Gary L. Beck

The Administrative Colloquium: Developing Management and Leadership Skills for Faculty

OBJECTIVE Development of leadership competencies has become a priority for many academic health science centers. However, traditional faculty development has focused almost exclusively on improving teaching skills. The process and outcomes of developing leadership skills for academic health science center faculty has not been extensively studied. METHODS The University of Nebraska Medical Center (UNMC) created a year-long course, called the Administrative Colloquium, as a means to enhance faculty leadership skills. Completion of the course required attendance at 8 half-day workshop sessions, each devoted to teaching a leadership competency (eg, leading with vision, managing change) and completing a project with a project report (oral or poster presentation). Course evaluation was multifaceted. Attendees were queried multiple times by a pre- and poststrategy and retrospective pre- and poststrategy concerning their perceptions about knowledge obtained during the course. Paired t testing was used to determine statistical differences between the mean pre- versus postvalues and the retrospective pre- versus postvalues. Project content was qualitatively analyzed for themes. RESULTS All comparisons of pre- and postdata and retrospective pre- and postdata were statistically significant (P <.05). Three themes arose from the analysis of projects: change, management, and interpersonal communications. CONCLUSIONS The pre- and postknowledge data and the retrospective pre- and postknowledge data demonstrate that learning was significant as well as sustained. Qualitative analysis of the project content demonstrates that the participants were applying the course content to solving real-world problems. These results give preliminary support to the conclusion that the Administrative Colloquium has had an impact on faculty leadership development at UNMC.

A Comparison of Clinical Pediatric Patient Encounters in University Medical Center and Community Private Practice Settings

BACKGROUND Growing numbers of medical students complete clerkships in community private practice (CPP) settings instead of the more traditional university-based clinics, yet few empirical studies have evaluated how setting type impacts clinical experiences, skill development, and student satisfaction. OBJECTIVE This study compared the pediatric patient encounters seen by third-year medical students in university medical center (UMC) and CPP settings. METHODS Third-year medical students were required to keep a log of all patients seen during their 8-week pediatric clerkship. Logbook entries were coded and then analyzed for differences in the number and distribution of the primary diagnostic categories between settings. RESULTS CPP students reported, on the average, seeing over 3 times more patients than UMC students. The case mix distribution also differed significantly by setting. In general, CPP students reported seeing proportionately more routine illnesses, whereas UMC students reported seeing proportionately more uncommon disorders. Because CPP students saw more patients overall, they averaged more cases in almost all diagnostic categories. CONCLUSION CPP students received more clinical patient exposure than UMC students, except for patients in a few diagnostic categories.

Assessment of Initial Serum Vancomycin Trough Concentrations and Their Association with Initial Empirical Weight-Based Vancomycin Dosing and Development of Nephrotoxicity in Children: A Multicenter Retrospective Study

To determine whether a relationship exists between initial serum vancomycin trough concentrations and initial empirical vancomycin dose, patient weight, and patient age, and to determine the risks for vancomycin‐associated nephrotoxicity in pediatric patients stratified by hospital setting.

Clinical experience and examination performance: is there a correlation?

Context  The Liaison Committee on Medical Education (LCME) requires there to be: ‘…comparable educational experiences and equivalent methods of evaluation across all alternative instructional sites within a given discipline’. It is an LCME accreditation requirement that students encounter similar numbers of patients with similar diagnoses. However, previous empirical studies have not shown a correlation between the numbers of patients seen by students and performance on multiple‐choice examinations.

Advancing Interprofessional Education: A Qualitative Analysis of Student and Faculty Reflections

Interprofessional education (IPE) is imperative when training health professions students to practice in an environment requiring a team based approach. IPE has not been widely practiced in the United States (US) since its immergence in the 1970’s and waning in the 1980’s.Contemporary curricula, instruction, and IPE activities still need to be tested. This report focuses on the analysis of qualitative feedback collected from faculty and students participating in IPE activities, designed for first year health professions students in the Fall 2010 (n=542), and Fall 2011 (n=555). An interprofessional research team conducted analysis using an immersion/crystallization framework. Eight major themes emerged from comments provided through evaluations of the IPE activities. Students expressed a desire to learn more about roles, skills, and responsibilities of other professions and wanted additional IPE opportunities integrated throughout their education. Skill level of small IPE group facilitators emerged as an important component for successful IPE activities. Lessons learned through this analysis will guide future augmentation of interprofessional activities locally and can be applied at other medical campuses.

Unexpected findings from an interdisciplinary case conference

There has been recognition of the need to train clinicians in the methods of Evidence-based Medicine (EBM). There is considerable variation in the methods of teaching EBM in clinical settings, very often left to the initiative of enthusiastic individuals. Teach the teacher (TTT) EBM courses might help to improve teaching quality and set a standard for EBM teaching. We determined the availability and content of TTT EBM courses. A questionnaire developed by the EU EBM partnership (Thangaratinam et al. 2009) was sent to medical institutions potentially offering TTT EBM courses in the United Kingdom, Germany, Hungary, Poland and the Netherlands. The country specific infrastructure and existing networks were used to reach out to target organisations between August 2008 and March 2009. We encouraged recipients to forward the questionnaire if not addressed correctly. All courses of which the organisers stated to be a TTT EBM course were included. We identified 16 courses out of 114 responses (multiple responses per institution): four in Hungary, four in the Netherlands, four in the United Kingdom and four in Germany. The courses mainly targeted academic specialists or medical practitioners and were taught by academic specialists (N1⁄4 15) and/or methodologists/statisticians (N1⁄4 11). Twelve courses regarded teaching the various steps of EBM; seven regarded teaching integration of EBM into daily clinical practice. The clinical learning opportunities chosen were (in order of frequency): journal club, ward rounds, outpatient practice, formal clinical meeting and formal assessments. In eight courses, e-learning modules aided teaching. Eleven courses were officially certified or CMEcredited, also eleven concluded with a formal assessment. Course organisers highlighted the need for help providing practical examples on successful techniques for teaching EBM in clinical practice (N1⁄4 7), help with a curriculum for trainers to train healthcare workers (N1⁄4 7) and help with funding of TTT courses (N1⁄4 7). The low availability of TTT courses in Europe might indicate a need for development of TTT courses that can be used as a reference point for EBM teaching for postgraduate teachers.

Enhancing situational interest in pediatrics

Background: Individual interest, something that persists regardless of the situation, and situational interest, finding personal value in an educational context, have not been studied in medical student education. Objective: To determine if individualized case discussions enhance interest in pediatric medicine. Methods: During the 2008/2009 academic year, 88 clerkship students participated in clinical case discussions. At orientation, students completed an Interest in Pediatrics (IIP) questionnaire, responding 1 = Strongly Disagree to 5 = Strongly Agree. Intervention and control groups were randomly assigned. The intervention group personalized cases to students’ medical specialty interests. The control group discussed the case presentation. Groups met twice during the 8-week clerkships, completing a post-IIP at the end of the clerkship. Results: Intervention group interest increased from pre-IIP, mean = 3.64, to post-IIP, mean = 4.22 (z = −2.994, p < 0.05, r = −0.44). On post-IIP, application of pediatric medicine increased for both groups; the intervention group was most significant from pre-IIP, mean = 1.09, to post-IIP, mean = 4.33 (z = −6.038, p < 0.05, r = −0.88). Discussion: Enhanced interest in pediatrics from the intervention group indicates that creating a learning environment personally relevant to students’ careers facilitates interest to learn.