Browsing by Subject "Education, Medical, Graduate"

Now showing 1 - 20 of 27
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    2016-2017 Medical School Catalog
    (University of Texas Southwestern Medical Center, 2017)
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    2017-2018 Medical School Catalog
    (University of Texas Southwestern Medical Center, 2018)
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    2018-2019 Medical School Catalog
    (University of Texas Southwestern Medical Center, 2019)
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    2019-2020 Medical School Catalog
    (University of Texas Southwestern Medical Center, 2020)
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    2020-2021 Medical School Catalog
    (University of Texas Southwestern Medical Center, 2021)
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    Analysis of Resident Conducted Social Determinants of Health Informed Home Visits
    (2020-01-21) Cline, Matthew; Day, Philip; Gimpel, Nora; Pagels, Patti
    CONTEXT: Home visits can improve quality of care, save money, improve health outcomes, and provide a unique opportunity for residents to learn more about patients' social context and assess the various social determinants of health (SDH) that impact patients' health and wellbeing. In order to facilitate a SDH-focused visit, the Department of Family and Community Medicine at UT Southwestern implemented a brief SDH questionnaire in all home visits. OBJECTIVE: The objective of this study is to assess patient self-reported SDH and resident reflections on patient social status, the utility of a SDH survey during home visits, and resident comfort levels with addressing patient SDH HUMAN SUBJECTS REVIEW: This study was approved as an "exempt" study by the UTSW IRB DESIGN: Mixed methods pilot study utilizing patient self-reported data and open- ended reflection questions SETTINGS: Home health visits for patients from an urban safety-net clinic in Dallas, TX. Participants: Adult patients >18 years of age, selected by the resident INTERVENTION/INSTRUMENT (AS PERTINENT): Quantitative survey domains include: demographics, financial status, social support, safety, employment, and living conditions. Open response questions queried resident impressions of the survey, comfort during the interview, new insights about the patient, impact on future practice, and ability to address SDH concerns. ANTICIPATED RESULTS: 42 surveys collected from 42 home visits. Most patients were female (61.9%) and African-American (45.2%), aging from 25 to 88 years (mean=60.24). Prevalence of adverse SDH were relatively low. Common themes of resident responses: positive utility of the survey as a guide for understanding and assessing patient SDH; wide variation in comfort level when inquiring about patient SDH with positive influence from prior experience, assistance from colleagues, or prior good relations with patients; and expressed intention to include SDH assessment in their continuing career. CONCLUSIONS: Residents recognized the value of assessing SDH during home visits and expressed implement a standardized process for selecting patients for home visits as this was largely left to the discretion of the resident. More thorough assessment of patient SDH may help to craft a more robust and standardized system to prioritize patients that would most benefit from receiving home visits.
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    Catalog for ... / Southwestern Medical School, University of Texas Southwestern Medical Center at Dallas
    (1954-04-01) University of Texas Southwestern Medical School at Dallas
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    Catalog for ... / Southwestern Medical School, University of Texas Southwestern Medical Center at Dallas
    (1953-06-01) University of Texas Southwestern Medical School at Dallas
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    Catalog for ... / The Southwestern Medical School of the University of Texas
    (1950-04-01) University of Texas Southwestern Medical School at Dallas
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    Catalog for Southwestern Medical School, University of Texas Southwestern Medical Center at Dallas
    (The University of Texas Southwestern Medical Center at Dallas, 2009-07) University of Texas Southwestern Medical Center at Dallas
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    An Exanimation of GME Funding: A Critical Look at Non-ACGME Surgical Fellowships
    (2020-05-01T05:00:00.000Z) Lee, Joo Hyun; Scott, Daniel; Sendelbach, Dorothy; Pearson, Mary Jane
    BACKGROUND: Since 1997, the Fellowship Council (FC) has evolved into a robust organization that is responsible for the advanced training of nearly half of the U.S. residency graduates entering general surgery practice. While FC fellowships are competitive (55% match rate) and offer outstanding educational experiences, funding is arguably vulnerable as external support has diminished. OBJECTIVE: The aim of this study was to investigate the current funding models of FC fellowships. METHODS: Under an IRB-approved protocol, an electronic survey was administered to 167 FC programs with subsequent phone interview follow-ups to collect data on total cost and sources of funding. De-identified data were also obtained via 2020-2021 Foundation for Surgical Fellowships (FSF) grant applications. Means and ranges are reported. RESULTS: Data were obtained from 59 programs (35% response rate) via the FC survey and 116 programs via FSF applications. The results from the FC and FSF data sets indicated that the average cost to train one fellow per year was USD 107,957 and USD 110,816, respectively. Similar averages were reported for the four components of cost. Programs received an average funding of USD 109,118 and USD 110,816, respectively. Most programs utilized departmental and grants funds. Additionally, 36% (FC data) to 39% (FSF data) of programs indicated that they billed for their fellow, generating USD 74,824 (range USD 15,000-USD 200,000) and USD 33,281 on average (range USD 11,500 - 66,259), respectively. 14% of programs via FC survey reported generating net positive revenue whereas 100% of programs from FSF application declared budget neutral. CONCLUSIONS: Our results indicated similar findings in support of the overall accuracy of these data. Most programs seemed to rely heavily on subsidies from both internal and external sources, although some programs were able to generate a positive revenue stream. The most notable difference was the revenue amount generated from billing. Programs that generated a positive revenue often billed for fellows. Given the value of these fellowships and the inherent vulnerabilities associated with graduate medical education funding, new alternative grant funding models are encouraged. In addition, standardization of annual cost and funding reports would provide greater insights into funding models.
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    Optimizating and Diffusing a Handover Behavioral Assessment Tool for Simulation
    (2021-03-18) Chen, Rodney; Reed, W. Gary; Greilich, Philip; Phelps, Eleanor
    INTRODUCTION: With multiple simulated and clinical scenarios included in the ongoing Quality Enhancement Plan (QEP), a standardized approach to assessing and trending handover quality across class years could quantify the improvements established through the QEP. This study assesses the utility of the Liang Handover Assessment Tool for Simulation (L-HATS), a valid and reliable behavioral assessment tool tested during the transition to clerkship (T2C) handover module. Here, we use the L-HATS to assess handovers delivered during residency essentials (RE) and COVID-19 telehealth courses, checking for tool reliability in settings other than T2C. In cases where we find the tool to be less reliable, we optimize the L-HATS by improving the observer training course. The study aim is to confirm tool reliability of ICC>0.75, consistent with levels of reliability found during testing in the T2C module. METHODS: We select volunteer observers from a group of medical students who had completed the T2C course, with each observer assigned a set of videos to score for each activity. The primary outcome measure for this study is the two-way random effects ICC, which represents tool inter-rater reliability in each novel activity. An ICC>0.75 is considered good reliability, an ICC 0.5-0.75 is considered moderate reliability, and an ICC<0.5 is considered poor reliability. As the volunteer observer training improves across activities, we assess for observers' intra-rater reliability. Intra-rater reliability is assessed along the same scale used for inter-rater reliability. RESULTS: RE inter-rater reliability was 0.561 [0.167, 0.953], with each of six observers scoring four videos. COVID-19 telehealth inter-rater reliability was 0.644 [0.244, 0.964], with five observers each scoring four videos. The intra-rater reliability calculated for the telehealth course ranged from 0.105 [-0.361, 0.863] to 0.667 [0.020, 0.971]. CONCLUSION: This study demonstrates moderate levels of reliability in both the RE and telehealth courses. However, neither novel activity could match the reliability scores calculated during original L-HATS testing, suggesting that the tool is less reliable in settings outside of the T2C course. Future studies might increase the number of graded videos per handover activity, to narrow the confidence intervals found in the present study. Moreover, we find that a universally flexible assessment tool is difficult to design, suggesting that each new learning activity may require a uniquely tailored behavioral assessment tool.
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    Physical exam: past, present and future
    (2020-08-07) Bhushan, Sujata