Journal of medical education and training最新文献

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Implementation and Evaluation of Shared Medical Appointments for Type 2 Diabetes at a Free, Student-Run Clinic in Alamance County, North Carolina. 在北卡罗莱纳Alamance县的一个免费的、学生经营的诊所中,2型糖尿病共享医疗预约的实施和评估。
Anna R Kahkoska, Nicholas F Brazeau, Kyle A Lynch, M Sue Kirkman, Joseph Largay, Laura A Young, John B Buse
{"title":"Implementation and Evaluation of Shared Medical Appointments for Type 2 Diabetes at a Free, Student-Run Clinic in Alamance County, North Carolina.","authors":"Anna R Kahkoska,&nbsp;Nicholas F Brazeau,&nbsp;Kyle A Lynch,&nbsp;M Sue Kirkman,&nbsp;Joseph Largay,&nbsp;Laura A Young,&nbsp;John B Buse","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes is a significant problem among uninsured patients. Shared medical appointments (SMA) have been shown to improve outcomes in type 2 diabetes. We hypothesized that the SMA model could be adapted for a non-profit clinic in North Carolina that serves uninsured patients with diabetes that have incomes at/below 150% of the federal poverty line.</p><p><strong>Research design and methods: </strong>We implemented and sustained a patient-driven, student-led SMA model that incorporated the monthly rotations of students, physician assistant, and undergraduate students as well as pharmacy residents and an endocrinologist who collectively provide diabetes care at the free clinic. SMA groups are 'open' cohorts and include 4-12 patients scheduled for the monthly clinic. Teams of transdisciplinary trainees work together to perform triage, medication reconciliation, brief history, and physical exam, after which patients participate in the SMA. The endocrinologist evaluates SMA patients individually during and after the visit.</p><p><strong>Results: </strong>Between November 2015 and January 2017, we enrolled 29 patients in SMA. There was high variability in HbA1c at baseline. Among eight type 2 diabetes patients seen in endocrine clinic and with complete data one year before and after SMA implementation, the mean (SD) HbA1c before SMA was 9.7% ± 1.7% (83±7 mmol/ mol); mean HbA1c after SMA was 9.2% ± 1.8% (77 ± 8mmol/mol). The median HbA1c before SMA was 9.5% (80 mmol/mol); median HbA1c after SMA was 8.9% (74 mmol/mol). Overall, 6/8 patients showed decreased HbA1c after SMA although there was variability between individuals in response of glycemic control to SMA. SMA increased clinic efficiency and offered an opportunity to integrate transdisciplinary trainees. Trainees gain experience with novel models of care and the complexities of the patient experience of diabetes.</p><p><strong>Conclusions: </strong>We hope this observation encourages others to implement such programs to enhance the evidence-base for SMA to address health disparities and increase the quality of free diabetes care.</p>","PeriodicalId":92247,"journal":{"name":"Journal of medical education and training","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6053275/pdf/nihms975921.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36336057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing Progression of Resident Proficiency during Ophthalmology Residency Training: Utility of Serial Clinical Skill Evaluations. 评估眼科住院医师培训期间住院医师熟练程度的进展:系列临床技能评估的效用。
Journal of medical education and training Pub Date : 2017-01-01 Epub Date: 2017-09-09
Grace L Paley, Thomas S Shute, Geetha K Davis, Susan M Culican
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引用次数: 0
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