Leslie J. Sandlow

Addiction Medicine and Continuing Medical Education

Addictive disorders are one of the most common problems encountered by primary care physicians. In the last decades there has been a significant effort by organizations, universities, and private foundations to increase the teaching of alcohol and drug abuse issues to medical students, residents and practitioners. Still, up to now, the subject has not been presented appropriately at either the undergraduate or graduate medical education level and the majority of physicians in practice have not been adequately instructed in addiction medicine. This article reviews the literature on addictive disorders and medical education, exploring issues concerning continuing medical education (CME) in particular. The authors discuss the problems relative to this subject and the educational techniques and methods most appropriate to changing attitudes and behaviors of physicians. They also design an approach to a CME program on addictive disorders for primary care physicians that incorporates multiple teaching/learning methodologies.

Data repositories for medical education research: issues and recommendations.

The authors explore issues surrounding digital repositories with the twofold intention of clarifying their creation, structure, content, and use, and considering the implementation of a global digital repository for medical education research data sets—an online site where medical education researchers would be encouraged to deposit their data in order to facilitate the reuse and reanalysis of the data by other researchers. By motivating data sharing and reuse, investigators, medical schools, and other stakeholders might see substantial benefits to their own endeavors and to the progress of the field of medical education. The authors review digital repositories in medicine, social sciences, and education, describe the contents and scope of repositories, and present extant examples. The authors describe the potential benefits of a medical education data repository and report results of a survey of the Society for Directors of Research in Medicine Education, in which participants responded to questions about data sharing and a potential data repository. Respondents strongly endorsed data sharing, with the caveat that principal investigators should choose whether or not to share data they collect. A large majority believed that a repository would benefit their unit and the field of medical education. Few reported using existing repositories. Finally, the authors consider challenges to the establishment of such a repository, including taxonomic organization, intellectual property concerns, human subjects protection, technological infrastructure, and evaluation standards. The authors conclude with recommendations for how a medical education data repository could be successfully developed.

Teaching problem-oriented recording: a systematic approach.

Medical students and practitioners usually learn how to use problem-oriented medical records (POMR) by haphazard means. In attempting to put system into the teaching of POMR, the authors devised teaching case material and two instructional formats: self-instruction and workshop. The results of a controlled study with second-year medical students to determine the relative effectiveness of instructional formats and case materials are presented. At the end of instruction POMR performance was measured by assessing the students ability to convert a case to POMR format. The results suggest that all student groups attained an acceptable performance level no matter which format they experienced.

Format Review: Evaluating Implementation of the Problem-Oriented Medical Record

As interest in the problem-oriented medical record (POMR) develops, and more medical settings begin to implement the system, many observers are expressing a desire to know how well the system is being used and accepted. Moreover, settings currently using the POMR system have a need to document the effectiveness of their POMR program as a means of insuring continued progress and for addressing difficulties and obstacles affecting its use. Format review is a technique for reviewing patient records and describing patterns of POMR use. Patient records of an institution are reviewed concurrent to the patients contact with the institution. Data collected from each record is summarized to provide an overview on patterns of POMR use and to identify areas of difficulty. These findings can serve as the basis for educational and administrative intervention to improve use of POMR. The format review technique is explained and examples of its application are given. The technique has been used at Michael Reese Hospital and Medical Center over the past two years, and has proven to be a useful tool in describing the implementation progress of POMR.

University of Illinois College of Medicine at Chicago.

Mechanisms for curriculum review and assessment are structured so that each program site can maintain oversight of curricular content and integration through the local curriculum committees (see Figure 1). Each site curriculum committee has subcommittees that focus on basic or clinical sciences and groups that focus on integration and reinforcement of basic science principles in the clinical years and increasing clinical relevance within the basic sciences. Within the core clinical disciplines, the basic sciences, and the bridging courses, Education Coordinating Committees (ECCs) composed of department heads, course and clerkship directors, or key faculty members at each site recommend policy on educational issues and coordinate implementation of essential knowledge and procedural competencies. Both sets of committees report directly to the College Committee on Instruction and Appraisal (CCIA). The College is committed to the success of the educational program to support learning, to enforce educational accountability, and to assess the extent to which students are mastering objectives. Other integrating mechanisms include regular meetings of the academic associate deans, the student affairs deans, and the Academic Council of Deans. The Executive Committee and the CCIA have balanced representation from the four sites, and meetings are rotated among the sites, videoconferenced, or teleconferenced.