domingo, 30 de novembro de 2014

Lectures in Medical Education

The Blessings and Benefits of Using Guest Lecturers

As we face the perpetual challenge of keeping each class session fresh and interactive, I suggest we consider an old idea that never really got stale. Inviting guest lecturers to your classroom has benefits for your learners, for you, and for the guest lecturers. Learners of all ages and experience levels are hungry for variety, and seeing a new face in front of the room can liven up the class; but there are also deeper pedagogical reasons for using guest lecturers. Here are a few to consider.

None of us is an expert on everything, so bringing in speakers with proven expertise in a topic provides added credibility to our content. These experts can be faculty from your institution (but perhaps outside of your department or school) or experts from the community. Van Hoek et al. (2011) found that in a course with profound practical applications, such as supply chain management, voices from the field seemed to carry as much or more credibility than those from the academic side.

Hearing new voices provides students not only with different points-of-view, but also with potential resources they can apply in later courses. For example, asking a research librarian to discuss effective literature search strategies before assigning a research project gives students not only the “just in time” information but also some long-term skills. But a word of caution if you have students who are new to higher education (or a few whose motivation is a bit sub-par); make sure students understand that they are just as responsible for mastering content from guest lecturers as they are for mastering the content you provide. Guest lecturers are not substitute teachers.

Having a guest lecturer also opens your lesson design to new options. For example, you and your guest can work together to field questions or even debate issues. Let students apply their critical thinking to compare points of view.

When seeking guest lecturers for your course, do not be afraid to work “up” the academic ladder by inviting senior or tenured faculty. There could be benefits for all in this exchange.

Working with a guest lecturer
Like all guests, guest lecturers should be treated very well, especially if you want their help in future courses! Provide as much lead-time as possible so they can prepare and so you can share materials from your guest lecturer with your students. Willis (2013) found that the flipped classroom format could be used by guest faculty, but it was slightly less effective than when used by regular faculty (perhaps because it combines new materials and an unknown instructor). So allow more classroom time for review when using that teaching strategy with guests.

Be very clear with guest faculty about the content you want covered, the time and technology available, and the class size and composition. Determine who has which responsibilities, such as posting or printing handouts or other learning materials.

Formal letters of thanks are useful in the business world and the academic world. In the academic world, it is a good idea to copy the appropriate Dean or Department Chair when thanking faculty for their help.

When you’re the guest lecturer
From a faculty point of view, being invited to guest lecture is a very nice addition to your CV. It is also a good opportunity to see how content from other courses relate to your own (i.e. Is my content redundant or reinforcing? Am I teaching my content at the right level?) When you are invited as a guest, make sure you know exactly what is expected in both content and logistics. If you rely on PowerPoint or Internet connectivity to present, make sure to confirm availability. (It’s often easier to carry presentations on a zip drive rather than relying on connecting your laptop to someone else’s projector.) If you plan to use handouts and the course has web support, provide that material ahead of time so it can be uploaded to the course site. If you welcome the idea of students contacting you for more information, put your email as a header or footer to the handouts where it will not be misplaced. No detail is too small when working in a new environment, and you don’t want to lose momentum while you make adjustments to your technology as students wait.

Higher education today embraces the ideas of interdisciplinary thinking and performance, and what better way to model this than to have guests from other disciplines teaching content from their perspective. It takes both prior planning and organized follow-up, but is well worth the effort.

Willis, C.G.,(2013). Flipping Flop? Can Guest Lecturers Use the Flipped Classroom Format. Presentations. Paper 88.

van Hoek, R., et al. (2011). Embedding insights from industry in supply chain programmes: the role of guest lecturers. Supply Chain Management: An International Journal, 16 (2), 142 – 147.

Karen Hughes Miller, associate professor, graduate medical education, University of Louisville School of Medicine.

quinta-feira, 27 de novembro de 2014


ATA Clinical Guidelines for Telepathology

Pantanowitz Liron, Dickinson Kim, Evans Andrew J., Hassell Lewis A., Henricks Walter H., Lennerz Jochen K., Lowe Amanda, Parwani Anil V., Riben Michael, Smith COL Daniel, Tuthill J. Mark, Weinstein Ronald S., Wilbur David C., Krupinski Elizabeth A., and Bernard Jordana. 
Telemedicine and e-Health. November 2014, 20(11): 1049-1056.

The American Telemedicine Association (ATA) brings together diverse groups from traditional medicine, academia, technology and telecommunications companies, e-health, allied professional and nursing associations, medical societies, government, and others to overcome barriers to the advancement of telemedicine through the professional, ethical, and equitable improvement in healthcare delivery.
ATA has embarked on an effort to establish practice guidelines for telemedicine to help advance the science and to assure the uniform quality of service to patients. They are developed by panels that include experts from the field and other strategic stakeholders and are designed to serve as both an operational reference and an educational tool to aid in providing appropriate care for patients. The guidelines generated by ATA undergo a thorough consensus and rigorous review, with final approval by the ATA Board of Directors. Existing products are reviewed and updated periodically.
The purpose of these guidelines is to assist practitioners in pursuing a sound course of action to provide effective and safe medical care that is founded on current information, available resources, and patient needs. The guidelines recognize that safe and effective practices require specific training, skills, and techniques, as described in each document. The resulting products are properties of the ATA, and any reproduction or modification of the published guideline must receive prior approval by the ATA.
The practice of medicine is an integration of both the science and art of preventing, diagnosing, and treating diseases. Accordingly, it should be recognized that compliance with these guidelines alone will not guarantee accurate diagnoses or successful outcomes. If circumstances warrant, a practitioner may responsibly pursue an alternate course of action different from the established guidelines. A divergence from the guidelines may be indicated when, in the reasonable judgment of the practitioner, the condition of the patient, restrictions or limits on available resources, or advances in information or technology occur subsequent to publication of the guidelines. Nonetheless, a practitioner who uses an approach that is significantly different from these guidelines is strongly advised to provide documentation, in the patient record, that is adequate to explain the approach pursued.
Likewise, the technical and administrative guidelines in this document do not purport to establish binding legal standards for carrying out telemedicine interactions. Rather, they are the result of the accumulated knowledge and expertise of the ATA Working Groups and other leading experts in the field, and they are intended to improve the technical quality and reliability of telemedicine encounters. The technical aspects of and administrative procedures for specific telemedicine arrangements may vary depending on the individual circumstances, including location of the parties, resources, and nature of the interaction.

Telemedicine and e-Health is the leading international peer-reviewed journal covering the full spectrum of advances and clinical applications of telemedicine and management of electronic health records. It places special emphasis on the outcome and impact of telemedicine on the quality, cost effectiveness, and access to healthcare. Telemedicine applications play an increasingly important role in health care. They offer indispensable tools for home healthcare, remote patient monitoring, and disease management, not only for rural health and battlefield care, but also for nursing home, assisted living facilities, and maritime and aviation settings.
Telemedicine and e-Health offers timely coverage of the advances in technology that offer practitioners, medical centers, and hospitals new and innovative options for managing patient care, electronic records, and medical billing.

Telemedicine and e-Health coverage includes:

  • Clinical telemedicine practice
  • Technical advances
  • Medical connectivity
  • Enabling technologies
  • Education
  • Health policy and regulation
  • Biomedical and health services research
Telemedicine and e-Health is under the editorial leadership of Editors-in-Chief Ronald C. Merrell, MD, Virginia Commonwealth University; Charles R. Doarn, MBA, Department of Family and Community Medicine, University of Cincinnati; and other leading investigators. View the entire editorial board.
Audience: Remote patient monitoring professionals; biomedical informatics technologists; extreme, rural, and urban environment patient care specialists; experts in telecommunications technology and R & D; among others

segunda-feira, 24 de novembro de 2014

Avaliação da Atenção Básica

Avaliação da Atenção Básica à Saúde no Brasil
Publicada anualmente, a edição especial da Revista Saúde em Debate esse ano aborda a Atenção Básica no Brasil e seus processos avaliativos. Os trabalhos foram realizados no Brasil, com análises de base nacional, regional e municipal.

Entre os temas em destaque da edição (vol 38), o importante processo de expansão da Atenção Primária à Saúde (APS) no Brasil. Mesmo sem sistematização e monitoramento ao longo de todo o período, a expansão foi acompanhada por diversas iniciativas esparsas de avaliação e de processos de indução da institucionalização da avaliação da Atenção Básica no SUS.

Vale ressaltar a iniciativa do Ministério da Saúde, de 2011, que propôs mudanças nas diretrizes da Política Nacional de Atenção Básica (PNAB) e, como estratégia indutora de um processo permanente e progressivo de ampliação do acesso e de qualificação das práticas de gestão, cuidado e participação na Atenção Básica, implementou o Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB), a partir de 2012.

O PMAQ-AB está em seu segundo ciclo de avaliação e já foi ampliado para equipes de Saúde Bucal e equipes dos Núcleos de Apoio à Saúde da Família (NASF).

Na autoria dos artigos, pequisadores participantes do processo de Avaliação Externa (uma das fases do ciclo do PMAQ-AB), que analisaram dados do banco do Programa, bem como resultados de pesquisas a partir de diferentes modelos adotados na avaliação (tais como Primary Care Assessment Tools — PCATool).

Leia revista - RSD_AB_WEB_031114

sexta-feira, 21 de novembro de 2014

Community-based HPE

Community-Based Education in the Health Professions: learning with the Brazilian experience

During the XXXI' Network - Towards Unity for Health  meeting, held in Fortaleza (Brazil),  FAIMER Brazil  Institute promoted the release of the book "Educação Médica baseada na Comunidade para as Profissões da Saúde: aprendendo com a experiencia brasileira"  -  Community-Based Education in the Health Professions: learning with the Brazilian experience , product of a collaborative work of the special interest group on Community-based Education.

The book, organized by Valdes Roberto Bollela, Ana Claudia Camargo G Germani, Henry de Holanda Campos and Eliana Amaral presents 23 chapters, written in a 'tour de force' manner by 119 authors.

The English version is being prepared carefully for forthcoming publication.

segunda-feira, 17 de novembro de 2014

Atenção primária

Primary care research

The Lancet, Volume 384, Issue 9955, Pages 1671 - 1672, 8 November 2014

Michael Kidd , Garth Manning , Amanda Howe , Waris Qidwai, John W Beasley, Chris van Weel

In his Comment (Sept 20, 2014)1 about primary care research, Richard Horton described exciting new developments in Sweden. We applaud the leadership of Lars Lindholm and would like to raise awareness of primary health-care research capacity building on a broader scale because some important developments since the family medicine research meeting 2 hosted by WONCA (World Organization of Family Doctors) might have been missed.

The first reassurance comes from the Kingston Conference2 itself that resulted in an extensive review of the priorities of primary health-care research and recommendations to build the research capacity to approach these priorities, and which has served as a template for WONCA and its member organisations in 131 nations to advocate and support research in primary care in all regions of the world. The WONCA guidebook3 has an excellent section on the way each nation can support primary care research. WONCA has a thriving Working Party on Research and active regional groups, including the South Asia Primary Care Research Network, the North America Primary Care Research Group, and the European GP Research Network, which hold regular workshops to support and encourage those working in family practice to take part in primary care research. WONCA has also supported the Brisbane Initiative for International Leadership, which holds yearly meetings in Oxford, UK.4

One of the recommendations of the Kingston Conference2 was the establishment of multidisciplinary research training programmes. In addition to Sweden, these initiatives have since been developed in Scotland, England, The Netherlands, and USA, each resulting in thriving primary health-care research outputs.5, 6 The Netherlands School of Primary Care Research, for example, produced more than 100 PhD theses in 2013. Family doctors around the world take research seriously and promote and engage in research in primary care. WONCA regional and special interest conferences every year provide evidence of these efforts for all to see, and for all to critically appraise.

Finally, we are sorry that Richard Horton had such a wretched time in Kingston, Canada, all those years ago.1 Family doctors are held responsible for many things, but even we cannot be blamed for the weather.

We declare no competing interests.

1 Horton R. Offline: How to save primary care research. Lancet 2014; 384: 1082. Full Text | PDF(193KB) | CrossRef | PubMed
2 Improving health globally and the need for primary care research: report of the WONCA Kingston conference. Ann Fam Med2004; 2 (suppl 2): S1-64. CrossRef | PubMed
3 In: Kidd M, ed. The contribution of family medicine to improving health systems. London: Radcliffe Publishing, 2013.
4 Magin PJ, Furler JS, van Driel ML. The Brisbane International initiative: fostering leadership and international collaboration in primary care research. Med J Aust 2008; 189: 100-102. PubMed
5 Glanville J, Kendrick T, McNally R, Campbell J, Hobbs FD. Research output on primary care in Australia, Canada, Germany, the Netherlands, the United Kingdom, and the United States: bibliometric analysis. BMJ 2011; 342: d1028. CrossRef | PubMed
6 Beasley JW, Karsh BT. What can we learn from effective collaboration in primary care research? One success story. Prim Health Care Res Dev 2010; 11: 203-205. PubMed