Assessing and Enhancing the Clinical Skills of Medical Students: The Comprehensive Clinical Skills Exam
New York University School of Medicine
The goals of this project are to develop a Comprehensive Clinical Skills Exam to assess the communication, physical examination, history-taking, and clinical reasoning skills of all fourth year students at the New York University School of Medicine, to provide feedback to students on their clinical skills on the basis of their performance on this exam, and to determine the exam’s predictive validity by comparing it to students’ subsequent performance on a clinical skills exam required for medical licensure (USMLE Step 2 Clinical Skills CS Examination).
Principal Investigator(s): Colleen Gillespie
Enhancing Communication Skills Among Students and Residents at Three Medical Schools
Josiah Macy Jr. Foundation
Three medical schools (New York University, Case Western Reserve University, University of Massachusetts) committed themselves to developing and implementing major new curricula designed to improve doctor-patient communications. The heart of the evaluation, funded by the Josiah Macy Junior Foundation, consists of a controlled, performance-based assessment examining change in communication abilities among medical students exposed to the new curriculum as compared to students undergoing traditional training at the three institutions. Standardized patients (i.e., actors trained to portray patients) and associated scoring protocols have been employed to assess student performance on an objective structured clinical exam (OSCE), using a pre-/post-test design. Major findings were published in last year’s education issue of the Journal of the American Medical Association.
Principal Investigator(s): Colleen Gillespie
Evaluation of “Psychosocial Aspects of Bioterrorism and Disaster Response: Education for Readiness and Response.”
New York University School of Medicine, American Association of Medical Colleges/Centers for Disease Control and Prevention, Specialty Center for Public Health Preparedness
This project evaluates a national model curriculum to teach the psychosocial aspects of bioterrorism and response to health professionals, including data collection and analysis to describe and inform the process of adapting and enriching the curriculum for use with particular professions (physicians, nurses, physician assistants) and to assess the impact and degree of dissemination of the curriculum.
Principal Investigator(s): Colleen Gillespie
Factors Associated with Use of Management Research in Health Systems
This study seeks to advance the theory and empirical research on factors associated with healthcare managers’ use of research to improve health system performance. It will examine challenges managers face in finding, assessing, and using research. Through structured interviews with senior and mid-level health care managers, the study will identify factors associated with knowledge transfer in health systems. Specifically, it seeks to enhance the literature on knowledge transfer in four specific areas: 1) How do hospital systems implement and evaluate disease management programs for asthma, diabetes, and depression? 2) Do hospital systems use budgeting processes that include an examination of alternative expenditures and revenues and associated outcomes? 3) How do hospital systems set targets and benchmarks in a balanced scorecard system, and how do they change those targets? 4) Does the method of compensation for hospital managers improve the performance of departments in which there are many physicians?
Principal Investigator(s): Anthony Kovner
Rethinking Doctor-Patient Relationships
Agency for Healthcare Research and Policy (AHRQ: R01 HS013654)
This project investigates new ways of structuring doctor-patient relationships to promote patient-centered care by studying five innovative practices: 1) cancer self-help and advocacy because it offers new sources of support and shared authority among peers, 2) palliative care because it demands maintenance of trust while shifting the overall goal of care, 3) complementary medicine because it embraces approaches that rely upon disparate knowledge bases, 4) group visits for chronic illness care in managed care organizations because they draw upon shared experience and learning among peers, and 5) new communications curricula in medical education because they can prepare physicians to assume new roles with patients. These cases have been selected because they demonstrate variability in key elements in the structure of the doctor-patient relationship: exercise of authority, distribution of responsibility among patients and providers, patient access to expertise, the range of patient needs addressed, affective involvement of both parties, and maintenance of trust. The project has a built-in mechanism for assuring that the findings have relevance to leaders in medical education who are committed to improving the quality of training. While the project will focus on physicians and illness care, it aims to illuminate patient relationships with other health care providers and address broader conceptions of health care.
Training Physicians and Nurse Practitioners for Delivery of Population-based Care: Evaluation of Partnerships for Quality Education (PQE)
The Robert Wood Johnson Foundation
This multi-site, national evaluation, funded by the Robert Wood Johnson Foundation, is designed to identify training experiences that will prepare physicians and other health care providers to effectively incorporate population-based health practices in routine delivery of care. The research sites consist of training programs at over 160 academic health centers. Three separate initiatives are being evaluated: 1) population health training programs, 2) collaborative interdisciplinary team education, and 3) disease management training for diabetes and asthma. Measures have been developed to assess the effectiveness of training with regard to the Accreditation Council for Graduate Medical Education (ACGME’s) new required competencies in system-based practice, practice-based learning and improvement, and related aspects of population health.
Co-Principal Investigator(s): Jessica Greene
