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There is currently wide variation in the structure and content of higher medical training in geriatric medicine across Europe and no common framework within which existing efforts can be compared. We set out to develop an audit tool to compare training between countries. An initial review of indexed and grey literature was used to develop an audit tool which was used as the basis of an Internet-based modified Delphi process incorporating the views of 14 expert geriatricians from across Europe. Items in the audit tool were included or excluded when supported by ≥75% or <50% of respondents, respectively. Items supported by 50-74% of respondents were carried forward with additional suggestions and modifications included following Round 1. Thirteen experts representing 12 countries responded to both rounds. 40/45 items were supported at Round 1. Five items were carried forward. A further 13 elements were introduced for consideration at Round 2. Consensus was gained after the second round. The final tool describes 52 items across four domains: general considerations, topics referring to knowledge in patient care, different roles that should be considered in medical training and topics regarding assessment. The resulting tool can be used as a basis for comparing higher medical training programmes in geriatric medicine between countries. Individual countries can use this to audit current practice. At an European Union level, the insights gained through such audit will form the basis of future work to develop an agreed postgraduate curriculum in the specialty. [ABSTRACT FROM AUTHOR]

Context: Evidence suggests widespread adoption of the entry-level doctorate among health professions, although little is known about how these changes have impacted associated professions and influenced education, collaborative practice, professional advancement, or professional salaries. Objective: Threefold: (1) What doctoral education models are currently utilized among health care professional education programs in the United States? (2) How do entry-level clinical doctorates in health care professions impact research training and productivity? (3) How do clinical doctorates among health professions influence practice opportunities and salary? Design: Data were extracted from various sources including professional organizations, accrediting body Web sites, and the US Department of Labor database. Full-text articles published in English between the years 2001-2011 were extracted from a search of 38 databases in the University of Washington libraries. The remaining article abstracts were reviewed for compatibility with our research questions. Data were extracted using a standardized rubric and coded according to emergent themes. Results: Two-thirds of 14 examined health professions (n = 10) followed the medical model of postbaccalaureate entry-topractice professional doctoral education. Less than a third (n = 4) of surveyed professions reserved doctoral-level education for advanced practice, and 1 profession maintains both entry-level and advanced practice doctorates. Only 4 of the 14 clinical doctoral degrees required completion of an original research project. Entry-level clinical doctorates may provide insufficient specialty training, necessitating further training after graduation. Conclusions: Most health care professions follow the medical model for professional preparation, though at reduced intensity with fewer clinical hours than physician training. Clinical doctorates are perceived to increase professional opportunities and are associated with higher salaries and doctoral education among health care professions has become the new educational standard, though research training, research productivity, diversity, and professional debt burden have been negatively impacted by this trend. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at a meeting of the Section of Epidemiology and Community Medicine and the Section of Medical Education on February 8, 1979 is presented. The inclusion of epidemiology in the medical curriculum of the Medical School of Southampton University in England was the main focus of the meeting. The meeting featured several medical experts including Geoffrey Rose, Estlin Waters and Brendan Hicks.

Objectives: The objectives of this review are to summarize the current training modalities and assessment tools used in urological robotic surgery and to propose principles to guide the formation of a comprehensive robotics curriculum. Materials and Methods: The PUBMED database was systematically searched for relevant articles and their citations utilized to broaden our search. These articles were reviewed and summarized with a focus on novel developments. Results: A multitude of training modalities including didactic, dry lab, wet lab, and virtual reality have been developed. The use of these modalities can be divided into basic skills-based exercises and more advanced procedure-based exercises. Clinical training has largely followed traditional methods of surgical teaching with the exception of the unique development of tele-mentoring for the da Vinci interface. Tools to assess both real-life and simulator performance have been developed, including adaptions from Fundamentals of Laparoscopic Surgery and Objective Structured Assessment of Technical Skill, and novel tools such as Global Evaluative Assessment of Robotic Skills. Conclusions: The use of these different entities to create a standardized curriculum for robotic surgery remains elusive. Selection of training modalities and assessment tools should be based upon performance data-based validity and practical feasibility. Comparative assessment of different modalities (cross-modality validity) can help strengthen the development of common skill sets. Constant data collection must occur to guide continuing curriculum improvement. [ABSTRACT FROM AUTHOR]

Objective: The authors developed an elective course to assist students in (1) understanding the changing nature of scholarly communication and online publishing, (2) identifying resources and strategies for searching current best evidence, and (3) demonstrating effective communication of information. Setting: The course took place in a medical school in the Southwest. Participants: Second- and third-year medical students participated in the course. Intervention: A pass-fail, undergraduate-level elective was first offered October to December 2006. This 7.5 hour course, developed and co-taught by 2 health sciences library faculty, consisted of hands-on exercises, small group discussion, and didactic lecture. Conclusion: Presenting a medical school elective is one possible outlet for intensive bibliographic instruction. Illustrating the flow of information from creation to management and presentation affords students an opportunity to understand information in context. This elective has been consistently ranked very high in student evaluations and led to new and expanded teaching opportunities. [ABSTRACT FROM AUTHOR]

Background: Principles of evidence-based medicine (EBM) may be inconsistently applied to clinical decision-making due to lack of practice-based training, experience, and time. Objectives: The authors sought to design, implement, and test the feasibility of an experiential learning model for senior emergency medicine (EM) residents to apply EBM principles during real-time clinical practice. Methods: Targeted program evaluation of this learning model was conducted through a prospective observational cohort study involving EM residents at a large, urban, 4-year EM residency program. The curriculum development of a case-based knowledge translation shift followed Kern's six-step design process. Subjects asynchronously completed a 1-hour EBM tutorial and were then assigned to clinical shifts in which they contributed to the care of emergency department (ED) patients by completing formal literature searches related to active management questions. Pre- and post-intervention self-assessments of practice norms and attitudes were used to evaluate the effect of this experiential learning model for individual residents. Self-assessments of the likelihood that the experience would result in future practice change were reported on a five-point Likert scale (1 = greatly impeded, 2 = somewhat impeded, 3 = no change, 4 = somewhat improved, 5 = greatly improved). Subjects presented available evidence to the primary ED team, formally disseminated their findings as a brief 'EBM rounds' at sign-out and completed an 'EBM consult note' and case log to document shift performance. Changes in patient management and/or disposition were recorded. EBM search questions and resultant findings were entered in a local database. Results: Of the 45 eligible senior EM resident shifts, 91% resulted in complete sets of performance data and self-assessments. A total of 80 patient encounters were documented during 45 scheduled shifts over a 3-month study period. Literature review took a mean (±SD) of 36.2 (±26.4) minutes per case. During the 3-hour interval before or after shift sign-out, residents completed a mean (±SD) of 2.11 (±1.4) literature searches and recorded a mean (±SD) of 3.0 (±1.5) articles for each case. Alterations in ED management for 13 of 80 patient encounters (16.3%) were documented to be the direct result of on-shift literature searches. Conclusions: Case-based knowledge translation shifts for senior EM residents can provide opportunities to practice EBM skills in the ED. This experiential learning model may result in future practice change by resident learners, as well as affect the management of active patients in the ED. ACADEMIC EMERGENCY MEDICINE 2010; 17:S42-S48 © 2010 by the Society for Academic Emergency Medicine [ABSTRACT FROM AUTHOR]

Incorporating evidence-based medicine (EBM) into clinical practice is an important competency that residency training must address. Residency program directors, and the clinical educators who work with them, should develop curricula to enhance residents' capacity for independent evidence-based practice. In this article, the authors argue that residency programs must move beyond journal club formats to promote the practice of EBM by trainees. The authors highlight the limitations of journal club, and suggest additional curricular approaches for an integrated EBM curriculum. Helping residents become effective evidence users will require a sustained effort on the part of residents, faculty, and their educational institutions. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Governing bodies for medical education recommend that spirituality and medicine be incorporated into training. AIM: To pilot a workshop on spirituality and medicine on a convenience sample of preclinical medical students and internal medicine residents and determine whether content was relevant to learners at different levels, whether preliminary evaluation was promising, and to generate hypotheses for future research. SETTING: Private medical school and university primary care internal medicine residency program, both in the Northeast. CURRICULUM DESCRIPTION: The authors designed and implemented a required 2-hour workshop for all second-year medical students and a separate required 1.5-hour workshop for all primary care internal medicine house staff. The workshops used multiple educational strategies including lecture, discussion, and role-play to address educational objectives. PROGRAM EVALUATION: Learners completed optional, anonymous pre and postworkshop surveys with six 5-point Likert-rated statements and space to cite the most useful part of the curriculum and their remaining questions. One hundred and thirty-seven learners participated and 100 completed both surveys. Medical students and residents had increased (all P≤.002): agreement regarding the appropriateness of inquiring about spiritual and religious beliefs in the medical encounter, their perceived competence in taking a spiritual history, and their perceived knowledge of available pastoral care resources. Medical students, but not residents, had an increase in their perceived comfort in working with hospital chaplains. DISCUSSION: A brief pilot workshop on spirituality and medicine had a modest effect in improving attitudes and perceived competence of both medical students and residents. [ABSTRACT FROM AUTHOR]

Interns are expected to teach medical students, yet there is little formal training in medical school to prepare them for this role. To enhance the teaching skills of our graduating students we initiated a 4-hour ‘teaching to teach’ course as part of the end of the fourth-year curriculum. Course evaluations demonstrate that students strongly support this program (overall ratings 2000 to 2005: mcan=4.4 [scale 1 to 5], n=224). When 2004 course participants were surveyed during the last month of their internship, 84% ‘agree’ or ‘strongly agree’ with the statement: ‘The teaching to teach course helped prepare me for my role as a teacher during internship’ (2005: mean 4.2 [scale 1 to 5], n=45, response rate 60%). A course preparing fourth-year students to teach during internship is both feasible and reproducible, with a minimal commitment of faculty and resident time. Participants identify it as an important addition to their education and as useful during internship. [ABSTRACT FROM AUTHOR]