Background: This paper describes the design and protocol of a pragmatic, randomized trial to evaluate the comparative effectiveness of shared decision making versus motivational interviewing plus cognitive behavioral therapy for chronic pain for the voluntary tapering of opioid dose in adults with chronic noncancer pain. Integrated Services for Pain: Interventions to Reduce Pain Effectively (INSPIRE) is a multicenter, randomized trial conducted at three academic health centers in the southeastern United States. Participants are adults receiving long-term opioid therapy of at least 20 morphine milligram equivalents daily for chronic noncancer pain.
View Article and Find Full Text PDFJ Neuropsychiatry Clin Neurosci
January 2024
Behavioral neurology & neuropsychiatry (BNNP) fellowships are accredited by the United Council for Neurologic Subspecialties (UCNS). Programs cover the UCNS-recommended topics differently. A curriculum accessible to all fellowships would standardize education and identify gaps in topics that are less well covered across programs.
View Article and Find Full Text PDFPurpose: Women are underrepresented in radiology and experience barriers to professional growth that can affect job satisfaction and career advancement. The authors hypothesized that a structured, intentional Women in Radiology (WiR) program would increase women faculty members' perceptions of workplace gender equity, satisfaction with pace of professional advancement, interest in research and teaching, and perceptions of work-life balance and mentorship opportunities.
Methods: Components and structure of a sustainable WiR program are described in detail.
Jt Comm J Qual Patient Saf
February 2020
Background: In 2008 The Joint Commission issued a Sentinel Event Alert that further defined "behaviors that undermine a culture of safety," stating that "intimidating and disruptive behaviors" can result in medical errors that affect patient care and safety. The American College of Physician Executives found that more than 95% of respondents encountered "disturbing . .
View Article and Find Full Text PDFBurnout remains a widespread issue in graduate medical education, with current trends to mitigate burnout shifting toward institutional systematic interventions as opposed to personal individual interventions. In this article, we propose utilizing Knowle's adult learning theory in conjunction with Maslach's organizational context for burnout to implement systemic changes within the postgraduate training environment that we posit would both optimize the learning experience and reduce the incidence of burnout.
View Article and Find Full Text PDFClinician-educators are responsible for providing education to trainees in medical centers. There is no clear overview of what opportunities exist for training clinician-educators in medical education related skills and techniques. We conducted a systematic review of multiple websites and a medical educator listserve to identify medical education training opportunities for clinician-educators.
View Article and Find Full Text PDFRationale And Objectives: Women are under-represented in the field of radiology, occupy a minority of leadership positions, and, at our institution, have not achieved the same level of academic success as their male counterparts. Consequently, the authors designed, implemented, and evaluated the Leadership Intervention to Further the Training of Female Faculty (LIFT-OFF) program to (1) improve access to opportunities for women's faculty development and advancement, and (2) improve clarification of expectations about the role and path of advancement.
Materials And Methods: LIFT-OFF was developed based on the results of a needs assessment survey.
On a daily basis, patients put their trust in the healthcare system for safe and high-quality healthcare. However, what evidence do we have as an educational community that our supervising faculty members are competent to fulfill this responsibility? Few, if any, requirements exist for faculty members to have continuous professional development in the field of medical education. Many faculty "love to teach", however, this love of teaching does not make them competent to teach or assess the competence of trainees whom they supervise.
View Article and Find Full Text PDFJ Med Educ Curric Dev
January 2016
Introduction: The authors developed and evaluated a faculty development program on clinical teaching skills to address barriers to participation and to impact teaching behaviors.
Methods: Four one-hour workshops were implemented over five months. Evaluation included participant satisfaction and pre/post self-assessment.
Background: Controlled prescription drug (CPD) abuse has reached epidemic proportions in the United States. Most physicians attending a 3-day continuing medical education (CME) professional development program (PDP) lack training in identifying risk and in managing patients who misuse CPDs. To address this issue, the authors conducted an evaluation of a PDP that trains physicians on proper prescribing, identifying substance abuse, utilizing screening, brief intervention, and referral to treatment (SBIRT), and implementing motivational interviewing (MI).
View Article and Find Full Text PDFMedical education fellowship programs (MEFPs) are a form of faculty development contributing to an organization's educational mission and participants' career development. Building an MEFP requires a systematic design, implementation, and evaluation approach which aligns institutional and individual faculty goals. Implementing an MEFP requires a team of committed individuals who provide expertise, guidance, and mentoring.
View Article and Find Full Text PDFPrescription drug abuse is increasing at alarming rates in this country. Most often drugs are obtained through relatives or friends. An important step in addressing this problem is educating healthcare providers in the proper prescribing of scheduled drugs.
View Article and Find Full Text PDFControlled prescription drug (CPD) abuse is an increasing threat to patient safety and health care providers (HCPs) are not adequately prepared nor do they routinely employ proper screening techniques. Using standardized patients (SPs) as an instructional strategy, the trained physicians on proper prescribing practices and SBIRT (Screening, Brief Intervention, and Referral to Treatment) in a continuing medical education (CME) course. The authors compared two physician cohorts receiving standard CME course (control) versus CME plus SP practice.
View Article and Find Full Text PDFObjectives: To examine the relationship between smoking and weight status in adult women and whether this association differed by race.
Methods: The study sample consisted of 22,949 African American and 7831 white women enrolled in the Southern Community Cohort Study from 2002 to 2006.
Results: Both African American and white current smokers had decreased odds of being overweight or obese compared to normal-weight nonsmokers, and the inverse trends between current smoking and BMI held for both groups.
To help address the clinical care gap, a working group discussed the future of faculty development in academic medicine, explored problems within the large, current enterprise devoted to continuing medical education (CME), and described four domains core to its revitalization and reformation. These domains are (1) preparing and supporting an engaged clinician-learner, (2) improving the quality of knowledge or evidence shared, (3) enhancing the means by which to disseminate and implement that knowledge and evidence, and (4) reforming the patient, health care, and regulatory systems in and for which the process of CME exists. Reshaping these domains requires the consideration of a more seamless, evidence-based, and patient-oriented continuum of medical education.
View Article and Find Full Text PDFPhysicians exhibiting a pattern of disruptive conduct represent a small portion of all healthcare professionals. Available evidence demonstrates, however, that their behaviors can result in increased workplace stress; contribute to poor workplace environments; contribute to dysfunctional teams; reduce quality of care for patients and families; and increase risk of litigation for hospitals and institutions. Our experience at Vanderbilt reveals that both internal and external factors play a role in a physician's behavior and ability to cope with workplace stresses.
View Article and Find Full Text PDFTreating pain may be difficult in patients with a coexisting substance abuse disorder. Opioids can be used successfully to control pain in such a patient population, but the physician must have a general understanding of addictive behavior and early signs of abuse. The challenge is not in treating pain, but identifying true pain from drug-seeking behaviors.
View Article and Find Full Text PDFObjectives: Because psychiatry residents have important roles as teachers and significant opportunities to contribute to medical student education, we set out to: identify all randomized control trials (RCT) for residents' teaching skills programs in psychiatry and to identify the efficacy of those interventions for improving teaching skills; identify the strengths and weaknesses of the available studies across medical disciplines; and identify currently available methods for enhancing residents' teaching skills for residents training in psychiatry.
Methods: The published English-language literature was searched using PubMed, Social Sciences Index, and PsycINFO databases, with key search words including: residents, teaching skills, residents as teachers, psychiatry, and assessments. Both RCT and controlled, nonrandomized trials of residents' teaching programs directed to enhance residents' teaching skills were selected and critically appraised.
Purpose: To identify existing organizations that recognize faculty members' excellence as educators (Academies) in the United States, and describe the organizations' characteristics.
Method: A 31-item questionnaire inquiring about Academies or equivalent programs was sent to deans of medical education at all 125 U.S.