Linda A. Deloney

The POD: a new model for mentoring underrepresented minority faculty.

Mentoring, long recognized as a catalyst for successful careers, is particularly important to the career development of underrepresented minority (URM) faculty. In academic medicine, mentor–protégé relationships are seriously threatened by increased clinical, research, and administrative demands and an emphasis on scholarship over citizenship. New mentoring models are needed, and they should be adaptable to a medical school’s unique structure and mission. The Peer-Onsite-Distance (POD) model, developed in 2002 by the authors and introduced at the College of Medicine at the University of Arkansas for Medical Sciences, is a targeted, multilevel mentoring prototype that is built on a solid research foundation and tailored to the unique needs of URM medical school faculty. The mentee’s individual needs for guidance related to career goals, resources, and the content and interaction skills that are known to be critical to successful academic careers are targeted for development. The multilevel approach provides a unique network of peer and faculty mentors who provide site-specific career guidance. Also in the network are leaders in their fields who can provide access to accurate information, cautions, predictions, and announcements of future resources or potential restrictions in academic medicine. Mentor commitments are clearly defined and time contributions are maximized. The POD model aims to promote retention and advance the careers of URM faculty by wrapping them in a protective cushion of interpersonal and intrapersonal support. The flexibility of the design allows for adaptation to any institution’s unique structure and mission.

Measuring Student Motivation in Health Professions' Colleges

Active, independent, self-directed learning requires motivation, or a willingness to exert high levels of effort toward educational goals, conditioned by individual need. Motivation maybe a function of individual differences or induced by situational constraints. Archer (1994), who used goal orientation to conceptualize university student motivation, theorized that students would exhibit a preference for either mastery orientation (desire to develop competence/increase understanding), performance orientation (desire to demonstrate competence/ability), or academic alienation (no concern for developing competence or demonstrating achievement). The purpose of this study was to identify and validate an instrument that would measure goal orientation preferences of students in health professions programs. The authors administered Archers survey to a sample of medical, nursing, and pharmacy students to determine if the instrument was appropriate for this population. Results demonstrated that goal orientation preference could be measured in these students and confirmed the instruments reliability and valid use for these populations.

The First Clinical Skill: Students Teach Students to Take Vital Signs

Abstract: Transition from the role of passive student to medical practitioner begins with learning the first clinical skill. This transition can be stressful for those experiencing it and to some extent by those coordinating it. Logistically, it requires demonstration of the techniques to the entire class by a single practitioner or to smaller groups of students by multiple practitioners. The former reduces the opportunity for close observation of technique and is less conducive to questions, while the latter requires multiple practitioners, which can be prohibitive given their already dense schedules. To reduce the stress for all involved and to maximize learning opportunities, an innovative approach to teaching the first skill, vital signs measurement, was developed. Small group instruction and practice were facilitated by senior medical student volunteers in a simulated outpatient clinic using actual equipment. Instruction was provided in a relaxed, but guided format. Students were provided with a lesson plan that detailed both, technique and brief physiology points, as well as check sheets to use during the lab and later as a refresher guide. The lesson plan, instructions for facilitators, and student check sheets were developed by a senior medical student and reviewed by the course faculty. Recruitment and briefing of student facilitators and conduct of the lab were also performed by the senior student. The purpose of this trend article is to describe the development of a new course format and to report our experience with implementation of the new format. It is intended to spark interest in applying similar approaches to other curricular issues.

Using electronic journal writing to foster reflection and provide feedback in an introduction to clinical medicine.

No abstract available.

Establishment of a Simple and Inexpensive Remote Radiology Conference

t t p q m f P c c r V esidents’andfacultymembers’particpation ineducational conferences is reuired [1], but the delivery of quality onferences is a challenge in today’s acdemic environment. Didactic confernces are time and labor intensive, resients and faculty members are often ocated in multiple sites, and heavy linical workloads can preclude particiation [2,3]. Videoconferencing is a popular ay to transmit information to a disant site, but setup is expensive, and issatisfaction with quality has been eported [4]. A cost-effective alternaive is the Web conference. Real-time udio and video transmissions have ade Web conferencing possible, hile significant improvements in nformation technology and comunication bandwidth have faciliated the rapid development of reote conferencing capabilities [2,5]. Conference attendance in our raiology residency program suffered hen major construction projects ere under way on 2 of our 3 camuses. We sought an alternative that ould eliminate the travel burden. In haring our experience, we hope that ther medical education programs ill be able to implement similar ost-effective options using off-thehelf materials.

Radiology Boot Camp: Facilitating the Transition of Interns into Residents

It is no secret that transitions inmedical education are challengingand inherently stressful. New in-ternsstrugglewithalackofmedicalknowledge, poor organizationalskills, inadequate ability to reflectand self-assess, and underdevelo-ped professionalism, most oftenattributed to a lack of thoroughpreparation in medical school [1-3]. Then, after a year of clinicalpracticeinmedicineorsurgeryoratransitional year, the transition toradiology residency presents a newsetofchallenges.Theradiologyres-ident is no longer the the primarycontact in direct patient care anddecisionmaking,butisexpectedtobe an imaging consultant, operat-ing largely behind the scenes in anunfamiliar specialty [4-6]. Few res-idents gain skills and experienceswith imaging modalities and stud-ies during medical school and in-ternship, so they find themselves asnovices once again [7]. Additionalstresses are created by having toadapt to a hospital-based learningenvironmentand,often,anewpro-gram director and set of peers. Ourspecialty’s reliance on the internetanddigitaldevicesforaccessinged-ucational material requires a highlevel of technological savvy [8,9].Thevolumeandcomplexityofnewinformation to be assimilated canparalyze and demoralize any newradiology resident.Research on “resident readiness”suggests the usefulness of focusededucationalinterventionstoimprovethe clinical orientation process andincrease residents’ confidence [2,6,7,10-13].Asmallbutgrowingcollec-tion of literature has focused on“boot camps,” which are being usedin graduate medical education tomaximize fundamental teachingtime while fostering team building[5,11].Colloquially, “boot camp” refersto military recruit training as anabrupt,oftenshockingtransitiontoanew way of life, with strict disciplineand an emphasis on hard work andphysical conditioning. Companiesalso use boot camps to immerse re-cruitsinbothtechnicalskillsandcor-porateculture.Asaresult,therecruitsdevelop strong bonds to their peersand the organization [14]. Havingpeerstheycanrelyonhelpsresidentscopeandalleviatessomeofthenega-tive effects of high stress levels.The literature on preparation andreadiness for radiology is sparse butemerging. One program’s lecture se-ries designed specifically for incom-ing residents resulted in an increasein residents’ confidence (althoughclinical performance improvementcould not be demonstrated) [7].Inanotherprogram,theadditionofres-ident-to-resident role-oriented pre-sentations decreased anxiety andincreased role awareness more thanlectures alone [6].

Grover disease (Transient Acantholytic Dermatosis) in acute myeloid leukemia on FDG PET/CT

A 48-year-old man with a newly diagnosed acute myeloid leukemia developed purpuric rash on day 6 after chemotherapy. Skin biopsy on day 8 demonstrated Grover disease. Triamcinolone treatment started on day 10 with subjective improvement on day 15. Initial FDG PET/CT on day 12 demonstrated rarely seen diffuse skin uptake that was interpreted as technical artifact and repeated on day 16. Accurately reviewing both PET and CT imaging would prevent confusion between diffuse cutaneous hypermetabolic activity and a technical artifact. Grover disease usually affects the trunk and may be related to the elimination of chemotherapy agents by sweating.

Lightly Embalmed Cadavers as a Training Tool for Ultrasound-Guided Procedures Commonly Used in Interventional Radiology

RATIONALE AND OBJECTIVES Competency in ultrasound (US) imaging and US-guided procedures is often difficult for medical students and residents to master. The use of simulation training has been strongly encouraged but the quality of phantom models available for US-guided procedures is limited. As a feasible alternative, we describe the innovative use of a lightly embalmed cadaver for realistic practice of common interventional radiology (IR) procedures prior to direct patient care. MATERIALS AND METHODS Lightly embalmed cadavers were positioned as patients would be in the IR suite: supine, prone, and erect seated position. Lidocaine was injected and visualized under standard percutaneous techniques and sonographic guidance was used to simulate common US-guided procedures performed in IR including liver biopsy, kidney biopsy, thoracentesis, and vascular access. RESULTS The ability to position cadavers was a key factor that allowed entire procedures to be simulated. Medical students with very limited exposure to US imaging and diagnostic radiology residents with minimal exposure to US imaging successfully completed common US-guided procedures. Arterial and venous vascular access was obtained. Wires were passed and catheters easily placed via both access sites. The texture of the tissue layers provided realistic feedback for the trainees as they advanced the needle or dilated the tissues. Images from each simulated procedure resembled images expected in a living patient. CONCLUSION Lightly embalmed cadavers are an innovative and feasible tool to simulate common IR US-guided procedures in a realistic fashion for deliberate practice in advance of first-attempt encounters with patients.

Server-based enterprise collaboration software improves safety and quality in high-volume PET/CT practice.

With increasing volumes of complex imaging cases and rising economic pressure on physician staffing, timely reporting will become progressively challenging. Current and planned iterations of PACS and electronic medical record systems do not offer workflow management tools to coordinate delivery of imaging interpretations with the needs of the patient and ordering physician. The adoption of a server-based enterprise collaboration software system by our Division of Nuclear Medicine has significantly improved our efficiency and quality of service.