large-scale-sars-cov-2-testing-utilizing-saliva-transposition-sample

Large-Scale SARS-CoV-2 Testing Utilizing Saliva and Transposition Sample Pooling

Identification and isolation of contagious individuals along with quarantine of close contacts, is critical for slowing the spread of COVID-19. ...

This paper reports research undertaken to assess US certified nurse-midwives' (CNMs) knowledge of, access to, and use of evidence-based medicine (EBM). Findings are presented in the context of interprofessional, institutional, and popular culture. The descriptive study follows concepts of diffusion of innovation, evidence-based patient choice, and authoritative knowledge to analyse incentives and barriers to the implementation of evidence-based midwifery care. Structured interviews were conducted with practicing CNMs in an urban practice site and a regional teaching centre. The analysis of responses explored congruence between practitioner knowledge, professed practice, and published professional as well as hospital-based internal practice guidelines, for two specific interventions for which there is ample systematic review, epidural and episiotomy. The CNMs demonstrated enthusiasm for their own individual understanding of EBM, but responses to specific questions about EBM-supported practice indicate that many had an incomplete understanding of the concept. Furthermore, in those cases where CNMs demonstrated accurate knowledge of EBM, practice protocols followed subspecialty dictates, thereby preventing their knowledge from translating into adherence to EBM-guided clinical practice guidelines. Finally, patient expectations for technological intervention appeared to influence CNMs' care decisions, even when those expectations lacked sound supporting evidence. If, as conceived by its originators and champions, EBM is to be widely adopted, then practitioners such as CNMs need to accurately understand its concepts and also to be afforded the opportunity to exercise professional control over its implementation. Central to an epistemically balanced EBM is the need to ensure that midwifery knowledge contributes in a robust and ongoing fashion to EBM's scientific research base. Lastly, EBM advocates must identify balanced strategies to both rationally and fairly address consumerist pressures for aggressive health care consumption.

The contextual influence of professional culture: certified nurse-midwives' knowledge of and reliance on evidence-based practice.

When our school organized the curriculum around a core set of medical student competencies in 2004, it was clear that more numerous and more varied student assessments were needed. To oversee a systematic approach to the assessment of medical student competencies, the Office of College-wide Assessment was established, led by the Associate Dean of College-wide Assessment. The mission of the Office is to 'facilitate the development of a seamless assessment system that drives a nimble, competency-based curriculum across the spectrum of our educational enterprise.' The Associate Dean coordinates educational initiatives, developing partnerships to solve common problems, and enhancing synergy within the College. The Office also works to establish data collection and feedback loops to guide rational intervention and continuous curricular improvement. Aside from feedback, implementing a systems approach to assessment provides a means for identifying performance gaps, promotes continuity from undergraduate medical education to practice, and offers a rationale for some assessments to be located outside of courses and clerkships. Assessment system design, data analysis, and feedback require leadership, a cooperative faculty team with medical education expertise, and institutional support. The guiding principle is 'Better Data for Teachers, Better Data for Learners, Better Patient Care.' Better data empowers faculty to become change agents, learners to create evidence-based improvement plans and increases accountability to our most important stakeholders, our patients.

Better data for teachers, better data for learners, better patient care: college-wide assessment at Michigan State University's College of Human Medicine.

Using a problem-based learning case to facilitate curriculum redesign.

The College of Human Medicine (CHM) at Michigan State University, which graduated its first class in 1972, was one of the first community-based medical schools in the country. It was established as a state-funded medical school with specific legislative directives to educate primary care physicians who would serve the needs of the state, particularly those of underserved areas. However, the model has proved challenging to sustain with the many changes to the health care system and the economic climate of Michigan. In 2006, a two-phase expansion plan was implemented, and in 2010, CHM permanently expanded the matriculating class from 106 to 200 students with the establishment of a second four-year site for medical education in Grand Rapids. This article describes what school leaders and faculty have learned as they look back at the opportunity provided by expansion as well as the growing pains and lessons learned. The community-based model met many of the mission-related goals for CHM's graduates, who represent a diverse group of practitioners whose values resonate with the school's mission. Expansion has offered an opportunity to explore new research and clinical opportunities as well as to more fully realize the potential of community partners to meet local health care needs and reinvent a robust future for community-integrated medical education.

The College of Human Medicine at Michigan State University: expansion and reinvention.

We operationalized the taxonomy developed by Hauer and colleagues describing common clinical performance problems. Faculty raters pilot tested the resulting worksheet by observing recordings of problematic simulated clinical encounters involving third-year medical students. This approach provided a framework for structured feedback to guide learner improvement and curricular enhancement.

Documenting clinical performance problems among medical students: feedback for learner remediation and curriculum enhancement.

Although evidence of medical student mistreatment has accumulated for more than 20 years, only recently have professional organizations like the Association of American Medical Colleges (AAMC) and the American Medical Association truly acknowledged it as an issue. Since 1991, the AAMC's annual Medical School Graduation Questionnaire (GQ) has included questions about mistreatment. Responses to the GQ have become the major source of evidence of the prevalence and types of mistreatment. This article reviews national mistreatment data, using responses to the GQ from 2000 through 2012; examines how students' experiences have changed over time; and highlights the implications of this information for the broader medical education system. The authors discuss what mistreatment is, including the changing definitions from the GQ; the prevalence, types, and sources of mistreatment; and evidence of students reporting incidents. In addition, they discuss next steps, including better defining mistreatment, specifically public humiliation and belittling, taking into account students' subjective evaluations; understanding and addressing the influence of institutional culture and what institutions can learn from current approaches at other institutions; and developing better systems to report and respond to reports of mistreatment. They conclude with a discussion of how mistreatment currently is conceptualized within the medical education system and the implications of that conceptualization for eradicating mistreatment in the future. 

Learning about medical student mistreatment from responses to the medical school graduation questionnaire.

To examine the relationship between experiences of discrimination, institutional responses to seminal race events, and depressive symptoms among Black medical students.

Article	Year
The contextual influence of professional culture: certified nurse-midwives' knowledge of and reliance on evidence-based practice. Social science & medicine (1982)\| PubMed ID: 16377047	2006
Better data for teachers, better data for learners, better patient care: college-wide assessment at Michigan State University's College of Human Medicine. Medical education online\| PubMed ID: 21249172	2011
Using a problem-based learning case to facilitate curriculum redesign. Medical education\| PubMed ID: 23078696	2012
The College of Human Medicine at Michigan State University: expansion and reinvention. Academic medicine : journal of the Association of American Medical Colleges\| PubMed ID: 23095925	2012
Documenting clinical performance problems among medical students: feedback for learner remediation and curriculum enhancement. Medical education online\| PubMed ID: 23880149	2013
Learning about medical student mistreatment from responses to the medical school graduation questionnaire. Academic medicine : journal of the Association of American Medical Colleges\| PubMed ID: 24667505	2014
Experiences of Discrimination, Institutional Responses to Seminal Race Events, and Depressive Symptoms in Black U.S. Medical Students. Academic medicine : journal of the Association of American Medical Colleges\| PubMed ID: 35703911	2022

Aron Sousa

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