Publications by authors named "K A Umstead"

16 Publications

Twelve tips to stimulate creative problem-solving with design thinking.

Med Teach 2021 05 26;43(5):501-508. Epub 2020 Aug 26.

North Carolina State University College of Design, North Carolina State University, Raleigh, NC, USA.

Design thinking is increasingly applied in healthcare and health professions education to generate innovative solutions to difficult problems. The design thinking framework helps individuals approach problems with a user-centered focus; the emphasis is on understanding the user experience, their challenges, and possible design solutions that are aligned with their needs. In this twelve tips paper, we describe strategies that health professions educators can use to prepare for, conduct, and support design thinking. These strategies may also be useful to learners, practitioners, and organizations to address complex problems.
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http://dx.doi.org/10.1080/0142159X.2020.1807483DOI Listing
May 2021

Perceptions of uncertainties about carrier results identified by exome sequencing in a randomized controlled trial.

Transl Behav Med 2020 05;10(2):441-450

Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD, USA.

How individuals perceive uncertainties in sequencing results may affect their clinical utility. The purpose of this study was to explore perceptions of uncertainties in carrier results and how they relate to psychological well-being and health behavior. Post-reproductive adults (N = 462) were randomized to receive carrier results from sequencing through either a web platform or a genetic counselor. On average, participants received two results. Group differences in affective, evaluative, and clinical uncertainties were assessed from baseline to 1 and 6 months; associations with test-specific distress and communication of results were assessed at 6 months. Reductions in affective uncertainty (∆x̅ = 0.78, 95% CI: 0.53, 1.02) and evaluative uncertainty (∆x̅ = 0.69, 95% CI: 0.51, 0.87) followed receipt of results regardless of randomization arm at 1 month. Participants in the web platform arm reported greater clinical uncertainty than those in the genetic counselor arm at 1 and 6 months; this was corroborated by the 1,230 questions asked of the genetic counselor and residual questions reported by those randomized to the web platform. Evaluative uncertainty was associated with a lower likelihood of communicating results to health care providers. Clinical uncertainty was associated with a lower likelihood of communicating results to children. Learning one's carrier results may reduce perceptions of uncertainties, though web-based return may lead to less reduction in clinical uncertainty in the short term. These findings warrant reinforcement of clinical implications to minimize residual questions and promote appropriate health behavior (communicating results to at-risk relatives in the case of carrier results), especially when testing alternative delivery models.
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http://dx.doi.org/10.1093/tbm/ibz111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7237536PMC
May 2020

Using information literacy to teach medical entrepreneurship and health care economics.

J Med Libr Assoc 2019 Apr 1;107(2):163-171. Epub 2019 Apr 1.

Innovation and Design Coach, Trig, Chapel Hill, NC,

Objective: Entrepreneurship and innovative product design in health care requires expertise in finding and evaluating diverse types of information from a multitude of sources to accomplish a number of tasks, such as securing regulatory approval, developing a reimbursement strategy, and navigating intellectual property. The authors sought to determine whether an intensive, specialized information literacy training program that introduced undergraduate biomedical engineering students to these concepts would improve the quality of the students' design projects. We also sought to test whether information literacy training that included active learning exercises would offer increased benefits over training delivered via lectures and if this specialized information literacy training would increase the extent of students' information use.

Methods: A three-arm cohort study was conducted with a control group and two experimental groups. Mixed methods assessment, including a rubric and citation analysis, was used to evaluate program outcomes by examining authentic artifacts of student learning.

Results: Student design teams that received information literacy training on topics related to medical entrepreneurship and health care economics showed significantly improved performance on aspects of project performance relevant to health care economics over student design teams that did not receive this training. There were no significant differences between teams that engaged in active learning exercises and those that only received training via lectures. Also, there were no significant differences in citation patterns between student teams that did or did not receive specialized information literacy training.

Conclusions: Information literacy training can be used as a method for introducing undergraduate health sciences students to the health care economics aspects of the medical entrepreneurship life cycle, including the US Food and Drug Administration regulatory environment, intellectual property, and medical billing and reimbursement structures.
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http://dx.doi.org/10.5195/jmla.2019.577DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466497PMC
April 2019

A qualitative review of the design thinking framework in health professions education.

BMC Med Educ 2019 Apr 4;19(1):98. Epub 2019 Apr 4.

NC State University College of Design, Raleigh, North Carolina, USA.

Background: Design thinking is a problem-solving framework that has been used to enhance patient experiences, improve clinical outcomes, and refine medical curricula. This study reviewed the use of design thinking in health professions education.

Methods: A search yielded 169 articles, which were excluded if they were: (1) not related to education; (2) lacking an application of design thinking; or (3) not associated with healthcare. The final review yielded 15 articles, which were analyzed using qualitative methods.

Results: All articles were published in 2009 or later and were diverse in their context, participants, and approach. Six studies emphasized the early stages of design thinking, with inspiration and ideation stages fostered through a variety of activities, such as lectures, small group discussions, and workshops. Studies examined a range of outcomes, including self-efficacy, perceptions, and solutions to a specific problem.

Conclusions: Our findings raise important considerations for health professions education, including the extent to which we should: 1) teach design thinking to students as a skill-based tool to prepare students for problem solving in complex healthcare environments; and 2) use design thinking to create, implement, and refine health professions curricula and educational programs. Despite the apparent benefits of design thinking, many questions for health professions education remain.
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http://dx.doi.org/10.1186/s12909-019-1528-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449899PMC
April 2019

Evaluation of Recipients of Positive and Negative Secondary Findings Evaluations in a Hybrid CLIA-Research Sequencing Pilot.

Am J Hum Genet 2018 09 16;103(3):358-366. Epub 2018 Aug 16.

Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, Bethesda, MD 20892, USA. Electronic address:

While consensus regarding the return of secondary genomic findings in the clinical setting has been reached, debate about such findings in the research setting remains. We developed a hybrid, research-clinical translational genomics process for research exome data coupled with a CLIA-validated secondary findings analysis. Eleven intramural investigators from ten institutes at the National Institutes of Health piloted this process. Nearly 1,200 individuals were sequenced and 14 secondary findings were identified in 18 participants. Positive secondary findings were returned by a genetic counselor following a standardized protocol, including referrals for specialty follow-up care for the secondary finding local to the participants. Interviews were undertaken with 13 participants 4 months after receipt of a positive report. These participants reported minimal psychologic distress within a process to assimilate their results. Of the 13, 9 reported accessing the recommended health care services. A sample of 107 participants who received a negative findings report were surveyed 4 months after receiving it. They demonstrated good understanding of the negative secondary findings result and most expressed reassurance (64%) from that report. However, a notable minority (up to 17%) expressed confusion regarding the distinction of primary from secondary findings. This pilot shows it is feasible to couple CLIA-compliant secondary findings to research sequencing with minimal harms. Participants managed the surprise of a secondary finding with most following recommended follow up, yet some with negative findings conflated secondary and primary findings. Additional work is needed to understand barriers to follow-up care and help participants distinguish secondary from primary findings.
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http://dx.doi.org/10.1016/j.ajhg.2018.07.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128311PMC
September 2018