3,193 results match your criteria implementation senior

Commentary: The COVID-19 Pandemic Is Not a Good Time to Weaken Restrictions on Alcohol Availability.

Healthc Policy 2021 May;16(4):25-30

Senior Scientist, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON.

Alcohol use is well established globally as one of the major risk factors for burden of disease and mortality. Although it is not yet clear how the COVID-19 pandemic has impacted the overall level of alcohol use in Canada, we do know that various levels of government have promoted its use - either by designating it essential or by increasing its availability. Such actions may have both an immediate and sustained impact on alcohol-related harm in Canada. Read More

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A theoretically informed, mixed-methods study of pharmacists' aspirations and readiness to implement pharmacist prescribing.

Int J Clin Pharm 2021 Jun 14. Epub 2021 Jun 14.

Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar.

Background Studies have highlighted advancing clinical pharmacy practice in Qatar. Objective To explore pharmacists' aspirations and readiness to implement pharmacist prescribing. Setting Hamad Medical Corporation (HMC), the main provider of secondary and tertiary care. Read More

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Health Promotion Planning and an Interview With Dr. Lawrence Green.

Paul E Terry

Am J Health Promot 2021 Jul;35(6):760-765

American Journal of Health Promotion, Senior Fellow, 444143HERO (The Health Enhancement Research Organization).

"If we are to have more evidence-based practice, we need more practice-based evidence." This quote has become something of a mantra for the health promotions profession's most pre-eminent scholar, Dr. Lawrence W. Read More

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Video case review for quality improvement during cardiac arrest resuscitation in the emergency department.

Int J Clin Pract 2021 Jun 13:e14525. Epub 2021 Jun 13.

Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.

Background: Out-of-Hospital-Cardiac-Arrests (OHCA) are a leading global cause of mortality. The American Heart Association (AHA) promotes several important strategies associated with improved cardiac arrest outcomes, including decreasing pulse check time and maintaining a chest compression fraction (CCF) > 0.80. Read More

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Implementation and Evaluation of a Healthcare System's Approach to Surge Staffing and Training.

J Nurses Prof Dev 2021 Jun 11. Epub 2021 Jun 11.

Christina Kelley, DNP, APRN, AGCNS-BC, NE-BC, NPD-BC, CNE, CCRN-K, is Director of Education, Research, and Professional Practice, Sharp Chula Vista Medical Center, California. Verna Sitzer, PhD, RN, CNS, is Director of Professional Practice, Research, and Innovation, Sharp Memorial Hospital, San Diego, California. Kathleen Neumann MSN, RN, NPD-BC, is Senior Specialist, Sharp Coronado Hospital, California. Julie Williams, MSN, RN, CNS, MICN, CEN, is Clinical Nurse Specialist, Sharp Grossmont Hospital, San Diego, California. Laurie Ecoff, PhD, RN, NEA-BC, CNL, is Vice President, Sharp HealthCare Terrence and Barbara Caster Institute for Nursing Excellence, San Diego, California.

In response to the coronavirus pandemic, a multihospital healthcare system expanded its nursing resources to accommodate the anticipated and actual surge of patients infected with COVID-19. Nursing professional development practitioners rapidly implemented and evaluated a novel, structured orientation and training program to provide additional surge staffing. Transitioning to a team-based model using the new role of nurse extender ensured the continued deployment of safe, person-centered care. Read More

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Bridging the Divide: An Analysis of Allied Health Quality and Research Projects.

J Contin Educ Health Prof 2021 Jun 8. Epub 2021 Jun 8.

Dr. Dennett: Research fellow, School of Allied Health, Human Services and Sport, La Trobe University and Allied Health Clinical Research Office, Eastern Health, Victoria, Australia. Mr. Taylor: Professor of Allied Health School of Allied Health, Human Services and Sport, La Trobe University and Allied Health Clinical Research Office, Eastern Health, Victoria, Australia. Ms. Porter: Professor of Dietetics, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Victoria, Australia. Ms. Evans: Director-Quality, Planning and Innovation, Corporate Services, Performance Excellence & Consumer Engagement, Department of Quality, Planning and Innovation, Eastern Health, Victoria, Australia. Ms. Horne-Thompson: Associate Director-Student Programs, Learning and Teaching Directorate, Department of Learning and Teaching, Eastern Health, Victoria, Australia. Ms. Harding: Senior Research Fellow and Manager Allied Health Clinical Research Office, School of Allied Health, Human Services and Sport, La Trobe University and Allied Health Clinical Research Office, Eastern Health, Victoria, Australia.

Introduction: A range of activities are conducted in health care settings aiming to improve health care processes and outcomes. In many settings, these activities are classified into two broad domains of "quality improvement" and "health services research" each with its own methods, continuing education, support structures, and governance systems. We aimed to explore differences and similarities in the purpose, methods, and outcomes of approved allied health projects conducted under each of these domains at a large metropolitan health network. Read More

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Keys to Success: A Professional Development Program to Support Care of Patients With Autism Spectrum Disorder.

J Nurses Prof Dev 2021 Jun 9. Epub 2021 Jun 9.

Dennis P. Doherty, PhD, RN, NPD-BC, is a Senior Professional Development Specialist, Clinical Education, Informatics, Practice, and Quality, Boston Children's Hospital. Kristin Coffey, MS, CCLS, is a Certified Child Life Specialist, Autism Spectrum Center, Boston Children's Hospital. Laura Weissman, MD, is an Attending Physician, Division of Developmental Medicine, Boston Children's Hospital. Patricia A. Dwyer, PhD, RN, is the Director of Nursing Research, Satellite Clinical Operations, Boston Children's Hospital.

Patients with autism spectrum disorder present with an extensive range of communication and social skills that require healthcare workers to have a comprehensive understanding of best practices for providing holistic care. This article presents the planning, curriculum development, implementation, and evaluation of a professional development program aimed at providing interprofessional staff with strategies and resources to use when caring for patients with autism spectrum disorder. Read More

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Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial.

Glob Ment Health (Camb) 2021 26;8:e18. Epub 2021 May 26.

Catholic Relief Services Head Quarters, Baltimore, MD, USA.

Background: Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial (cRCT), based in Northern Ghana, are to assess the impact of the lay counselor-delivered, group-based Integrated Mothers and Babies Course and Early Childhood Development (iMBC/ECD) program on (1) the mental health of mothers of children under age 2; and (2) the socio-emotional development of their children.

Methods: This cRCT randomized 32 women's groups - 16 received iMBC/ECD content (intervention) and 16 received general health education content (control). Read More

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Cultural And Structural Features Of Zero-Burnout Primary Care Practices.

Health Aff (Millwood) 2021 Jun;40(6):928-936

Deborah J. Cohen is a professor of family medicine and vice chair of research in the Department of Family Medicine, Oregon Health and Science University.

Although much attention has been focused on individual-level drivers of burnout in primary care settings, examining the structural and cultural factors of practice environments with no burnout could identify solutions. In this cross-sectional analysis of survey data from 715 small-to-medium-size primary care practices in the United States participating in the Agency for Healthcare Research and Quality's EvidenceNOW initiative, we found that zero-burnout practices had higher levels of psychological safety and adaptive reserve, a measure of practice capacity for learning and development. Compared with high-burnout practices, zero-burnout practices also reported using more quality improvement strategies, more commonly were solo and clinician owned, and less commonly had participated in accountable care organizations or other demonstration projects. Read More

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The ARRIVE guidelines 2.0: updated guidelines for reporting animal research.

BMJ Open Sci 2020 Jul 20;4(1):e100115. Epub 2020 Jul 20.

Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

Reproducible science requires transparent reporting. The ARRIVE guidelines (Animal Research: Reporting of In Vivo Experiments) were originally developed in 2010 to improve the reporting of animal research. They consist of a checklist of information to include in publications describing in vivo experiments to enable others to scrutinise the work adequately, evaluate its methodological rigour and reproduce the methods and results. Read More

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Design and Implementation of Flexible Advanced Training in Rheumatology: Report of a pilot program.

Intern Med J 2021 Jun 6. Epub 2021 Jun 6.

Department of Rheumatology, Level 6 West, Main Building, Concord General Repatriation Hospital, Concord, NSW, 2139.

Background: Training in medicine is highly demanding and coincides with critical life tasks including relationship development, childbearing, and rearing. The rigid requirements of training programs risk precluding successful achievement of these extracurricular roles, forcing choices between work and other life commitments. Flexible employment structures that facilitate the development of high-quality physicians are needed. Read More

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Implementation of START (STrAtegies for RelaTives) for dementia carers in the third sector: Widening access to evidence-based interventions.

PLoS One 2021 2;16(6):e0250410. Epub 2021 Jun 2.

University College London, London, United Kingdom.

Family members remain the main care providers for the increasing numbers of people with dementia, and often become depressed or anxious. In an implementation research project, we aimed to widen access to Strategies for RelaTives (START), a clinically and cost-effective intervention for the mental health of family carers, by laying the foundations for its implementation in the third sector. We used the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to guide implementation of START, a manual-based, individually-delivered, multicomponent eight-session coping strategy intervention. Read More

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The End of Step 2 CS Should Be the Beginning of a New Approach to Clinical Skills Assessment.

Timothy K Baker

Acad Med 2021 Jun 1. Epub 2021 Jun 1.

T.K. Baker is senior associate dean for academic affairs and associate professor, Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, Nevada.

The discontinuation of the United States Medical Licensing Examination Step 2 Clinical Skills (CS) in 2020 in response to the COVID-19 pandemic marked the end of a decades-long debate about the utility and value of the exam. For all its controversy, the implementation of Step 2 CS in 2004 brought about profound changes to the landscape of medical education, altering the curriculum and assessment practices of medical schools to ensure students were prepared to take and pass this licensing exam. Its elimination, while celebrated by some, is not without potential negative consequences. Read More

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Operational research capacity building through the Structured Operational Research Training Initiative (SORT-IT) in China: implementation, outcomes and challenges.

Infect Dis Poverty 2021 Jun 1;10(1):80. Epub 2021 Jun 1.

Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, China.

Background: Chinese Center for Disease Control and Prevention (China CDC) introduced the Structured Operational Research Training Initiative (SORT IT) into China to build a special capacity and equip public health professionals with an effective tool to support developing countries in strengthening their operational research. The paper aims to investigate and analyze the implementation, outcomes and challenges of the first cycle of SORT IT in China.

Main Text: As a result of the successful implementation, SORT IT China, Cycle 1 has demonstrated fruitful outputs as exemplified by the 18-month follow-up to the post-training initiatives of the twelve participants, who all achieved the four milestones required by SORT IT. Read More

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Caregiver Burden and Associated Factors for the Respite Care Needs among the Family Caregivers of Community Dwelling Senior Citizens in Chiang Mai, Northern Thailand.

Int J Environ Res Public Health 2021 May 30;18(11). Epub 2021 May 30.

Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan.

Background: Families are the backbone of caregiving for older adults living in communities. This is a tradition common to Thailand and many low- and middle-income countries where formal long-term care services are not so available or accessible. Therefore, population aging demands more and more young people engaging as family caregivers. Read More

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Assessing webinar outcomes for health professionals: a perspective from Indonesia during coronavirus disease 2019 pandemic.

Korean J Med Educ 2021 Jun 26;33(2):87-96. Epub 2021 May 26.

Urology Medical Staff Group, Universitas Indonesia Hospital, Universitas Indonesia, Depok, Indonesia.

Purpose: With the ongoing coronavirus disease 2019 (COVID-19) pandemic, health institutions and hospitals are increasingly relying on e-learning for continuing education. However, in many countries there is still limited data on the effectiveness of online learning particularly in the healthcare field. This study aims to evaluate whether webinar as a form of online educational intervention is satisfactory and effective for the continuing education of health professionals in Indonesia. Read More

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Managing patients receiving new and unfamiliar cancer treatments: A qualitative study of general practitioners' experience.

Aust J Gen Pract 2021 06;50(6):426-430

MA, MBBCh, MRCGP, FRACGP, DPhil, Herman Professor of Primary Care Cancer Research, Department of General Practice, and Centre for Cancer Research, University of Melbourne, Vic.

Background And Objectives: As systemic cancer treatments increase in complexity, general practitioners (GPs) need access to reliable information to support patients on new and often unfamiliar treatments. The authors explored the experience of GPs in supporting patients receiving anticancer therapy, and the barriers and facilitators to the implementation of a new resource designed to support GPs in this role.

Method: Semi-structured qualitative interviews were conducted with 15 GPs and oncology clinicians. Read More

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Developing a children's health risk behaviour prevention program targeting grade 4-7 learners in the western cape, South Africa: a study protocol.

BMC Public Health 2021 05 30;21(1):1021. Epub 2021 May 30.

Department of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, University Drive, Durban, 4001, South Africa.

Background: Health risk behaviour among South African youth is a significant public health concern. Despite a societal mind shift to educating the public on the prevention of health risk behaviour, behavioural change is not progressing at the rate needed to influence health risk behaviour positively. The project aims to explore behavioural trends and willingness to engage in risky behaviour among senior primary school children. Read More

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Evaluating the Implementation of a Pragmatic Person-Centered Communication Tool for the Nursing Home Setting: PAL Cards.

Clin Gerontol 2021 May 31:1-13. Epub 2021 May 31.

College of Nursing, Program for Person-Centered Living Systems of Care, the Polisher Research Institute at Abramson Senior Care, The Pennsylvania State University, University Park, Pennsylvania, USA.

: The purpose of this quality improvement project was to evaluate the implementation of a person-centered communication tool in nursing homes (NH). The Preferences for Activity and Leisure (PAL) Cards were developed to communicate residents' preferences for activities across care team members.: Providers were recruited to assess resident important preferences and create PAL Cards for 15-20 residents and collected data aligned with the RE-AIM framework. Read More

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Effecting a national implementation project through distributed leadership in the West Midlands: rising to the spread challenge.

BMJ Open Qual 2021 05;10(2)

Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, UK

We describe the utility and impact of a distributed leadership model to implement a National Health Service (NHS) England Academic Health Sciences national quality improvement programme, in the West Midlands. This model was adopted to address the inherent difficulties of implementing change in practice in a large geographical region with a diverse population of health service personnel. We report on the inclusion of a senior trainee as part of the implementation team, supported by a multidisciplinary clinical consultant team, with equal agency in decision making, acting as mentors and activators in the background. Read More

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Implementation of training to improve communication with disabled children on the ward: a feasibility study.

Health Expect 2021 May 28. Epub 2021 May 28.

Peninsula Childhood Disability Research Unit (PenCRU) and National Institute of Health Research Applied Research Collaboration for the South West Peninsula (penARC), University of Exeter Medical School, University of Exeter, Exeter, UK.

Background: Parents of disabled children report poorer inpatient experiences when they stay in hospital, and some staff report finding communicating with disabled children challenging. This study tested the feasibility of implementing a training package for staff on paediatric wards to improve communication with disabled children, especially those with communication difficulties, and their families. The package was developed with parent carers and clinicians, and comprises a manual, a video of parent carers talking about real experiences, discussion points and local resources. Read More

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Implementation of a complex intervention to improve hospital discharge: process evaluation of a cluster randomised controlled trial.

BMJ Open 2021 05 27;11(5):e049872. Epub 2021 May 27.

Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland.

Objectives: To study the implementation of a cluster randomised controlled effectiveness-implementation hybrid trial testing the effectiveness of a medication review at hospital discharge combined with a communication stimulus between hospital physicians (HPs) and general practitioners (GPs) on rehospitalisation of multimorbid older patients.

Design: Extension of Grant's mixed method process evaluation framework to trials with multilevel clustering.

Setting: General internal medicine wards in Swiss hospitals. Read More

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Level of Supervision and Radiation Exposure of Senior Orthopedic Residents During Surgical Treatment of Proximal Femur Fracture.

Orthopedics 2021 May-Jun;44(3):e402-e406. Epub 2021 May 1.

The sustained use of intraoperative fluoroscopy has led to increased use of minimally invasive surgical techniques, enhanced surgeon proficiency, improved anatomic corrections, reduced patient morbidity, earlier functional recovery, and decreased length of hospital stay. As a result, orthopedic attending surgeons and residents are exposed to more radiation, increasing the risk of cancer and radiation-induced cataracts compared with the general population and those who work in other surgical specialties. The magnitude of radiation exposure depends on the susceptibility of the tissues affected, medical specialty, the position of the C-arm, distance from the radiation beam, level of difficulty of the surgical procedure, surgeon experience, level of resident training, and level of supervision by the attending surgeon. Read More

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Impact of Scribe Intervention on Documentation in an Outpatient Pediatric Primary Care Practice.

Acad Pediatr 2021 May 18. Epub 2021 May 18.

Penn State Children's Hospital, Penn State College of Medicine, Department of Pediatrics, 500 University Drive, Hershey, PA 17033, United States of America; Penn State College of Medicine, Department of Humanities, 500 University Drive, MC-H134, Hershey, PA 17033, United States of America. Electronic address:

Purpose: The use of the Electronic Health Record (EHR) has led to physician dissatisfaction, physician burnout, and delays in documentation and billing. Medical scribes can mitigate these unintended consequences by reducing documentation workload and increasing efficiency.

Objective: To study the effects of medical scribes on time to completion of notes and clinician experience, with a focus on time spent charting during clinic and after-hours. Read More

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Implementation Road Map of Health Technology Assessment in Middle-Income Countries: The Case of Jordan.

Value Health Reg Issues 2021 May 17;25:126-134. Epub 2021 May 17.

Semmelweis University, Center for Health Technology Assessment, Budapest, Hungary; Syreon Research Institute, Budapest, Hungary.

Objectives: Health technology assessment (HTA) can increase the appropriateness and transparency of pricing and reimbursement decisions. Jordan is still in the early phase of its HTA implementation, although the country has very limited public resources for the coverage of healthcare technologies. The study objective was to explore and validate priorities in the HTA road map for Jordan and propose to facilitate the preferred HTA status. Read More

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Impact of the acute care surgery model on resident operative experience in emergency general surgery.

Can J Surg 2021 May 20;64(3):E298-E306. Epub 2021 May 20.

From the Department of Surgery, McMaster University, Hamilton, Ont. (Meschino, Giles, Engels, Rice, Nenshi, Maraccio).

Background: The acute care surgery (ACS) model has been shown to improve patient, hospital and surgeon-specific outcomes. To date, however, little has been published on its impact on residency training. Our study compared the emergency general surgery (EGS) operative experiences of residents assigned to ACS versus elective surgical rotations. Read More

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An environmentally friendly alternative to single-use plastics for radiotherapy bladder preparation.

Tech Innov Patient Support Radiat Oncol 2021 Jun 3;18:29-31. Epub 2021 May 3.

Royal Marsden NHS Foundation Trust, United Kingdom.

More than 60,000 plastic cups were used annually for bladder preparation in one radiotherapy centre. As an alternative, patients were provided with a specifically designed reusable water bottle, aiming to reduce waste and improve bladder filling compliance. Cup usage and bladder volume at treatment were calculated pre- and post-implementation. Read More

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Verification and Validation of Digital Pathology (Whole Slide Imaging) for Primary Histopathological Diagnosis: All Wales Experience.

J Pathol Inform 2021 23;12. Epub 2021 Jan 23.

Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales.

Aims: The study is aimed to verify Aperio AT2 scanner for reporting on the digital pathology platform (DP) and to validate the cohort of pathologists in the interpretation of DP for routine diagnostic histopathological services in Wales, United Kingdom.

Materials Methods And Results: This was a large multicenter study involving seven hospitals across Wales and unique with 22 (largest number) pathologists participating. 7491 slides from 3001 cases were scanned on Leica Aperio AT2 scanner and reported on digital workstations with Leica software of e-slide manager. Read More

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January 2021

Longitudinal Milestone Assessment Extending Through Subspecialty Training: The Relationship Between ACGME Internal Medicine Residency Milestones and Subsequent Pulmonary and Critical Care Fellowship Milestones.

Acad Med 2021 May 18. Epub 2021 May 18.

J.K. Heath is an assistant professor, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0002-0533-3088. T. Wang is an associate professor, Department of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California. L. Santhosh is an assistant professor, Department of Medicine, University of California San Francisco, San Francisco, California. J.L. Denson is an assistant professor, Section of Pulmonary, Critical Care, and Environmental Medicine, Tulane University School of Medicine, New Orleans, Louisiana; ORCID: https://orcid.org/0000-0002-8654-7765. E. Holmboe is an adjunct professor, Department of Medicine, Yale University, New Haven, Connecticut; and the Chief Research, Milestone Development, and Evaluation Officer for the Accreditation Council for Graduate Medical Education, Chicago, Illinois. K. Yamakazi is the senior analyst for the Accreditation Council for Graduate Medical Education, Chicago, Illinois. A.S. Clay is an assistant professor, Department of Medicine, Duke University, Durham, North Carolina. W.G. Carlos is an associate professor, Department of Medicine, Indiana University, Indianapolis, Indiana.

Purpose: The Accreditation Council for Graduate Medical Education (ACGME) milestones were implemented across medical subspecialties in 2015. Although milestones were proposed as a longitudinal assessment tool potentially providing opportunities for early implementation of individualized learning plans in fellowship, the association of subspecialty fellowship ratings with prior residency ratings remains unclear. This study aimed to assess the relationship between internal medicine (IM) residency milestones and pulmonary-critical care medicine (PCCM) fellowship milestones. Read More

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Building Mental Health Capacity: Exploring the Role of Adaptive Expertise in the ECHO Virtual Learning Model.

J Contin Educ Health Prof 2021 04;41(2):104-110

Dr. Sockalingam is professor and vice-chair education, Department of Psychiatry, University of Toronto, Faculty of Medicine; vice president education and clinician scientist, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Ms. Rajaratnam is a research analyst, ECHO Ontario Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Zhou is a resident in Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Serhal is senior director of Outreach, Telemental Health and ECHO Ontario Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Crawford is an associate professor, Department of Psychiatry, University of Toronto, Faculty of Medicine; associate chief, Outreach and Telemental Health, Centre for Addiction and Mental Health, Toronto, Canada. Dr. Mylopoulos is an associate professor, scientist, and associate director of training programs, Wilson Centre and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.

Introduction: With the proliferation of virtual learning programs during the COVID-19 pandemic, there is increased need to understand learner experiences and impact on developing expertise. Project Extension for Community Healthcare Outcomes (Project ECHO®) is an established hub-and-spoke tele-education model aimed at building capacity and expertise in primary care providers. Our qualitative study explored how learning experiences within an ECHO mental health care program supported provider learning and ability to solve complex clinical problems. Read More

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