Quality LGBT Health Education: A Review of Key Reports and Webinars

An identified gap in training in the field of psychology is training on lesbian, gay, bisexual, and transgender (LGBT) health. Through a systematic review, we identified excellent LGBT health key reports and webinars that are in English, up‐to‐date, and easily accessible for free on the Internet. This article reviews 26 LGBT health key reports to identify core content themes (terminology, differences within LGBT populations, health and health disparities, transgender‐specific content, and diversity). A summary table is provided for each of these 26 key reports with regard to how well they capture the core themes and what strengths they offer clinical psychologists. The authors used these themes to evaluate the quality of LGBT health education webinars. Webinars were also evaluated to see whether they employed material intended to promote transfer and retention of knowledge and improve learner's clinical practice. The criteria we identified to evaluate the LGBT health webinars may also serve as a guide to content experts interested in creating new webinars or other educational programs on LGBT health care.     

Coordinating People and Knowledge: Efficiency in the Context of the Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act (ACA, 2010) will have a remarkable impact on mental health services, yet enormous implementation challenges exist. This commentary examines some of the issues related to workforce development and performance measures raised by Chor, Olin, and Hoagwood (2014). In particular, we examine inefficiencies related to the Mental and Behavioral Health Education and Training Grants, current training models, national initiatives to identify consensus quality indicators, and electronic health records. We highlight opportunities for psychology to lead effective reform by developing efficient training and knowledge architectures.     

A call for outcomes research in medical education.

The primary goal of medical education is to produce physicians who deliver high-quality health care. Recent calls for greater accountability in medical education and the development of outcomes research methodologies should encourage a new research effort to examine the effects of medical training upon clinical outcomes. The authors offer a research agenda that links medical education and quality of health care and give specific examples of potential research projects that would begin to examine that relationship. A proposed model of patient outcomes research in medical education recognizes the contributory effects of health care system-level factors as well as the continuum of medical education, process measures, and individual training and preparedness to deliver high-quality care. There exists an opportunity to create a research agenda in medical education outcomes research that is multidisciplinary, broad based, and focused on patient-centered outcomes.     

The Israel Center for Medical Simulation: a paradigm for cultural change in medical education.

Simulation-based medical education (SBME) is a rapidly growing field, as is illustrated by the increased development of simulation centers worldwide. SBME is becoming a powerful force in addressing the need to increase patient safety through quality-care training. Recognizing the benefits of SBME, increasing numbers of bodies involved in medical and health care education and training are establishing simulation centers worldwide. The general model of most facilities focuses on a single simulation modality or a specific branch of medicine or health care, limiting their overall impact on patient safety and quality of care across the health care systems. MSR, the Israel Center for Medical Simulation, is a comprehensive, national, multimodality, multidisciplinary medical simulation center dedicated to enhancing hands-on medical education, performance assessment, patient safety, and quality of care by improving clinical and communication skills. The center uses an "error-driven" educational approach, which recognizes that errors provide an opportunity to create a unique beneficial learning experience. The authors present the Israeli experience as an alternative model, and describe the impact of the MSR model on the Israeli medical community during four years of activity. They also describe the opportunities this model has opened towards changing the culture of medical education and patient safety within Israel Although this model may require modification when implemented in other medical systems, it highlights important lessons regarding the power of SBME in triggering and bringing about cultural changes in traditional medical education.     

A Healthy New World: Emergent Opportunities for Clinical Psychologists in the Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act (ACA) is radically transforming the health and mental healthcare landscape. Emergent opportunities exist for clinical psychologists to redefine their role in health care. We reflect on Chor, Olin, and Hoagwood ( 2014 ) and present additional recommendations for consideration. Specifically, we highlight three points: (a) moving beyond just training and hoping; (b) recovery, not just symptom reduction; and (c) it's a healthy new world. Under each of these points, we suggest tactics for how to achieve these goals.     

Current and (Potential) Future Effects of the Affordable Care Act on HIV Prevention

Recent advances in science, program, and policy could better position the nation to achieve its vision of the USA as a place where new HIV infections are rare. Among these developments, passage of the Patient Protection and Affordable Care Act (ACA) in 2010 may prove particularly important, as the health system transformations it has launched offer a supportive foundation for realizing the potential of other advances, both within and beyond the clinical arena. This article summarizes opportunities to expand access to high-impact HIV prevention interventions under the ACA, examines whether available evidence indicates that these opportunities are being realized, and considers potential challenges to further gains for HIV prevention in an era of health reform. This article also highlights the new roles that HIV prevention programs and providers may assume in a health system no longer defined by fragmentation among public health, medical care, and community service providers.     

Promoting interprofessional education in health sector within the European Interprofessional Education Network

According to a common definition, interprofessional education (IPE) is described as "occasions when two or more professions learn from and about each other to improve collaboration and the quality of care". The Leonardo project under the name European Interprofessional Education Network (EIPEN) in health and social care, has been dealing with the challenges of interprofessional education. The EIPEN project tries to develop a transnational network of universities and employers in the six participating countries and at the same time to promote good practices in interprofessional learning and teaching in health and social care. IPE provides opportunities for students and practitioners to learn with, from and about each other during qualifying and post-qualifying training and in their practice. IPE in health and social care includes the education and training of practitioners in human and animal medicine, dentistry, nursing, physiotherapy, occupational therapy, pharmacy and all other health professions including public and environmental health and health promotion, and social work. The outcomes of the EIPEN Project will provide means, material and guidelines for the enhancement of professional education in the multi-disciplinary field of Health Informatics. The methodology on the development of the Greek Interprofessional Network was based on a series of workshops aiming to document the educational process in healthcare institutes and universities followed by the assessment of the needs for the development of an interprofessional environment. The outcomes will provide means, material and guidelines for the enhancement of professional education in the multi-disciplinary field of Health Informatics.     

Addressing the leadership gap in medicine: residents' need for systematic leadership development training

All clinicians take on leadership responsibilities when delivering care. Evidence suggests that effective clinical leadership yields superior clinical outcomes. However, few residency programs systematically teach all residents how to lead, and many clinicians are inadequately prepared to meet their day-to-day clinical leadership responsibilities. The purpose of this article is twofold: first, to make the case for the need to refocus residency education around the development of outstanding "frontline" clinical leaders and, second, to provide an evidence-based framework for designing formal leadership development programs for residents. The authors first present a definition of clinical leadership and highlight evidence that effective frontline clinical leadership improves both clinical outcomes and satisfaction for patients and providers. The authors then discuss the health care "leadership gap" and describe barriers to implementing leadership development training in health care. Next, they present evidence that leaders are not just "born" but, rather, can be "made," and offer a set of best practices to facilitate the design of leadership development programs. Finally, the authors suggest approaches to mitigating barriers to implementing leadership development programs and highlight the major reasons why health care delivery organizations, residency programs, and national accreditation bodies must make comprehensive leadership education an explicit goal of residency training.     

The ever-widening training-practice gap.

The quality of health care in this country depends, in part, on the quality of physician training. Educators in graduate medical education (GME) increasingly are concerned that residency training is not keeping pace with the changing demands of medical practice. This widening training-practice gap creates challenges for physicians entering practice, burdens physician employers with educational responsibilities, and has the potential to negatively affect the quality of health care. This article reviews the data supporting these concerns, considers how GME arrived at this state, and suggests a number of steps that need to be taken to begin to narrow the training-practice gap.     

The problem-oriented system and record keeping in the behavioral therapies.

The Problem-Oriented System (POS) provides systematic guidelines for health care record keeping. Behavioral therapy records share, with health care records in general a quality of inadequacy for contemporary needs. Likewise, behavior therapy training shares with other health care training inadequate attention to record-keeping. This conclusion arises from a search of recent journals and books concerned with behavior therapy issues. This article reviews the POS and proposes that is guidelines and advantages are suited for incorporation into behavioral therapy training. The expected result of such training should be records more amenable to audit or review for such purposes as third party payment, supervision, and peer review. Research is needed to help select the record-keeping training methods that would best meet these contemporary needs for increased quality in the documentation of health care provision.     

Promoting Diversity in the Clinical and Translational Research Workforce

The positive impact of diversity in increasing the effectiveness of the research workforce has been undeniably demonstrated to be an essential element for achieving health equity. Diversity is also instrumental for the research workforce to advance discovery, eliminate health disparities, improve minority health and achieve effective patient-centered outcomes in the quest for better health. One of the sustainable ways to achieve diversity in the workforce is through training, education and career development of all interested individuals including minority, underserved, underrepresented and populations with special needs. A Hispanic public, academic health center, and a historically black private medical school, have joined efforts in this article to share their experiences in addressing diversity in the clinical and translational research workforce with grant support from the National Institutes of Health. The purpose of this paper is to describe how diversity has been achieved through a concerted effort to recruit and develop underrepresented junior faculty and doctoral candidates for successful careers in clinical and translational research focused on health disparities and minority health. We describe Initiatives designed to achieve diversity in recruitment and development of research teams, together with an evaluation of outcomes to determine the success of the program and its participants.     

Meeting the challenges facing clinical research: solutions proposed by leaders of medical specialty and clinical research societies.

The development of a robust national clinical research enterprise is needed to improve health care, but faces formidable challenges. To define the impediments and formulate solutions, the Institute of Medicine's Clinical Research Roundtable convened leaders from medical specialty and clinical research societies in 2003. Participants considered how to influence clinical research funding priorities, promote mechanisms to train physicians and other health care professionals to conduct clinical research, and how to encourage health care providers to follow evidence-based medical practice. Consensus emerged on multiple issues, including intersociety collaboration, the need for a core clinical research curriculum for training the new cadre of clinical researchers, joint advocacy for increased funding of clinical research and for the education of policymakers and the public on the benefits of clinical research. Specific recommendations were made on mechanisms for recruitment, training, and retention of clinical research trainees and mentors. Steps were outlined (1) to overcome career disincentives and develop appropriate reward systems for mentors and trainees, (2) to encourage use of web-based and continuing-medical-education-based mechanisms to bring practitioners up to date on issues in and results of clinical research, and (3) to create incentives for individuals, clinics, and hospitals to practice evidence-based medicine (EBM). Collectively, the response and proposed strategies can serve as a roadmap to improve clinical research funding and training, evidence-based medical practice, and health care quality.     

全科住院医师内分泌代谢疾病临床规范化培训问题与对策

提高全科住院医师规范化培训内分泌代谢疾病专业临床教学质量是培养合格的全科医生的关键。本文通过分析全科住院医师规范化培训中内分泌代谢疾病专业教学要求及目标,结合临床教学实践,从教学内容方法、师资水平以及全科住院医师自身情况3方面总结全科住院医师规范化培训中内分泌专业教学中存在的问题,并结合本专业临床教学特点,提出提高全科住院医师规范化培训中内分泌专业教学质量的具体实施建议,包括如何优化教学内容、教学方法实施、提高全科医师自我认知以及全科师资培训建议。     

In Pursuit of Empirically Supported Assessment for Use in Medical Settings

Psychological assessment in the medical setting presents many opportunities and challenges. On the question of what constitutes empirically supported assessment practice, there are few clear answers and perhaps fewer exemplars. The goal of this article was not to review the current status of empirically supported assessment in medical settings, but rather to highlight some areas of measurement innovation that may move this field toward its promise of a more stable evidence base supporting the use of patient‐reported outcome measures for clinical research, patient education, and clinical care. In addition, assessment in the medical setting provides one very unique opportunity that many psychologists are not honed in on: the use of psychological assessment to assess quality health care. This is an emerging reality that poses significant methodological puzzles and opens doors for those committed to psychological assessment.     

男医学生在妇产科实习的素质能力培养

21世纪需要高素质人才，素质教育是关键。从一定意义上说素质教育就是因材施教，妇产科作为一门比较特殊的学科，在实践教学工作中女患者不愿意示教的情况越来越严重，尤其对于男医学生。本文对男医学生在妇产科实习的素质能力培养进行实践与研究，提出以素质教育为中心，培养出具备高尚的医德、扎实的专业本领和丰富的人文知识的新型人才。     

Cross-cultural medical education: conceptual approaches and frameworks for evaluation.

Given that understanding the sociocultural dimensions underlying a patient's health values, beliefs, and behaviors is critical to a successful clinical encounter, cross-cultural curricula have been incorporated into undergraduate medical education. The goal of these curricula is to prepare students to care for patients from diverse social and cultural backgrounds, and to recognize and appropriately address racial, cultural, and gender biases in health care delivery. Despite progress in the field of cross-cultural medical education, several challenges exist. Foremost among these is the need to develop strategies to evaluate the impact of these curricular interventions. This article provides conceptual approaches for cross-cultural medical education, and describes a framework for student evaluation that focuses on strategies to assess attitudes, knowledge, and skills, and the impact of curricular interventions on health outcomes.     

Assessing the usefulness of anticardiolipin antibody assays: a cautious approach is suggested by high variation and limited consensus in multilaboratory testing

An anticardiolipin antibody (ACA) assay has become a laboratory standard for the detection of antiphospholipid antibodies. We evaluated data from a quality assurance program to assess ACA assay usefulness. Cross-laboratory (n = 56) testing of 12 serum samples yielded interlaboratory coefficients of variation (CVs) for lgG ACA and IgM ACA that were higher than 50% in 17 (71%) of 24 cases. The situation for testing consensus was of equal concern. Total consensus occurred in 6 (25%) of 24 cases. General consensus (interlaboratory agreement, 90% or more) was obtained in 10 (42%) of 24 cases. In the majority of test cases, laboratories could not agree on whether a serum sample tested was ACA-positive or ACA-negative. Differing method-related issues also were evident; some methods tended toward higher or lower ACA values. Method-based majority consensus differed from participant majority consensus on many test occasions. Exceedingly high interlaboratory result variation, combined with a general lack of test result grading consensus and method-based variation, indicate that a cautious clinical approach toward laboratory findings is prudent. Laboratory tests should be repeated at least once before making a clinical diagnosis of any anti-phospholipid syndrome-like disorder.     

Attending the birth: competition for obstetrical training by medical students and midwives in nineteenth-century France

Though male doctors gained prominence at the bedsides of pregnant mothers in nineteenth-century Europe, the clinical training they received in medical academies remained cursory. In France, to supplement the medical faculties, the government set up schools for both health officers and midwives which were meant to teach practical obstetrics. This paper focusses on the city of Arras, where these two groups of students competed for the limited numbers of pregnant patients on which to practice their future professions. Like many in their field, two prominent instructors in Arras at each end of the century promoted male obstetrical education over female, arguing that practical education for health officers would lead to safer births for mothers and infants. By the 1870s, the obstetrics instructor adopted germ theory, tying improved hygiene and thus mortality rates to male students’ access to hospitalised patients. Despite their arguments, in Arras, the male students never gained priority in clinical obstetrical training, which midwifery students kept. To keep male students out of maternity wards, local administrators used fears that gender mixing would lead to immoral acts or thoughts. In doing so, they protected the traditional system of midwifery rather than invest in more costly male medical education. Championing midwifery students’ rights to the spaces and bodies needed for their education, however, delayed adoption of hygiene and antiseptic practices that led to lower maternal mortality. Unable to adapt to changing requirements by the state, the medical school closed in 1883, while the midwifery programme thrived until the 1960s.     

新时期放射科住院医师规范化培训模式初探

住院医师规范化培训是毕业后继续医学教育的重要组成部分,是每一位临床医师成长的必由之路。本文针对放射科住院医师规范化培训的现状和存在的问题,从规章制度制定、轮转计划安排、培训过程落实、考核体系建立、培训质量监督等方面进行了初步实践和探索,希望对新时期的放射科住院医师规范化培训提供一些启示和借鉴。     

Responding to Clinical Psychology Practicum Competencies: An APPIC Perspective

This article offers a commentary by representatives of the Association of Psychology Postdoctoral and Internship Centers (APPIC) on the 2015 article written by Gonsalvez et al. related to the assessment of clinical competencies in clinical psychology practicum students. The four competency “super clusters” derived by Gonsalvez et al. result from a unique empirical hierarchical clustering approach and are sure to add important knowledge to the field. This commentary generalizes from clinical psychology education and training in Australia to the United States, expands from practica to internship and postdoctoral training, and reflects on some relevant APPIC issues and initiatives. Future research is also suggested.