Objective: The purpose of this exploratory study was to examine adverse childhood experiences (ACEs), knowledge, and screening practices. Methods: A convenience sample of pediatric primary care providers in a health-care system within a high-prevalence state were invited to participate. The original 12-item survey addressed familiarity, tools, barriers, and prevalence regarding ACEs. Results: Study participants reported familiarity with ACEs; however, only 23% reported the use of any screening tool(s). Primary barriers included time and lack of staff and/or knowledge/training. About 77% of respondents have encountered at least eight of the 10 major types of ACEs. Most frequently encountered ACEs included parental separation or divorce, substance abuse in the household, and mental illness in the household. About 73% expressed interest in continuing medical education. Conclusions: Provider knowledge/familiarity with ACEs does not imply systematic screening. An efficient and evidence-based standardization for screening merits consideration. Continued education and training may address barriers to both provider understanding and screening of ACEs.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Objective: The objective of this study was to outline the process and results of a curriculum map revision. Methods: A revision process was developed for curricular competencies and measurable abilities (MAs). A crosswalk of the original MAs to the revised MAs and curriculum mapping reports for the 2018–2019 and 2019–2020 academic years were evaluated. Results: The number of competencies decreased from 12 to 11 and MAs increased from 90 to 98. The MA word count decreased from 1719 to 1498 (12.9%); 25 were combined, 26 were deleted, seven were divided, and 47 were created. Course learning outcomes (CLOs) mapped to a mean of 139 and 39 MAs prerevision and postrevision, respectively. Prerevision, 86.9% of CLOs mapped to an MA. Postrevision, 100% of CLOs mapped to an MA. Conclusion: Our revision process reduced redundancy and complexity and addressed gaps. Institutions searching for a model to assist with curriculum mapping and revisions may find our process useful.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Medical knowledge continuously evolves and to help health care providers to stay up to date, the evidence-based medicine (EBM) model has emerged. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies and the direct application of the findings to patient care. Methods: This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum utilizing the expertise from faculty trained in basic science, nursing and primary care practice. Results: Collaboration of faculty with different educational backgrounds resulted in a course series that was equally strong in all aspects of EBM. This new course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. To assess the effectiveness of the EBM sequence a survey was developed and administered at the beginning and end of the sequence. Conclusion: EBM knowledge gained is essential to effective clinical decision making and this newly developed tool specifically helps to identify student competencies within the defined course objectives. Contributing to the uniqueness of the tool are case-based questions requiring integration of EBM knowledge by the student.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: This qualitative study applied discourse analysis to open ended question responses of fourth semester veterinary students enrolled in case based learning (CBL) course. This was the first CBL course incorporated into the curriculum and was delivered via teams of two professors for each of eight sessions. Aims: Questions were designed to investigate student perceptions of CBL and determine how it impacted their learning. Results: Results were reported to faculty to help them deliver high quality, engaging, and challenging CBL sessions that pushed students without being discouraging. From a cognition and learning perspective, students felt that CBL helped with learning at all levels of Bloom's taxonomy, encouraged metacognition, and helped prepare them for clinical rotations and postgraduation careers. From a mechanics and delivery perspective, students desired resources to help them use cases to learn about species in which they have a particular interest beyond the classroom; wanted interactive sessions and in class assessments, primarily involving individual responses using audience response software (clickers); enjoyed class and small group discussions; and preferred little to no out of classwork or assignments unless explicitly related to the case and expectations for the assignment(s) is/are clearly laid out. Conclusions: Overall, most students wanted more CBL and found it engaging, fun, and supportive of their learning.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Clinical decision support tools should have a role in the management of patients with comorbidities. But until now, these tools have offered minimal support for managing such patients. BMJ Best Practice has recently launched a new resource – the comorbidities tool from BMJ Best Practice. This article describes and contextualizes the themes discussed at a workshop with junior doctors on clinical decision support for health-care professionals on comorbidities. Comorbidities were vitally important to the clinical practice of all the doctors in the workshop, but most perceived a lack of specific teaching and support on the subject of comorbidities. Most of the doctors found it a challenge to manage patients with comorbidities and were enthusiastic about a tool that would help them overcome these challenges and improve their clinical decision-making. We found that a workshop led by junior doctors provided deep insights into the issue of clinical decision support for patients with comorbidities.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]