Charles W. Dohner

Defining and evaluating quality for ambulatory care educational programs.

As the training of medical students and residents increasingly moves to ambulatory care settings, clerkship and program directors must find a way to use their limited resources to guide the development and evaluation of the quality of these ambulatory-based learning experiences. To evaluate quality, directors must first define, in operational and measurable terms, what is meant by the term “quality” as it is applied to ambulatory-based education. Using educational theories and the definition of quality used by health care systems, the authors propose an operational definition of quality for guiding the planning, implementation, and evaluation of ambulatory care educational programs. They assert that quality is achieved through the interaction of an optimal learning environment, defined educational goals and positive outcomes, participant satisfaction, and cost-effectiveness. By describing the components of quality along with examples of measurable indicators, the authors provide a foundation for the evaluation and improvement of instructional innovations in ambulatory care education for the benefit of teachers, learners, and patients.

Medical education research at the University of Washington School of Medicine: lessons from the past and potential for the future.

Faculty in the Department of Medical Education and Biomedical Informatics at the University of Washington School of Medicine received over

Teaching Basic Science and Clinical Medicine at a Distance: An Evaluation of Satellite Communication

1.2 million in direct grant and contract support in 2003. In this case study, the authors provide some of the history and background of the evolution of the departments structure and its role in providing leadership in medical education research at the university, as well as regionally, nationally, and internationally. The authors offer their observations and reflections on what has helped and hindered the departments success, and end with some predictions on medical education research in the future. The University of Washingtons five-state regional WWAMI educational program, establishing a single medical school for the states of Washington, Wyoming, Alaska, Montana, and Idaho, has been an important environmental influence on the direction of the departments educational and research activities. External support has helped the department to create the Northwest Consortium for Clinical Performance Assessment, the Center for Medical Education Research, the Teaching Scholars Program, and a Biomedical and Health Informatics graduate and fellowship training program, as well as a number of international programs.

Evaluating Student Performance in a Decentralized Basic Science Program.

The evaluation plan arid preliminary results are reported for the ATS‐6 Satellite interactive telecommunication program for teaching at sites remote from an established medical school. The technical aspects of the system were seen as quite adequate and did not appear to substantially inhibit interaction. In the Fairbanks broadcasts analyzed, the average number of interactions ranged from 1.49 to 2.60 per minute. Ninety percent of the interaction flowed across the Satellite during Omak transmissions. Participants tended to initiate communication when they were on camera rather than when viewing their counterparts. Omak participants directed a higher percentage of the communication in student/resident programs (70%) than in faculty continuing education programs (59%). Interaction analysis indicated the categories of giving opinion, information, and suggestion were most frequent. Asking for opinion and suggestion occurred infrequently. The most frequent emotional expression was offering solidarity (e.g., rea...

Evaluating Decentralized Basic Science Medical Education: A Model

The results of the evaluation of the basic science curriculum in a regionalized medical education program in the states of Washington, Alaska, Montana, and Idaho (WAMI) are presented and discussed. The hypothesis that students taking the first quarter of basic science at universities remote from the Unversity of Washington School of Medicine (UWSM) will be no different in academic performance from those who remain at the UWSM is tested. The variables considered were student performance on (a) common tests in Anatomy/Histology, Biochemistry, Mechanisms of Physiology, and Epidemiology; (b) subsequent course work at the UWSM; and (c) the mini-tests and Part I of the examinations of the National Board of Medical Examiners. The developement of the common tests is described. Analysis of variance indicates that the null hypothesis cannot be rejected at the .05 level.

EVALUATION OF SATELLITE COMMUNICATION FOR TEACllINC BASIC SCIENCE AND CLINICAL MEDICINE

The Washington, Alaska, Montana, and Idaho Program in Decentralized Medical Education began in 1971. Since that time, more than 400 students have participated in the University Phase of the program. This article presents a modelfor evaluating the basic science portion of the program in which the first year of medical school is taught at sites remote from the medical center in Seattle, Washington. The article describes a methodology for assessing student performance and student and faculty satisfaction with the program. The results indicate (1) that students at remote sites are indistinguishable from those students who study at the University of Washington School of Medicine and (2) that they choose primary care pathways and residencies at a greater rate than their classmates at the School of Medicine.

Communications Satellites in Health Education and Health Care Delivery: Operation Considerations.

The evaluation plan and preliminary results are rcportcd for the ATS-6 Satellite interactive telecommmicntion program for teaching at sites remote from an cstni~lislicd medical school. The technical aspects of the system were seen as quite adequate and did not appear to substantially inhibit interaction. In the Fairbanks broadcasts analyzed, the average number of interactions ranged from 1.49 to 2.60 per minute. Ninety percent of che interaction flwrd across the Satellite during hak transmissions. Participants tended to initiate communication wlcm thcy were on camera rathex than when viewing their counterparts. hak participants directed a higher percentage of the communication in student/msident programs (70%) than in faculty continuing education programs (59%). Interaction ;~n;rlysis indicated the categories of giving opinion, Informat.ion, and suggestion were more frequent. Asking for opinion and suggestion occurred infre<quently. The most frequent emotional expression vas offering solidarity (e.g., reassurance), while thcre were cxceedingly few expressions of disagrremcnt, tension and antagonism. User acceptance of the system was determined to be very high. Participants with frequent exposure to the Satellite mod;iIity tended to have positive reaction. A significant difference in knowledge gain is reported in ow of two basic science areas taught via Satellite as compared to regular instruction.

Career preferences of first- and second-year medical students: the WAMI experience.

In the past decade, communication satellites have assumed an increasingly significant role in meeting world communication needs. Advocates project vast arrays of potential utilization for this distance independent technology. Such expansion of use depends upon user acceptance, a variable which has as a requisite dimension, the perception of trouble-free operation and similarity with face to face verbal interaction. Following two hundred twenty-two satellite-mediated broadcasts, the authors review the variety of user-related pitfalls which occurred during this experiment in health education and health care delivery. Specific consideration is given to those problems which need to be remedied for a “user acceptable” system of satellite communication in the health care arena. Though the technical system works, it is suggested that additional emphases upon participant acceptance are necessary before the technology will be widely accepted and utilized.