Intro -- FrontMatter -- Reviewers -- Foreword -- Acknowledgments -- Contents -- Boxes, Figures, and Tables -- Summary -- 1 Introduction -- 2 Background on the Pipeline to the Physician Workforce -- 3 GME Financing -- 4 Governance -- 5 Recommendations for the Reform of GME Financing and Governance -- Appendix A: Abbreviations and Acronyms -- Appendix B: U.S. Senate Letters -- Appendix C: Public Workshop Agendas -- Appendix D: Committee Member Biographies -- Appendix E: Data and Methods to Analyze Medicare GME Payments -- Appendix F: Illustrations of the Phase-In of the Committee's Recommendations.
Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.
Graduate medical education (GME) is critical to the career development of individual physicians, to the functioning of many teaching institutions, and to the production of our physician workforce. However, recent reports have called for substantial reform of GME. The current lack of established GME outcome measures limits our ability to assess the impact of individual graduates, the performance of residency programs and teaching institutions, and the collective contribution of GME graduates to the physician workforce. To examine the opportunities and challenges in measuring and assessing GME outcomes, the National Academies of Sciences, Engineering, and Medicine held a workshop on October 10â€"11, 2017, in Washington, DC. Workshop participants discussed: meaningful and measurable outcomes of GME; possible metrics that could be used to track these GME outcomes; possible mechanisms for collecting, collating, analyzing, and reporting these data; and further work to accomplish this ambitious goal. This publication summarizes the presentations and discussions from the workshop.
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
PRAISE FOR EDUCATING PHYSICIANS "Educating Physicians provides a masterful analysis of undergraduate and graduate medical education in the United States today. It represents a major educational document, based firmly on educational psychology, learning theory, empirical studies, and careful personal observations of many individual programs. It also recognizes the importance of financing, regulation, and institutional culture on the learning environment, which suffuses its recommendations for reform with cogency and power. Most important, like Abraham Flexner's classic study a century ago, the report recognizes that medical education and practice, at their core, are profoundly moral enterprises. This is a landmark volume that merits attention from anyone even peripherally involved with medical education." —Kenneth M. Ludmerer, author, Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care "This is a very important book that comes at a critical time in our nation's history. We will not have enduring health care reform in this country unless we rethink our medical education paradigms. This book is a call to arms for doing just that." —George E. Thibault, president, Josiah Macy, Jr. Foundation "The authors provide us with the evidence-based model for physician education with associated changes in infrastructure, policy, and our roles as educators. Whether you agree or not with their conclusions, if you are a teacher this book is a must-read as it will frame both what and how we discuss medical education throughout the current century." —Deborah Simpson, associate dean for educational support and evaluation, Medical College of Wisconsin "A provocative book that provides us with a creative vision for medical education. Using in-depth case studies of innovative educational practices illustrating what is actually possible, the authors provide sage advice for transforming medical education on the basis of learning theories and educational research." —Judith L. Bowen, professor of medicine, Oregon Health & Science University
This unique and engaging open access title provides a compelling and ground-breaking account of the patient safety movement in the United States, told from the perspective of one of its most prominent leaders, and arguably the movement’s founder, Lucian L. Leape, MD. Covering the growth of the field from the late 1980s to 2015, Dr. Leape details the developments, actors, organizations, research, and policy-making activities that marked the evolution and major advances of patient safety in this time span. In addition, and perhaps most importantly, this book not only comprehensively details how and why human and systems errors too often occur in the process of providing health care, it also promotes an in-depth understanding of the principles and practices of patient safety, including how they were influenced by today’s modern safety sciences and systems theory and design. Indeed, the book emphasizes how the growing awareness of systems-design thinking and the self-education and commitment to improving patient safety, by not only Dr. Leape but a wide range of other clinicians and health executives from both the private and public sectors, all converged to drive forward the patient safety movement in the US. Making Healthcare Safe is divided into four parts: I. In the Beginning describes the research and theory that defined patient safety and the early initiatives to enhance it. II. Institutional Responses tells the stories of the efforts of the major organizations that began to apply the new concepts and make patient safety a reality. Most of these stories have not been previously told, so this account becomes their histories as well. III. Getting to Work provides in-depth analyses of four key issues that cut across disciplinary lines impacting patient safety which required special attention. IV. Creating a Culture of Safety looks to the future, marshalling the best thinking about what it will take to achieve the safe care we all deserve. Captivatingly written with an “insider’s” tone and a major contribution to the clinical literature, this title will be of immense value to health care professionals, to students in a range of academic disciplines, to medical trainees, to health administrators, to policymakers and even to lay readers with an interest in patient safety and in the critical quest to create safe care.
Tomorrow's best physicians will be those who continually learn, adjust, and innovate as new information and best practices evolve, reflecting adaptive expertise in response to practice challenges. As the first volume in the American Medical Association's MedEd Innovation Series, The Master Adaptive Learner is an instructor-focused guide covering models for how to train and teach future clinicians who need to develop these adaptive skills and utilize them throughout their careers. - Explains and clarifies the concept of a Master Adaptive Learner: a metacognitive approach to learning based on self-regulation that fosters the success and use of adaptive expertise in practice. - Contains both theoretical and practical material for instructors and administrators, including guidance on how to implement a Master Adaptive Learner approach in today's institutions. - Gives instructors the tools needed to empower students to become efficient and successful adaptive learners. - Helps medical faculty and instructors address gaps in physician training and prepare new doctors to practice effectively in 21st century healthcare systems. - One of the American Medical Association Change MedEd initiatives and innovations, written and edited by members of the ACE (Accelerating Change in Medical Education) Consortium – a unique, innovative collaborative that allows for the sharing and dissemination of groundbreaking ideas and projects.
On November 13 and 14, 2018, members of the National Academies of Sciences, Engineering, and Medicine's Global Forum on Innovation in Health Professional Education participated in a joint workshop with affiliates of the National Center for Interprofessional Practice and Education. The workshop participants explored the intersection of health professions education and practice. Both sectors are working toward the same goal of improving the health of patients and populations, without compromising the mental stability and wellbeing of the workforce or its learners. However, while education and practice have the same goal, there is a need for greater alignment between the sectors to more fully realize these desired outcomes. For example, educators, practitioners, and administrators must learn to adapt and respond to the growing role of technology within a wider context, in order to most effectively apply higher education within health systems. This publication summarizes the presentations and discussions from the workshop.
