Restructuring Medical Education to Meet Current and Future Health Care Needs

Pershing, Suzann; Fuchs, Victor R.

doi:10.1097/acm.0000000000000020

Cited by 59 publications

(44 citation statements)

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“…9,10 This is true of the broader landscape of 21st century medical education, which must evolve to meet the changing competencies required of physicians. 11,12 As an adaptive challenge, 9,10 several important truths emerge about implementing milestones:…”

Section: Implementing the Pediatrics Milestones: An Adaptive Challengementioning

confidence: 99%

Putting the Pediatrics Milestones Into Practice: A Consensus Roadmap and Resource Analysis

et al. 2014

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The Accreditation Council for Graduate Medical Education has partnered with member boards of the American Board of Medical Specialties to initiate the next steps in advancing competency-based assessment in residency programs. This initiative, known as the Milestone Project, is a paradigm shift from traditional assessment efforts and requires all pediatrics residency programs to report individual resident progression along a series of 4 to 5 developmental levels of performance, or milestones, for individual competencies every 6 months beginning in June 2014. The effort required to successfully make this shift is tremendous given the number of training programs, training institutions, and trainees. However, it holds great promise for achieving training outcomes that align with patient needs; developing a valid, reliable, and meaningful way to track residents’ development; and providing trainees with a roadmap for learning. Recognizing the resources needed to implement this new system, the authors, all residency program leaders, provide their consensus view of the components necessary for implementing and sustaining this effort, including resource estimates for completing this work. The authors have identified 4 domains: (1) Program Review and Development of Stakeholders and Participants, (2) Assessment Methods and Validation, (3) Data and Assessment System Development, and (4) Summative Assessment and Feedback. This work can serve as a starting point and framework for collaboration with program, department, and institutional leaders to identify and garner necessary resources and plan for local and national efforts that will ensure successful transition to milestones-based assessment.

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Section: Implementing the Pediatrics Milestones: An Adaptive Challengementioning

confidence: 99%

Putting the Pediatrics Milestones Into Practice: A Consensus Roadmap and Resource Analysis

et al. 2014

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“…13 Indeed, the US Census Bureau projects a total population increase of approximately 74 million, of whom 40 million will be older than 65 years of age, underscoring that the number of people older than 65 years will double by 2040. 15 Therefore, the evolution of medical curricula to meet current and future vascular care needs is justifiable.…”

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confidence: 99%

Vascular Educational Needs in the “Real World” and Teaching of Vascular Surgery in Medical Schools

et al. 2016

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The prevalence of peripheral arterial disease (PAD) is 3% to 10% in the general population, increasing to 15% to 20% in those older than 70 years. 1 The Reduction of Atherothrombosis for Continued Health survey showed that almost 66% of patients with PAD had clinical evidence of other vascular disease. 2 Coronary artery disease is the most common cause of death among patients with PAD (40%-60%), cerebral artery disease accounts for 10% to 20% of deaths, 1,2 and 10% of deaths have been attributed to other vascular events, mostly ruptured aortic aneurysm.Although PAD is a major cause of mortality and morbidity, postgraduate doctors have poor knowledge about this topic. 3 Schwarcz et al recorded a moderate percentage of correct answers by internal medicine interns when questioned with respect to prevalence, screening, and treatment of vascular diseases (48.9%, 33.8%, and 45.0%, respectively). 4 Although the ankle-brachial index (ABI) is considered a reliable and accurate vascular biomarker in primary and secondary prevention of cardiovascular events, 5 Wyatt et al documented a poor level of baseline knowledge of calculation and interpretation of ABI among internal medicine residents, irrespective of the year of residency. 6 Likewise, Chaudru et al reported poor scores of 22%, 13%, and 41% among residents from 6 different medical schools in France regarding correct ABI measurement, calculation, and interpretation, respectively. 7 Therefore, it is not surprising that Campbell et al recorded uncertainty and disagreement about the skills expected from medical students by their tutors, with only one-third of the instructors considering the ability to estimate ABI using a Doppler device as necessary. 8 In agreement with deficient PAD knowledge at pre-and immediate postgraduate level, a survey in central Greece documented that PAD remains underdiagnosed and undertreated not only due to insufficient patient information and screening but also due to lack of awareness and inadequate vascular examination by many physicians in primary care. 9

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“…236,247,248,252 Outcomes data on these training programs are either limited or not comprehensive. 247,253 One advocate of this model noted that no evidence exists that demonstrates that these medical students will perform worse than traditional UME students on USMLE board examinations, placement in residency programs, or other significant metrics of competence.…”

Section: Shorten Training: Undergraduate Medical Educationmentioning

confidence: 99%

“…(Interestingly, CBC pathway programs for allopathic training are only scantily mentioned in the literature. 236 )…”

Section: Train More: Shorten the Duration Of Medical Trainingmentioning

confidence: 99%

“…235 The goal of team-based care is "to keep patients healthier at lower costs by enabling providers to work efficiently at maximum license." 236 Two promising team-based primary care models developing from the ACA are the PCMH and the ACO. Both models' success depends upon systematic change in primary care delivery where innovative new roles emerge, team members' capabilities are leveraged, and new technology is utilized.…”

Section: Finding Someone Else and Team-based Carementioning

confidence: 99%

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The association of medical student debt on choice of primary care specialty and rural practice location.

Ziegler

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Restructuring Medical Education to Meet Current and Future Health Care Needs

Cited by 59 publications

References 4 publications

Putting the Pediatrics Milestones Into Practice: A Consensus Roadmap and Resource Analysis

Putting the Pediatrics Milestones Into Practice: A Consensus Roadmap and Resource Analysis

Vascular Educational Needs in the “Real World” and Teaching of Vascular Surgery in Medical Schools

The association of medical student debt on choice of primary care specialty and rural practice location.

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