Molly Cooke in a recent article in the NEJM (Cooke, Molly Cost Consciousness in Patient Care -- What Is Medical Education's Responsibility? N Engl J Med 2010 0: NEJMp0911502) suggests that medical educators may have failed in their task of teaching medical students and house staff appropriate use of various diagnostic tests and therapeutic procedures.
While she acknowledges that there are various factors why physicians may order more tests or procedures, she states that medical educators need to do more to help change practice behavior of these future physicians.
Schools and residency programs already educate trainees on the concepts of Number Needed to Treat, Absolute and Relative Risk Reductions, Sensitivity, Specificity of Tests, Positive and Negative Predictive Values, Likelihood Ratios etc.
The New York Times in a recent article discusses whether the new health care reform act will lead to decrease in health care spending.
Do you think more training regarding cost conscious use of tests and procedures in medical school will lead to change in practice behavior of future physicians? Will other drivers like financial incentives overcome any effect of training? What do you think we can do as medical educators that will truly impact the cost of health care?
Neil Mehta
Showing posts with label Medical Teaching. Show all posts
Showing posts with label Medical Teaching. Show all posts
Monday, April 19, 2010
Thursday, January 22, 2009
WHAT'S SO GRAND ABOUT GRAND ROUNDS?
A recent article in The New York Times Education Section
http://www.nytimes.com/2009/01/13/us/13physics.html?partner=permalink&exprod=permalink described an enormous change in the way the introductory science courses are taught at MIT; yes, Massachusetts Institute of Technology! Rather than the traditional crowded lecture hall, small groups of students explore the problems of science by interacting with peers and using faculty as resources and facilitators. The “50 minute expert lecture” is dead; instead, professors engage students in small group work while clarifying key concepts as they roam from table to table.
How’s it working out?
“Last fall, after years of experimentation and debate and resistance from students, who initially petitioned against it, the department made the change permanent. Already, attendance is up and the failure rate has dropped by more than 50 percent.”
What does this have to do with Medical Education and Grand Rounds?
Everything!! For years, many of the Basic Science and Clinical teachers in medical schools and residency programs across the country have been “bucking” the “case-based and/or collaborative teaching” trends by saying that there is simply too much to “cover” to use these more interactive concept-based teaching approaches. It is true that you can cover more ground with a lecture, but if no one is awake, much less learning, what is the point?
Will medical and residency education be “brave enough” to follow the example of MIT? Can we resurrect interaction, clinical reasoning discussions and vigorous debate at some of our education meetings?
Can we change “Grand Rounds” into something really GRAND? Click on the link above and read the whole article. It is fascinating. We want to hear what your think?
http://www.nytimes.com/2009/01/13/us/13physics.html?partner=permalink&exprod=permalink described an enormous change in the way the introductory science courses are taught at MIT; yes, Massachusetts Institute of Technology! Rather than the traditional crowded lecture hall, small groups of students explore the problems of science by interacting with peers and using faculty as resources and facilitators. The “50 minute expert lecture” is dead; instead, professors engage students in small group work while clarifying key concepts as they roam from table to table.
How’s it working out?
“Last fall, after years of experimentation and debate and resistance from students, who initially petitioned against it, the department made the change permanent. Already, attendance is up and the failure rate has dropped by more than 50 percent.”
What does this have to do with Medical Education and Grand Rounds?
Everything!! For years, many of the Basic Science and Clinical teachers in medical schools and residency programs across the country have been “bucking” the “case-based and/or collaborative teaching” trends by saying that there is simply too much to “cover” to use these more interactive concept-based teaching approaches. It is true that you can cover more ground with a lecture, but if no one is awake, much less learning, what is the point?
Will medical and residency education be “brave enough” to follow the example of MIT? Can we resurrect interaction, clinical reasoning discussions and vigorous debate at some of our education meetings?
Can we change “Grand Rounds” into something really GRAND? Click on the link above and read the whole article. It is fascinating. We want to hear what your think?
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