Barbara E. Barnes

Creating an infrastructure for training in the responsible conduct of research: the University of Pittsburgh's experience.

In response to public concerns about the consequences of research misconduct, academic institutions have become increasingly cognizant of the need to implement comprehensive, effective training in the responsible conduct of research (RCR) for faculty, staff, students, and external collaborators. The ability to meet this imperative is challenging as universities confront declining financial resources and increasing complexity of the research enterprise. The authors describe the University of Pittsburghs design, implementation, and evaluation of a Web-based, institution-wide RCR training program called Research and Practice Fundamentals (RPF). This project, established in 2000, was embedded in the philosophy, organizational structure, and technology developed through the Integrated Advanced Information Management Systems grant from the National Library of Medicine. Utilizing a centralized, comprehensive approach, the RPF system provides an efficient mechanism for deploying content to a large, diverse cohort of learners and supports the needs of research administrators by providing access to information about who has successfully completed the training. During its first 3 years of operation, the RPF served over 17,000 users and issued more than 38,000 training certificates. The 18 modules that are currently available address issues required by regulatory mandates and other content areas important to the research community. RPF users report high levels of satisfaction with content and ease of using the system. Future efforts must explore methods to integrate non-RCR education and training into a centralized, cohesive structure. The University of Pittsburghs experience with the RPF demonstrates the importance of developing an infrastructure for training that is comprehensive, scalable, reliable, centralized, affordable, and sustainable.

What are the implications of implementation science for medical education

Background Derived from multiple disciplines and established in industries outside of medicine, Implementation Science (IS) seeks to move evidence-based approaches into widespread use to enable improved outcomes to be realized as quickly as possible by as many as possible. Methods This review highlights selected IS theories and models, chosen based on the experience of the authors, that could be used to plan and deliver medical education activities to help learners better implement and sustain new knowledge and skills in their work settings. Results IS models, theories and approaches can help medical educators promote and determine their success in achieving desired learner outcomes. We discuss the importance of incorporating IS into the training of individuals, teams, and organizations, and employing IS across the medical education continuum. Challenges and specific strategies for the application of IS in educational settings are also discussed. Conclusions Utilizing IS in medical education can help us better achieve changes in competence, performance, and patient outcomes. IS should be incorporated into curricula across disciplines and across the continuum of medical education to facilitate implementation of learning. Educators should start by selecting, applying, and evaluating the teaching and patient care impact one or two IS strategies in their work.Background Derived from multiple disciplines and established in industries outside of medicine, Implementation Science (IS) seeks to move evidence-based approaches into widespread use to enable improved outcomes to be realized as quickly as possible by as many as possible. Methods This review highlights selected IS theories and models, chosen based on the experience of the authors, that could be used to plan and deliver medical education activities to help learners better implement and sustain new knowledge and skills in their work settings. Results IS models, theories and approaches can help medical educators promote and determine their success in achieving desired learner outcomes. We discuss the importance of incorporating IS into the training of individuals, teams, and organizations, and employing IS across the medical education continuum. Challenges and specific strategies for the application of IS in educational settings are also discussed. Conclusions Utilizing IS in medical education can help us better achieve changes in competence, performance, and patient outcomes. IS should be incorporated into curricula across disciplines and across the continuum of medical education to facilitate implementation of learning. Educators should start by selecting, applying, and evaluating the teaching and patient care impact one or two IS strategies in their work.

Financial Conflicts of Interest in Continuing Medical Education: Implications and Accountability

n this era of major scientific advances and evolving models of care delivery and payment, physicians and other health care professionals struggle to remain current. Accredited continuing medical education (CME) activities are a key resource for providing credible and accessible information. However, serious concerns have been raised about the effectiveness of CME, from the perspectives of educational design as well as potential influence from commercial and other interests. As the profession of medicine strives to simultaneously balance the accessibility, cost, and quality of care, it is critical for CME activities to be focused on the best interests of patients and society rather than on constituencies whose priorities may be in conflict with the public good.

Nonstandard Programs: The University of Pittsburgh Medical Centerʼs Next Frontier in Graduate Medical Education

The University of Pittsburgh Medical Center has seen continuous growth in the number and types of graduate training programs not accredited by the Accreditation Council for Graduate Medical Education (ACGME), the American Board of Medical Specialties, or the American Osteopathic Association. For the purposes of ensuring best educational products and of controlling unrecognized competition with our accredited programs, a sequential process of centralized oversight of these nonstandard programs was undertaken. The first step involved programs whose fellows were hired and tracked like accredited fellows (i.e., not instructors). The basic process began with consensus among leadership, writing of policy with consultation as necessary, establishment of a registry of programs and graduates, and a committee to allow sharing of best practices and dissemination of policy. The second step applied the same process to instructor-level programs. Whereas the previous group of programs was made subject to ACGME regulations, more latitude in duty hours and progressive responsibility were allowed for instructor programs. The final step, in progress, is extending a similar but modified approach to short-duration clinical experiences and observerships. The outcomes of these efforts have been the creation of a centralized organizational structure, policies to guide this structure, an accurate registry of a surprising number of training programs, and a rolling record of all graduates from these programs. Included in the process is a mechanism that ensures that core program directors and department chairs specifically review the impact of new programs on core programs before allowing their creation.