Remediation in Medical Education: A Mid-Course Correction

Springer Science & Business Media
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Remediation in medical education is the act of facilitating a correction for trainees who started out on the journey toward becoming excellent physicians but have moved off course. This book offers an evidence-based and practical approach to the identification and remediation of medical trainees who are unable to perform to standards. As assessment of clinical competence and professionalism has become more sophisticated and ubiquitous, medical educators increasingly face the challenge of implementing effective and respectful means to work with trainees who do not yet meet expectations of the profession and society.

Remediation in Medical Education: A Mid-Course Correction describes practical stepwise approaches to remediate struggling learners in fundamental medical competencies; discusses methods used to define competencies and the science underlying the fundamental shift in the delivery and assessment of medical education; explores themes that provide context for remediation, including professional identity formation and moral reasoning, verbal and nonverbal learning disabilities, attention deficit disorders in high-functioning individuals, diversity, and educational and psychiatric topics; and reviews system issues involved in remediation, including policy and leadership challenges and faculty development.

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About the author

Adina L. Kalet, MD, MPH is a Professor of Medicine and Surgery at New York University and has conducted vast amounts of research on medical education over the course of her career. She is a member of the Society of General Internal Medicine and was recognized in 2008 with their National Award for Scholarship in Medical Education. She has directed the Primary Care Internal Medicine Residency, Medical Education for the Division of Primary Care, the Macy Initiative in Health Communication, and the Dean's Task Force on Clinical Assessment, all at NYU. She has also served as a Principal Investigator for the NYS Department of Health's project on medical school participation in ambulatory care and the co-director for the CDC's course on preparing primary care physicians for the psychosocial aspects of bioterrorism. Calvin Chou, MD, PhD is Professor of Clinical Medicine at UCSF, and staff physician at the VA Medical Center in San Francisco. As a faculty member of the American Academy on Communication in Healthcare, he is nationally recognized for his efforts in education and research to enhance communication between patients and physicians. Currently he is director of VALOR, an innovative longitudinal program based at the VA that emphasizes humanistic clinical skill development for medical students. He also holds the first endowed Academy Chair in the Scholarship of Teaching and Learning at UCSF. He has delivered communication skills curricula for providers at medical centers across the country, including Mayo Clinic, Cleveland Clinic Foundation, Stanford University, and New York University.
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Additional Information

Publisher
Springer Science & Business Media
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Published on
Nov 26, 2013
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Pages
367
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ISBN
9781461490258
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Language
English
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Genres
Education / General
Education / Teaching Methods & Materials / General
Medical / Ethics
Medical / General
Science / Philosophy & Social Aspects
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Content Protection
This content is DRM protected.
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This book exposes, and fills, a notable void in the educational content generally covered in modern schools of medicine. It provides an introduction to the field at large in terms of content that is relevant for each of the specialties and subspecialties of medicine; and to this end, it addresses the modern counterpart of the Hippocratic philosophy that was at the root of the genesis of modern medicine.

The much-needed but still-missing introductory content for the interdisciplinary 'medical common,' provided in this book, addresses mainly the most elementary concepts and principles of medicine. Those concepts flow, hierarchically, from the essence of (health and) ill-health/illness for one and that of medicine for another, both of these critically formulated; and those principles are dictates of logic and ethics, both specific to medicine.

While a modern physician is expected to be competent as a scholar in his/her particular discipline of medicine, study of this book is essential for the development of that competence -- for learning, for example, to make a tenable distinction between scientific medicine and medical science, and between knowledge-based medicine (scientific and other) and its opinion-based substitutes ('evidence-based' and other).

"To me it is astonishing and to medicine actually shameful that it has taken up to year 2015 before there is a work in which the essence of medicine is described and discussed."

-- J. Steurer, University of Zurich

"[In this book], Miettinen beautifully elucidates the concepts and principles of knowledge-based diagnosis, and prognosis, within medicine. Now, after six decades of keen observation and study, and critical reflection on medicine and medical research, Miettinen, in this book, shares the fundamental understandings he has reached; ..."

-- T. J. VanderWeele, Harvard University

"The aim of this book ... is admirable. The composition of the book -- from the key concepts to logical and ethical principles -- is very clear and systematic. I am convinced that this kind of book is needed."

-- I. Niiniluoto, University of Helsinki

Scientific medicine in Miettinen’s conception of it is very different from the two ideas about it that come to eminence in the 20th century. To him, medicine is scientific to the extent that it has a rational theoretical framework and a knowledge-base from medical science. He delineates the nature of that theoretical framework and of the research to develop the requisite knowledge for application in such a framework. The knowledge ultimately needed is about diagnostic, etiognostic, and prognostic probabilities, and it necessarily is to be codified in the form of probability functions, embedded in practice-guiding expert systems.

In these terms, today’s medicine still is mostly pre-scientific, and major innovations are needed within and around medicine for healthcare to get to be in tune with reasonable expectations about it in this Information Age. Thus, while the leading cause of litigation for medical malpractice in the U.S. is failure to expeditiously and correctly diagnose the probability of myocardial infarction in a hospital’s emergency room, this book shows that a typical modern textbook of cardiology, just as one of medicine at large, imparts no knowledge about the diagnostic probabilities needed in this, and that the prevailing type of diagnostic research will not produce the requisite knowledge. If the diagnostic pursuits in an ER would be guided by an emergency-room diagnostic expert system, this would guarantee expert diagnoses by all ER doctors.

Academic leaders of medicine and medical researchers concerned to advance the knowledge-base of medicine will find a wealth of stimulus for thinking about the deficiencies of the prevailing knowledge culture in and surrounding medicine, and about the directions of the needed progress toward genuinely scientific medicine.

A proven prescription for effective communication that will empower health professionals to deliver the highest quality care―from the Academy of Communication in Healthcare

Research shows that nothing impacts patient experiences more than the quality of communication. While beneficial, the latest in cutting-edge technology and techniques aren’t enough to ensure the best possible care for patients. The key to better healthcare outcomes is communication.

Over the past four decades, the Academy of Communication in Healthcare has worked tirelessly with health systems, teaching communication skills that put relationships—between patients and providers, as well as among providers—at the center of care. Now, for the first time, ACH’s proven and effective methodology is detailed in this invaluable step-by-step guide. You’ll learn communication skills that will enable you to:

* Provide more accurate diagnoses and effective treatments—and improve patient outcomes

* Boost patient adherence and lower hospital readmission rates

* Make fewer errors and reduce malpractice risks

* Increase patient satisfaction and build teamwork among providers

* Further develop your communication skill set—and help others do the same

In this practical—and potentially life-saving—volume, you’ll discover special sections on teamwork, coaching, shared decision-making, feedback, conflict engagement, diversity, and communicating through hierarchy. The book also provides institutional initiatives to help you implement change in your organization and outlines a field-tested blueprint for healthier communication across the entire industry.

To create effective communication and meaningful connections in healthcare, trust ACH. Communication is literally its middle name.


From the era of slavery to the present day, the first full history of black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment.

Medical Apartheid is the first and only comprehensive history of medical experimentation on African Americans. Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of blacks, and the view that they were biologically inferior, oversexed, and unfit for adult responsibilities. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions.

The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust. No one concerned with issues of public health and racial justice can afford not to read Medical Apartheid, a masterful book that will stir up both controversy and long-needed debate.
In this heartfelt memoir from one of the youngest recipients of the transorbital lobotamy, Howard Dully shares the story of a painfully dysfunctional childhood, a misspent youth, his struggle to claim the life that was taken from him, and his redemption.

At twelve, Howard Dully was guilty of the same crimes as other boys his age: he was moody and messy, rambunctious with his brothers, contrary just to prove a point, and perpetually at odds with his parents. Yet somehow, this normal boy became one of the youngest people on whom Dr. Walter Freeman performed his barbaric transorbital—or ice pick—lobotomy.

Abandoned by his family within a year of the surgery, Howard spent his teen years in mental institutions, his twenties in jail, and his thirties in a bottle. It wasn’t until he was in his forties that Howard began to pull his life together. But even as he began to live the “normal” life he had been denied, Howard struggled with one question: Why?

There were only three people who would know the truth: Freeman, the man who performed the procedure; Lou, his cold and demanding stepmother who brought Howard to the doctor’s attention; and his father, Rodney. Of the three, only Rodney, the man who hadn’t intervened on his son’s behalf, was still living. Time was running out. Stable and happy for the first time in decades, Howard began to search for answers.

Through his research, Howard met other lobotomy patients and their families, talked with one of Freeman’s sons about his father’s controversial life’s work, and confronted Rodney about his complicity. And, in the archive where the doctor’s files are stored, he finally came face to face with the truth.

Revealing what happened to a child no one—not his father, not the medical community, not the state—was willing to protect, My Lobotomy exposes a shameful chapter in the history of the treatment of mental illness. Yet, ultimately, this is a powerful and moving chronicle of the life of one man.

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