improve both sleep deprivation and burnout are warranted in health-care professionals. Interventions should be directed not only at individuals but also at the entire health system. This review highlights the latest developments and emerging concepts concerning the role of sleep and circadian disorders in physician burnout.

5.
JAMA Netw Open ; 2(7): e197774, 2019 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-31348500
6.
J Clin Pharm Ther ; 44(4): 579-587, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31152684

RESUMEN

WHAT IS KNOWN AND OBJECTIVE: The use of generic oral contraceptives (OCPs) can improve adherence and reduce healthcare costs, yet scepticism of generic drugs remains a barrier to generic OCP discussion and prescription. An educational web module was developed to reduce generic scepticism related to OCPs, improve knowledge of generic drugs and increase physician willingness to discuss and prescribe generic OCPs. METHODS: A needs assessment was completed using in-person focus groups at American College of Physicians (ACP) Annual Meeting and a survey targeting baseline generic scepticism. Insights gained were used to build an educational web module detailing barriers and benefits of generic OCP prescription. The module was disseminated via email to an ACP research panel who completed our baseline survey. Post-module evaluation measured learner reaction, knowledge and intention to change behaviour along with generic scepticism. RESULTS AND DISCUSSION: The module had a response rate of 56% (n = 208/369). Individuals defined as generic sceptics at baseline were significantly less likely to complete our module compared to non-sceptics (responders 9.6% vs non-responders 16.8%, P = 0.04). The majority (85%, n = 17/20) of baseline sceptics were converted to non-sceptics (P < 0.01) following completion of the module. Compared to non-sceptics, post-module generic sceptics reported less willingness to discuss (sceptic 33.3% vs non-sceptic 71.5%, P < 0.01), but not less willingness to prescribe generic OCPs (sceptic 53.3% vs non-sceptic 67.9%, P = 0.25). Non-white physicians and international medical graduates (IMG) were more likely to be generic sceptics at baseline (non-white 86.9% vs white 69.9%, P = 0.01, IMG 13.0% vs USMG 5.0% vs unknown 18.2%, P = 0.03) but were also more likely to report intention to prescribe generic OCPs as a result of the module (non-white 78.7% vs white 57.3%, P < 0.01, IMG 76.1% vs USMG 50.3% vs unknown 77.3%, P = 0.03). WHAT IS NEW AND CONCLUSION: A brief educational web module can be used to promote prescribing of generic OCPs and reduce generic scepticism.

8.
JAMA Netw Open ; 2(5): e193209, 2019 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-31050777

RESUMEN

Importance: As opioid-related mortality continues to increase, naloxone remains a critical intervention in preventing overdose death. Opportunities to expand access through the health care setting should be optimized. Objective: To determine the characteristics of naloxone prescribing for US patients at high risk of opioid overdose. Design, Setting, and Participants: This retrospective cohort study used Truven Health MarketScan data from October 1, 2015, through December 31, 2016, of individuals with International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes related to opioid use, misuse, dependence, and overdose. The cohort included 138 108 commercially insured individuals aged 15 years or older in the United States with claims related to opioid misuse or dependence, opioid-related overdose, or both. Exposures: Outpatient naloxone pharmacy claims. Main Outcomes and Measures: Demographic characteristics, clinical characteristics, health care service use, and proportion prescribed naloxone were included in multivariable logistic regression analyses to test the association of opioid risk group with naloxone claim. Results: Of 138 108 high-risk individuals (mean [SD] age, 43.4 [0.4] years; 72 435 [52.4%] men), 2135 (1.5%) were prescribed naloxone. Having prior diagnoses of both opioid misuse or dependence and overdose was associated with a greater likelihood of receiving naloxone (odds ratio [OR], 2.32; 95% CI, 1.98-2.72; P < .001) compared with having a prior diagnosis of opioid misuse or dependence without overdose. Having a prior diagnosis of opioid overdose alone was associated with a decreased likelihood of receiving naloxone (OR, 0.73; 95% CI, 0.57-0.94; P = .01) compared with having a prior diagnosis of opioid misuse or dependence without overdose. Factors associated with lower naloxone prescription included being aged 30 to 44 years (OR, 0.72; 95% CI, 0.62-0.84; P < .001) and being from the Midwest (OR, 0.62; 95% CI, 0.54-0.71; P < .001) or West (OR, 0.85; 95% CI, 0.74-0.98; P = .03). Opioid use disorder treatment, such as use of medication-assisted therapy (OR, 1.68; 95% CI, 1.53-1.86; P < .001), visiting a detoxification facility (OR, 1.51; 95% CI, 1.31-1.76; P < .001), or receiving other substance use disorder treatment (OR, 1.16; 95% CI, 1.04-1.30; P = .01), were associated with increased likelihood of receiving naloxone, as were receiving outpatient care from a pain specialist (OR, 1.57; 95% CI, 1.40-1.76; P < .001), psychologist (OR, 1.49; 95% CI, 1.29-1.70; P < .001), or surgeon (OR, 1.19; 95% CI, 1.08-1.32; P < .001). Overall, 98.5% (n = 135 973) of high-risk patients did not received naloxone, despite many interactions with the health care system, including 88 618 hospitalizations, 229 680 emergency department visits, 298 058 internal medicine visits, and 568 448 family practice visits. Conclusions and Relevance: Patients at high risk of opioid overdose rarely received prescriptions for naloxone despite numerous interactions with the health care system. Prescribing in emergency, inpatient, and outpatient settings represents an opportunity to improve access.

9.
J Hosp Med ; 14(5): 318-319, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30986185
10.
Sleep Med ; 57: 87-91, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30921685

RESUMEN

OBJECTIVE: To contextualize inpatient sleep duration and disruptions in a general pediatric hospital ward by comparing in-hospital and at-home sleep durations to recommended guidelines and to objectively measure nighttime room entries. METHODS: Caregivers of patients four weeks - 18 years of age reported patient sleep duration and disruptions in anonymous surveys. Average at-home and in-hospital sleep durations were compared to National Sleep Foundation recommendations. Objective nighttime traffic was evaluated as the average number of room entries between 11:00pm and 7:00am using GOJO brand hand-hygiene room entry data. RESULTS: Among 246 patients, patients slept less in the hospital than at home with newborn and infant cohorts experiencing 7- and 4-h sleep deficits respectively (Newborn: 787 ± 318 min at home vs. 354 ± 211 min in hospital, p < 0.001; Infants: 703 ± 203 min at home vs. 412 ± 152 min in hospital, p < 0.01). Newborn children also experienced >2 h sleep deficits at home when compared to NSF recommendations (Newborns: 787 ± 318 min at home vs. 930 min recommended, p < 0.05). Objective nighttime traffic measures revealed that hospitalized children experienced 7.3 room entries/night (7.3 ± 0.25 entries). Nighttime traffic was significantly correlated with caregiver-reported nighttime awakenings (Spearman Rank Correlation Coefficient: 0.83, p < 0.001). CONCLUSION: Hospitalization is a missed opportunity to improve sleep both in the hospital and at home.

11.
J Hosp Med ; 14(1): 38-41, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30667409

RESUMEN

We created Sleep for Inpatients: Empowering Staff to Act (SIESTA), which combines electronic "nudges" to forgo nocturnal vitals and medications with interprofessional education on improving patient sleep. In one "SIESTAenhanced unit," nurses received coaching and integrated SIESTA into daily huddles; a standard unit did not. Six months pre- and post-SIESTA, sleep-friendly orders rose in both units (foregoing vital signs: SIESTA unit, 4% to 34%; standard, 3% to 22%, P < .001 both; sleeppromoting VTE prophylaxis: SIESTA, 15% to 42%; standard, 12% to 28%, P < .001 both). In the SIESTAenhanced unit, nighttime room entries dropped by 44% (-6.3 disruptions/room, P < .001), and patients were more likely to report no disruptions for nighttime vital signs (70% vs 41%, P = .05) or medications (84% vs 57%, P = .031) than those in the standard unit. The standard unit was not changed. Although sleep-friendly orders were adopted in both units, a unit-based nursing empowerment approach was associated with fewer nighttime room entries and improved patient experience.

12.
J Grad Med Educ ; 10(5): 566-572, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30386484

RESUMEN

Background : The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review recommends that quality improvement/patient safety (QI/PS) experts, program faculty, and trainees collectively develop QI/PS education. Objective : Faculty, hospital leaders, and resident and fellow champions at the University of Chicago designed an interdepartmental curriculum to train postgraduate year 1 (PGY-1) residents on core QI/PS principles, measuring outcomes of knowledge, attitudes, and event reporting. Methods : The curriculum consisted of 3 sessions: PS, quality assessment, and QI. Faculty and resident and fellow leaders taught foundational knowledge, and hospital leaders discussed institutional priorities. PGY-1 residents attended during protected conference times, and they completed in-class activities. Knowledge and attitudes were assessed using pretests and posttests; graduating residents (PGY-3-PGY-8) were controls. Event reporting was compared to a concurrent control group of nonparticipating PGY-1 residents. Results : From 2015 to 2017, 140 interns in internal medicine (49%), pediatrics (33%), and surgery (13%) enrolled, with 112 (80%) participating and completing pretests and posttests. Overall, knowledge scores improved (44% versus 57%, P < .001), and 72% of residents demonstrated increased knowledge. Confidence comprehending quality dashboards increased (13% versus 49%, P < .001). PGY-1 posttest responses were similar to those of 252 graduate controls for accessibility of hospital leaders, filing event reports, and quality dashboards. PGY-1 residents in the QI/PS curriculum reported more patient safety events than PGY-1 residents not exposed to the curriculum (0.39 events per trainee versus 0.10, P < .001). Conclusions : An interdepartmental curriculum was acceptable to residents and feasible across 3 specialties, and it was associated with increased event reporting by participating PGY-1 residents.

13.
J Med Internet Res ; 20(11): e289, 2018 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-30409768

RESUMEN

BACKGROUND: The US News and World Report reputation score correlates strongly with overall rank in adult and pediatric hospital rankings. Social media affects how information is disseminated to physicians and is used by hospitals as a marketing tool to recruit patients. It is unclear whether the reputation score for adult and children's hospitals relates to social media presence. OBJECTIVE: The objective of our study was to analyze the association between a hospital's social media metrics and the US News 2017-2018 Best Hospital Rankings for adult and children's hospitals. METHODS: We conducted a cross-sectional analysis of the reputation score, total score, and social media metrics (Twitter, Facebook, and Instagram) of hospitals who received at least one subspecialty ranking in the 2017-2018 US News publicly available annual rankings. Regression analysis was employed to analyze the partial correlation coefficients between social media metrics and a hospital's total points (ie, rank) and reputation score for both adult and children's hospitals while controlling for the bed size and time on Twitter. RESULTS: We observed significant correlations for children's hospitals' reputation score and total points with the number of Twitter followers (total points: r=.465, P<.001; reputation: r=.524, P<.001) and Facebook followers (total points: r=.392, P=.002; reputation: r=.518, P<.001). Significant correlations for the adult hospitals reputation score were found with the number of Twitter followers (r=.848, P<.001), number of tweets (r=.535, P<.001), Klout score (r=.242, P=.02), and Facebook followers (r=.743, P<.001). In addition, significant correlations for adult hospitals total points were found with Twitter followers (r=.548, P<.001), number of tweets (r=.358, P<.001), Klout score (r=.203, P=.05), Facebook followers (r=.500, P<.001), and Instagram followers (r=.692, P<.001). CONCLUSIONS: A statistically significant correlation exists between multiple social media metrics and both a hospital's reputation score and total points (ie, overall rank). This association may indicate that a hospital's reputation may be influenced by its social media presence or that the reputation or rank of a hospital drives social media followers.

14.
J Hosp Med ; 13(11): 764-769, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30484779

RESUMEN

BACKGROUND: Twitter-based journal clubs are intended to connect clinicians, educators, and researchers to discuss recent research and aid in dissemination of results. The Journal of Hospital Medicine (JHM) began producing a Twitter-based journal club, #JHMChat, in 2015. OBJECTIVE: To describe the implementation and assess the impact of a journal-sponsored, Twitter-based journal club on Twitter and journal metrics. INTERVENTION: Each #JHMChat focused on a recently published JHM article, was moderated by a social media editor, and included one study author or guest. MEASUREMENTS: The total number of participants, tweets, tweets/participant, impressions, page views, and change in the Altmetric score were assessed after each session. Thematic analysis of each article was conducted, and post-chat surveys of participating authors and participant responses to continuing medical education surveys were reviewed. RESULTS: Seventeen Twitter-based chats were held: seven (47%) focused on value, six (40%) targeted clinical issues, and four (27%) focused on education. On average, we found 2.17 (±0.583 SD) million impressions/session, 499 (± 129 SD) total tweets/session, and 73 (±24 SD) participants/session. Value-based care articles had the greatest number of impressions (2.61 ± 0.55 million) and participants (90 ± 12). The mean increase in the Altmetric score was 14 points (±12), with medical education-themed articles garnering the greatest change (mean increase of 32). Page views were noted to have increased similarly to levels of electronic Table of Content releases. Authors and participants believed #JHMChat was a valuable experience and rated it highly on post-chat evaluations. CONCLUSIONS: Online journal clubs appear to increase awareness and uptake of journal article results and are considered a useful tool by participants.

15.
J Clin Sleep Med ; 14(11): 1895-1902, 2018 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-30373684

RESUMEN

STUDY OBJECTIVES: Sleep is critical to a child's health and well-being, but children are likely to sleep less and be awakened more often during the night in the hospital than at home. To date no studies have compared caregiver, nurse, and physician perspectives of nighttime sleep disruptions in the pediatric general medicine setting. Our aim was to assess caregiver, nurse, and physician perspectives on the most frequent in-hospital disruptors of sleep for pediatric patients. Additionally, we evaluated the degree of agreement of those opinions between the caregivers and medical team. METHODS: Caregivers, nurses, and physicians were surveyed using the Potential Hospital Sleep Disruption and Noises Questionnaire (PHSDNQ) regarding their opinions on factors that disrupt sleep. Caregiver responses were collected via a convenience sample of patients hospitalized from February to August 2017 and hospital staff was surveyed once regarding overall perception. The perceived percentage of patients disrupted by each factor was calculated and compared among groups using chi-square tests. Using caregiver rank order based on mean response as the reference gold standard, the absolute differences of nurse and physician rank orders were summed and analyzed using a two-sample test of proportion. In addition, staff was asked knowledge and empowerment questions about how to maximize patient sleep in the hospital and responses were compared using chi-square tests. RESULTS: A total of 162 caregivers, 77 nurses (84% response rate), and 81 physicians (90% response rate) completed surveys. Checking vital signs (50%), nurse/physician interruption (49%), and continuous pulse oximetry (38%) were the three most prevalent disruptors of pediatric inpatient sleep as reported by caregivers. Significant differences were observed between caregiver, nurse, and physician responses for pain, anxiety, alarms, noise, and tests (P ≤ .001 for all). Both nurse and physician rank orders were discordant when compared to caregivers; there was no significant difference between the two staff groups. When compared to physicians, nurses reported doing more to help children sleep in the hospital (33% versus 94%, P < .001). CONCLUSIONS: Although caregivers report medical interventions such as checking vital signs, nurse/physician interruption, and continuous pulse oximetry as the most frequent disruptors of inpatient pediatric sleep, pediatric staff has poor insight into these disruptions.

16.
Acad Med ; 2018 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-30334841

RESUMEN

PURPOSE: To determine the responsibilities of journal social media editors (SMEs) and describe their goals and barriers and facilitators to their position. METHOD: The authors identified SMEs using an informal listserv and snowball sampling. Participants were interviewed (June-July 2016) about their position, including responsibilities, goals, barriers and facilitators, and attitudes and perceptions about the position. Themes were identified through a thematic analysis and consensus building approach. Descriptive data, including audience metrics and 2016 impact factors, were collected. RESULTS: Thirty SMEs were invited; 24 were interviewed (19 by phone and 5 via e-mail). SMEs generally had a track record in the social media community before being invited to be SME; many had preexisting roles at their journal. Responsibilities varied considerably; some SMEs also served as decision editors. Many SMEs personally managed journal accounts, and many had support from non-physicians journal staff. Consistently, SMEs focused on improving reader engagement by disseminating new journal publications on social media. The authors identified goals, resources, and sustainability as primary themes of SMEs' perspectives on their positions. Editorial leadership support was identified as a key facilitator in their position at the journal. Challenges to sustainability included a lack of tangible resources and uncertainty surrounding, or lack of, academic credit for social media activities. CONCLUSIONS: Many of the participating SMEs pioneered the use of social media as a platform for knowledge dissemination at their journals. While editorial boards are qualitatively supportive, SMEs are challenged by limited resources and lack of academic credit for social media work.

19.
JMIR Med Educ ; 4(2): e18, 2018 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-30131315

RESUMEN

BACKGROUND: Although the Clerkship Directors in Internal Medicine (CDIM) has created a core subinternship curriculum, the traditional experiential subinternship may not expose students to all topics. Furthermore, academic institutions often use multiple clinical training sites for the student clerkship experience. OBJECTIVE: The objective of this study was to sustain a Web-based learning community across geographically disparate sites via enterprise microblogging to increase subintern exposure to the CDIM curriculum. METHODS: Internal medicine subinterns used Yammer, a Health Insurance Portability and Accountability Act (HIPAA)-secure enterprise microblogging platform, to post questions, images, and index conversations for searching. The subinterns were asked to submit 4 posts and participate in 4 discussions during their rotation. Faculty reinforced key points, answered questions, and monitored HIPAA compliance. RESULTS: In total, 56 medical students rotated on an internal medicine subinternship from July 2014 to June 2016. Of them, 84% returned the postrotation survey. Over the first 3 months, 100% of CDIM curriculum topics were covered. Compared with the pilot year, the scale-up year demonstrated a significant increase in the number of students with >10 posts (scale-up year 49% vs pilot year 19%; P=.03) and perceived educational experience (58% scale-up year vs 14% pilot year; P=.006). Few students (6%) noted privacy concerns, but fewer students in the scale-up year found Yammer to be a safe learning environment. CONCLUSIONS: Supplementing the subinternship clinical experience with an enterprise microblogging platform increased subinternship exposure to required curricular topics and was well received. Future work should address concerns about safe learning environment.

20.
Patient Educ Couns ; 101(12): 2156-2161, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30007764

RESUMEN

OBJECTIVE: Despite rapid EHR adoption, few faculty receive training in how to implement patient-centered communication skills while using computers in exam rooms. We piloted a patient-centered EHR use training to address this issue. METHODS: Faculty received four hours of training at Cleveland Clinic and a condensed 90-minute version at the University of Chicago. Both included a lecture and a Group-Objective Structured Clinical Exam (GOSCE) experience. Direct observations of 10 faculty in their clinical practices were performed pre- and post-workshop. RESULTS: Thirty participants (94%) completed a post-workshop evaluation assessing knowledge, attitude, and skills. Faculty reported that training was important, relevant, and should be required for all providers; no differences were found between longer versus shorter training. Participants in the longer training reported higher GOSCE efficacy, however shorter workshop participants agreed more with the statement that they had gained new knowledge. Faculty improved their patient-centered EHR use skills in clinical practice on post- versus pre-workshop ratings using a validated direct-observation rating tool. CONCLUSION: A brief lecture and GOSCE can be effective in training busy faculty on patient-centered EHR use skills. PRACTICE IMPLICATIONS: Faculty training on patient-centered EHR skills can enhance patient-doctor communication and promotes positive role modeling of these skills to learners.

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