Ralph Gillies | Augusta University (original) (raw)
Papers by Ralph Gillies
MedEdPORTAL Publications, 2017
Introduction: Many dental students find the amount of direct feedback they receive in dental scho... more Introduction: Many dental students find the amount of direct feedback they receive in dental school to be both unfamiliar and uncomfortable, as many new hand-skill courses are added to familiar lecture courses and traditional paper-and-pencil tests. In turn, when students react poorly to routine professional feedback, dental school faculty often complain they are too fragile. To address this clear gap in expectations between students and faculty in regard to feedback activities, this half-day workshop was developed for use during student orientation. Methods: In this workshop, students learn the theory of deliberate practice and the role that professional feedback will play in their training. Small-group workshops discuss past student experiences with feedback and use an origami exercise to explore student reactions to feedback. As is commonly done in technique courses, discussions about self-and peer assessment raise students' comfort levels with respect to sharing their work with their peers. Additionally, addressing feedback issues early in their professional education makes students aware of feedback's necessity in their professional development and helps them to deal with the emotional impact. Results: When we evaluated this course in 2014 and 2015, students rated this activity significantly higher than other orientation activities. Discussion: After several years of working with students who have had this orientation, faculty and administrators consider it highly valuable for setting expectations about feedback. They have also experienced fewer student concerns and complaints regarding feedback issues.
Canadian Family Physician, 2005
OBJECTIVE Many physicians access electronic databases to obtain up-to-date and reliable medical i... more OBJECTIVE Many physicians access electronic databases to obtain up-to-date and reliable medical information. In North America, physicians typically use MEDLINE as their sole electronic database whereas in Europe, physicians typically use EMBASE. While MEDLINE and EMBASE are similar, their coverage of the published literature diff ers. Searching a single literature database (eg, MEDLINE or EMBASE) has been shown not to yield all available citations, and using two or more databases yields a greater percentage of these available citations. This diff erence has been demonstrated in a variety of disciplines and in family medicine using the term "family medicine," but diff erences have not been shown using specifi c diagnostic terms common in family medicine. We sought to determine whether searching EMBASE with terms for common family medicine diagnoses yields additional references beyond those found by using MEDLINE alone. DESIGN Literature search comparison. SETTING An academic medical centre in the United States. INTERVENTIONS Fifteen family medicine topics were selected based on common diagnoses in US primary care health visits as described in a National Health Care Survey on Ambulatory Care Visits. To promote relevance to family medicine physicians and researchers, the qualifi ers "family medicine" and "therapy/therapeutics" were added. These topics were searched in EMBASE and MEDLINE. Searches were executed using Ovid search engine and were limited to the years 1992 to 2003, the English language, and human subjects. Total, duplicated, and unique (ie, nonduplicated) citations were recorded for each search in each database. MAIN OUTCOME MEASURES Number of citations for the 15 topics. RESULTS EMBASE yielded 2246 (65%) of 3445 total citations, whereas MEDLINE yielded 1199 citations. Of the total citations, only 177 articles were cited in both databases. EMBASE had 2092 unique citations to MEDLINE's 999 unique citations. EMBASE consistently found more unique citations in 14 of the 15 searches (P = .0005). CONCLUSION Overall, EMBASE provides twice as many citations per search as MEDLINE and provides greater coverage of total retrieved citations. More citations do not necessarily mean higher-quality citations. In a comprehensive search specifi c to family medicine, combined EMBASE and MEDLINE searches could yield more articles than MEDLINE could alone.
American Journal of Gastroenterology
Annals of Internal Medicine, 2010
Issue: Introversion is one of the personality factors that hasbeen shown to be associated with pe... more Issue: Introversion is one of the personality factors that hasbeen shown to be associated with performance in medical school. Prior cross-sectional studies highlight performance evaluation differences between introverted and extraverted medical students, though the mechanisms and implications of these differences remain relatively unexplained and understudied. This gap in the literature has become more salient as medical schools are employing more interactive learning strategies into their curricula which may disproportionately challenge introverted learners. Evidence:In this article, we provide an overview and working definition of introversion as a valid construct occurring on a continuum.We apply a goodness of fit model to explore how various medical training contexts may be more or less challenging for introverted students
and the potential consequences of a poor fit. As preliminary support for these hypothesized challenges, we share observations from students self-identified as introverts. Examples include introverted students feeling at times like misfits, questioning a need to change their identity to succeed in medical school, and being judged as underperforms. We offer pragmatic suggestions for improving the fit between introverted students and their training contexts, such as teachers and students pausing between a question being asked and the initial response being offered and teachers differentiating between anxious and introverted behaviors. We conclude with
suggested areas for future qualitative and quantitative research
to examine how medical school curricula and the teaching environment
may be differentially impacting the learning and health
of introverted and extraverted students. Implications: Extraverted
behaviors will continue to be an important part ofmedical training
and practice, but the merits of introverted behaviors warrant further
consideration as both medical training and practice evolve.
Educators who make manageable adjustments to current teaching
practices can improve the learning for both introverted and
extraverted styles of academic engagement.
Family medicine, 2011
Apologizing is an important component in addressing medical errors; yet, offering apologies conti... more Apologizing is an important component in addressing medical errors; yet, offering apologies continues to challenge physicians. To address limitations of prior educational interventions, a multi-faceted, apologies intervention was developed to provide medical students with increasingly applied learning opportunities. First-year medical students taking a professionalism course at the authors' Southeastern medical school in 2008 or 2009 were eligible for the study. Data from their assigned activities and a post-intervention survey were analyzed. A total of 384 students contributed study data; 57.8% were male, 58.6% white, 10.9% Asian-Indian, 10.9% Asian-Other, and 7.6% African-American. Seventy-four percent of students considered tasks as useful or extremely useful. Student confidence in providing effective apologies increased as well as their comfort in disclosing errors to a faculty member or patient. Perceived importance of apology skills similarly increased. Apologies written b...
Annals of Internal Medicine, 2010
... [PMID: 10513756] 6. Steyerberg EW, Eijkemans MJ, Harrell FE Jr, Habbema JD. Prognostic modell... more ... [PMID: 10513756] 6. Steyerberg EW, Eijkemans MJ, Harrell FE Jr, Habbema JD. Prognostic modelling with logistic regression analysis: a comparison of selection and estimation methods in small data sets. Stat Med. 2000;19:1059-79. [PMID: 10790680] 7. Little RJ, Rubin DB. ...
FAMILY MEDICINE-KANSAS …, 2005
The American Cancer Society estimates that in 2004, 146,940 new cases of colorectal cancer were d... more The American Cancer Society estimates that in 2004, 146,940 new cases of colorectal cancer were diagnosed among men and women in the United States, and 48,100 men and women died of colorectal cancer. 1 While the US Preventive Services Task Force has strongly urged all adults ages 50 and over to be screened for colorectal cancer, 2,3 only about one third of them are screened. 4 All current screening guidelines for colorectal cancer include fiberoptic flexible sigmoidoscopy (FS) as a screening option, and evidence exists as to the effectiveness of FS for colorectal screening 5-8 and as a method that may decrease mortality from distal colorectal cancers by 40%-50%. Thirty percent of primary care physicians perform FS and are responsible for two thirds of all FSs performed nationally. 9 A number of studies have reported on the implementation of FS in primary care, 10-13 and several studies have examined competency-based training in FS. 14-18 If trained in FS during their residency program, most family physicians continue to perform FS in their future practice. 19,20 A recent survey from the National Cancer Institute concluded that there was potential to increase capacity of screening sigmoidoscopy through training more primary care physicians to perform the procedure. To date, no study has evaluated the extent of FS training in family medicine residency programs or the number of residents who are certified to perform FS after graduation. In this publication and in the survey, we use the term "certified" to mean "competent in performing FS" as determined by the physician supervising the FS training at the individual residency program. This project examines the current state of FS training in accredited US family medicine residency programs.
Teaching and learning in medicine, 2015
Introversion is one of the personality factors that has been shown to be associated with performa... more Introversion is one of the personality factors that has been shown to be associated with performance in medical school. Prior cross-sectional studies highlight performance evaluation differences between introverted and extraverted medical students, though the mechanisms and implications of these differences remain relatively unexplained and understudied. This gap in the literature has become more salient as medical schools are employing more interactive learning strategies into their curricula which may disproportionately challenge introverted learners. In this article, we provide an overview and working definition of introversion as a valid construct occurring on a continuum. We apply a goodness of fit model to explore how various medical training contexts may be more or less challenging for introverted students and the potential consequences of a poor fit. As preliminary support for these hypothesized challenges, we share observations from students self-identified as introverts. E...
Purpose: A number of disorders cause dysphagia, which is the perception of an obstruction during ... more Purpose: A number of disorders cause dysphagia, which is the perception of an obstruction during swallowing. The purpose of this study was to determine the prevalence of dysphagia in primary care patients. Methods: Adults 18 years old and older were the subjects of an anonymous survey that was collected in the clinic waiting room before patients were seen by a
Health Psychol, 1994
Bicycle injuries follow a developmental pattern that differs from that of most injuries, where to... more Bicycle injuries follow a developmental pattern that differs from that of most injuries, where toddlers and individuals in young adulthood are most at risk. Children in late childhood and early adolescence appear most at risk for bicycle injuries. The present study of 2nd-grade, 4th-grade, 6th-grade, and undergraduate college students documented that after videotaped simulations of bicycle injury events, younger children anticipated greater injury severity and more fear than older children and adolescents. The potential influence of reduced expectations for injury with increasing age is described, and challenges are advanced for establishing the link between lowered injury expectancies and increased risky behavior.
Canadian family physician Medecin de famille canadien
To determine the effectiveness of presenting individualized colorectal cancer (CRC) risk informat... more To determine the effectiveness of presenting individualized colorectal cancer (CRC) risk information for increasing CRC screening rates in primary care patients at above-average risk of CRC.
Canadian family physician Médecin de famille canadien, 2005
Many physicians access electronic databases to obtain up-to-date and reliable medical information... more Many physicians access electronic databases to obtain up-to-date and reliable medical information. In North America, physicians typically use MEDLINE as their sole electronic database whereas in Europe, physicians typically use EMBASE. While MEDLINE and EMBASE are similar, their coverage of the published literature differs. Searching a single literature database (eg, MEDLINE or EMBASE) has been shown not to yield all available citations, and using two or more databases yields a greater percentage of these available citations. This difference has been demonstrated in a variety of disciplines and in family medicine using the term "family medicine," but differences have not been shown using specific diagnostic terms common in family medicine. We sought to determine whether searching EMBASE with terms for common family medicine diagnoses yields additional references beyond those found by using MEDLINE alone. Literature search comparison. An academic medical centre in the Unite...
Family medicine
The US Preventive Services Task Force has recommended that adults ages 50 and over be screened fo... more The US Preventive Services Task Force has recommended that adults ages 50 and over be screened for colorectal cancer. Flexible sigmoidoscopy (FS) is one available screening option. This study determined the current state of FS training in US family medicine residencies. Directors of the Accreditation Council for Graduate Medical Education-accredited family medicine residencies were surveyed regarding FS training. Of 486 mailed surveys, 370 (76%) were completed and returned. Fifty-two percent of responding residency programs trained at least one resident in FS in 2003. Residents in these programs performed a mean of 20.1 +/- 1.2 FSs during their training. In 2003, 44% of family medicine graduates from these programs were certified by their programs as competent to perform FS. Fewer residents were certified in FS by programs in the eastern versus western United States. Military programs certified more residents than did nonmilitary programs. More than half of programs offered FS train...
Family medicine, 2005
This study's objective was to ascertain factors contributing to high retention of community-b... more This study's objective was to ascertain factors contributing to high retention of community-based sites and their physicians in a 3-decade-old family medicine clerkship. Focus groups were conducted with community-based physicians from the Medical College of Georgia's family medicine clerkship. Transcripts were analyzed using an iterative process regarding physicians' initial and ongoing motivations for participating in the clerkship. Thirteen physicians participated. Six themes were generated: family medicine promotion, valued role of teaching, leadership style, clerkship ownership, resources, and challenges. In addition to intrinsic motivators such as valuing the role of teaching the next generation of physicians and promoting the family medicine specialty, the participative leadership style of a clerkship may be an important factor in physicians' decision to teach in a clerkship. The physicians in this study described having collegial working relationships with the...
MedEdPORTAL Publications, 2009
MedEdPORTAL Publications, 2009
MedEdPORTAL Publications, 2017
Introduction: Many dental students find the amount of direct feedback they receive in dental scho... more Introduction: Many dental students find the amount of direct feedback they receive in dental school to be both unfamiliar and uncomfortable, as many new hand-skill courses are added to familiar lecture courses and traditional paper-and-pencil tests. In turn, when students react poorly to routine professional feedback, dental school faculty often complain they are too fragile. To address this clear gap in expectations between students and faculty in regard to feedback activities, this half-day workshop was developed for use during student orientation. Methods: In this workshop, students learn the theory of deliberate practice and the role that professional feedback will play in their training. Small-group workshops discuss past student experiences with feedback and use an origami exercise to explore student reactions to feedback. As is commonly done in technique courses, discussions about self-and peer assessment raise students' comfort levels with respect to sharing their work with their peers. Additionally, addressing feedback issues early in their professional education makes students aware of feedback's necessity in their professional development and helps them to deal with the emotional impact. Results: When we evaluated this course in 2014 and 2015, students rated this activity significantly higher than other orientation activities. Discussion: After several years of working with students who have had this orientation, faculty and administrators consider it highly valuable for setting expectations about feedback. They have also experienced fewer student concerns and complaints regarding feedback issues.
Canadian Family Physician, 2005
OBJECTIVE Many physicians access electronic databases to obtain up-to-date and reliable medical i... more OBJECTIVE Many physicians access electronic databases to obtain up-to-date and reliable medical information. In North America, physicians typically use MEDLINE as their sole electronic database whereas in Europe, physicians typically use EMBASE. While MEDLINE and EMBASE are similar, their coverage of the published literature diff ers. Searching a single literature database (eg, MEDLINE or EMBASE) has been shown not to yield all available citations, and using two or more databases yields a greater percentage of these available citations. This diff erence has been demonstrated in a variety of disciplines and in family medicine using the term "family medicine," but diff erences have not been shown using specifi c diagnostic terms common in family medicine. We sought to determine whether searching EMBASE with terms for common family medicine diagnoses yields additional references beyond those found by using MEDLINE alone. DESIGN Literature search comparison. SETTING An academic medical centre in the United States. INTERVENTIONS Fifteen family medicine topics were selected based on common diagnoses in US primary care health visits as described in a National Health Care Survey on Ambulatory Care Visits. To promote relevance to family medicine physicians and researchers, the qualifi ers "family medicine" and "therapy/therapeutics" were added. These topics were searched in EMBASE and MEDLINE. Searches were executed using Ovid search engine and were limited to the years 1992 to 2003, the English language, and human subjects. Total, duplicated, and unique (ie, nonduplicated) citations were recorded for each search in each database. MAIN OUTCOME MEASURES Number of citations for the 15 topics. RESULTS EMBASE yielded 2246 (65%) of 3445 total citations, whereas MEDLINE yielded 1199 citations. Of the total citations, only 177 articles were cited in both databases. EMBASE had 2092 unique citations to MEDLINE's 999 unique citations. EMBASE consistently found more unique citations in 14 of the 15 searches (P = .0005). CONCLUSION Overall, EMBASE provides twice as many citations per search as MEDLINE and provides greater coverage of total retrieved citations. More citations do not necessarily mean higher-quality citations. In a comprehensive search specifi c to family medicine, combined EMBASE and MEDLINE searches could yield more articles than MEDLINE could alone.
American Journal of Gastroenterology
Annals of Internal Medicine, 2010
Issue: Introversion is one of the personality factors that hasbeen shown to be associated with pe... more Issue: Introversion is one of the personality factors that hasbeen shown to be associated with performance in medical school. Prior cross-sectional studies highlight performance evaluation differences between introverted and extraverted medical students, though the mechanisms and implications of these differences remain relatively unexplained and understudied. This gap in the literature has become more salient as medical schools are employing more interactive learning strategies into their curricula which may disproportionately challenge introverted learners. Evidence:In this article, we provide an overview and working definition of introversion as a valid construct occurring on a continuum.We apply a goodness of fit model to explore how various medical training contexts may be more or less challenging for introverted students
and the potential consequences of a poor fit. As preliminary support for these hypothesized challenges, we share observations from students self-identified as introverts. Examples include introverted students feeling at times like misfits, questioning a need to change their identity to succeed in medical school, and being judged as underperforms. We offer pragmatic suggestions for improving the fit between introverted students and their training contexts, such as teachers and students pausing between a question being asked and the initial response being offered and teachers differentiating between anxious and introverted behaviors. We conclude with
suggested areas for future qualitative and quantitative research
to examine how medical school curricula and the teaching environment
may be differentially impacting the learning and health
of introverted and extraverted students. Implications: Extraverted
behaviors will continue to be an important part ofmedical training
and practice, but the merits of introverted behaviors warrant further
consideration as both medical training and practice evolve.
Educators who make manageable adjustments to current teaching
practices can improve the learning for both introverted and
extraverted styles of academic engagement.
Family medicine, 2011
Apologizing is an important component in addressing medical errors; yet, offering apologies conti... more Apologizing is an important component in addressing medical errors; yet, offering apologies continues to challenge physicians. To address limitations of prior educational interventions, a multi-faceted, apologies intervention was developed to provide medical students with increasingly applied learning opportunities. First-year medical students taking a professionalism course at the authors' Southeastern medical school in 2008 or 2009 were eligible for the study. Data from their assigned activities and a post-intervention survey were analyzed. A total of 384 students contributed study data; 57.8% were male, 58.6% white, 10.9% Asian-Indian, 10.9% Asian-Other, and 7.6% African-American. Seventy-four percent of students considered tasks as useful or extremely useful. Student confidence in providing effective apologies increased as well as their comfort in disclosing errors to a faculty member or patient. Perceived importance of apology skills similarly increased. Apologies written b...
Annals of Internal Medicine, 2010
... [PMID: 10513756] 6. Steyerberg EW, Eijkemans MJ, Harrell FE Jr, Habbema JD. Prognostic modell... more ... [PMID: 10513756] 6. Steyerberg EW, Eijkemans MJ, Harrell FE Jr, Habbema JD. Prognostic modelling with logistic regression analysis: a comparison of selection and estimation methods in small data sets. Stat Med. 2000;19:1059-79. [PMID: 10790680] 7. Little RJ, Rubin DB. ...
FAMILY MEDICINE-KANSAS …, 2005
The American Cancer Society estimates that in 2004, 146,940 new cases of colorectal cancer were d... more The American Cancer Society estimates that in 2004, 146,940 new cases of colorectal cancer were diagnosed among men and women in the United States, and 48,100 men and women died of colorectal cancer. 1 While the US Preventive Services Task Force has strongly urged all adults ages 50 and over to be screened for colorectal cancer, 2,3 only about one third of them are screened. 4 All current screening guidelines for colorectal cancer include fiberoptic flexible sigmoidoscopy (FS) as a screening option, and evidence exists as to the effectiveness of FS for colorectal screening 5-8 and as a method that may decrease mortality from distal colorectal cancers by 40%-50%. Thirty percent of primary care physicians perform FS and are responsible for two thirds of all FSs performed nationally. 9 A number of studies have reported on the implementation of FS in primary care, 10-13 and several studies have examined competency-based training in FS. 14-18 If trained in FS during their residency program, most family physicians continue to perform FS in their future practice. 19,20 A recent survey from the National Cancer Institute concluded that there was potential to increase capacity of screening sigmoidoscopy through training more primary care physicians to perform the procedure. To date, no study has evaluated the extent of FS training in family medicine residency programs or the number of residents who are certified to perform FS after graduation. In this publication and in the survey, we use the term "certified" to mean "competent in performing FS" as determined by the physician supervising the FS training at the individual residency program. This project examines the current state of FS training in accredited US family medicine residency programs.
Teaching and learning in medicine, 2015
Introversion is one of the personality factors that has been shown to be associated with performa... more Introversion is one of the personality factors that has been shown to be associated with performance in medical school. Prior cross-sectional studies highlight performance evaluation differences between introverted and extraverted medical students, though the mechanisms and implications of these differences remain relatively unexplained and understudied. This gap in the literature has become more salient as medical schools are employing more interactive learning strategies into their curricula which may disproportionately challenge introverted learners. In this article, we provide an overview and working definition of introversion as a valid construct occurring on a continuum. We apply a goodness of fit model to explore how various medical training contexts may be more or less challenging for introverted students and the potential consequences of a poor fit. As preliminary support for these hypothesized challenges, we share observations from students self-identified as introverts. E...
Purpose: A number of disorders cause dysphagia, which is the perception of an obstruction during ... more Purpose: A number of disorders cause dysphagia, which is the perception of an obstruction during swallowing. The purpose of this study was to determine the prevalence of dysphagia in primary care patients. Methods: Adults 18 years old and older were the subjects of an anonymous survey that was collected in the clinic waiting room before patients were seen by a
Health Psychol, 1994
Bicycle injuries follow a developmental pattern that differs from that of most injuries, where to... more Bicycle injuries follow a developmental pattern that differs from that of most injuries, where toddlers and individuals in young adulthood are most at risk. Children in late childhood and early adolescence appear most at risk for bicycle injuries. The present study of 2nd-grade, 4th-grade, 6th-grade, and undergraduate college students documented that after videotaped simulations of bicycle injury events, younger children anticipated greater injury severity and more fear than older children and adolescents. The potential influence of reduced expectations for injury with increasing age is described, and challenges are advanced for establishing the link between lowered injury expectancies and increased risky behavior.
Canadian family physician Medecin de famille canadien
To determine the effectiveness of presenting individualized colorectal cancer (CRC) risk informat... more To determine the effectiveness of presenting individualized colorectal cancer (CRC) risk information for increasing CRC screening rates in primary care patients at above-average risk of CRC.
Canadian family physician Médecin de famille canadien, 2005
Many physicians access electronic databases to obtain up-to-date and reliable medical information... more Many physicians access electronic databases to obtain up-to-date and reliable medical information. In North America, physicians typically use MEDLINE as their sole electronic database whereas in Europe, physicians typically use EMBASE. While MEDLINE and EMBASE are similar, their coverage of the published literature differs. Searching a single literature database (eg, MEDLINE or EMBASE) has been shown not to yield all available citations, and using two or more databases yields a greater percentage of these available citations. This difference has been demonstrated in a variety of disciplines and in family medicine using the term "family medicine," but differences have not been shown using specific diagnostic terms common in family medicine. We sought to determine whether searching EMBASE with terms for common family medicine diagnoses yields additional references beyond those found by using MEDLINE alone. Literature search comparison. An academic medical centre in the Unite...
Family medicine
The US Preventive Services Task Force has recommended that adults ages 50 and over be screened fo... more The US Preventive Services Task Force has recommended that adults ages 50 and over be screened for colorectal cancer. Flexible sigmoidoscopy (FS) is one available screening option. This study determined the current state of FS training in US family medicine residencies. Directors of the Accreditation Council for Graduate Medical Education-accredited family medicine residencies were surveyed regarding FS training. Of 486 mailed surveys, 370 (76%) were completed and returned. Fifty-two percent of responding residency programs trained at least one resident in FS in 2003. Residents in these programs performed a mean of 20.1 +/- 1.2 FSs during their training. In 2003, 44% of family medicine graduates from these programs were certified by their programs as competent to perform FS. Fewer residents were certified in FS by programs in the eastern versus western United States. Military programs certified more residents than did nonmilitary programs. More than half of programs offered FS train...
Family medicine, 2005
This study's objective was to ascertain factors contributing to high retention of community-b... more This study's objective was to ascertain factors contributing to high retention of community-based sites and their physicians in a 3-decade-old family medicine clerkship. Focus groups were conducted with community-based physicians from the Medical College of Georgia's family medicine clerkship. Transcripts were analyzed using an iterative process regarding physicians' initial and ongoing motivations for participating in the clerkship. Thirteen physicians participated. Six themes were generated: family medicine promotion, valued role of teaching, leadership style, clerkship ownership, resources, and challenges. In addition to intrinsic motivators such as valuing the role of teaching the next generation of physicians and promoting the family medicine specialty, the participative leadership style of a clerkship may be an important factor in physicians' decision to teach in a clerkship. The physicians in this study described having collegial working relationships with the...
MedEdPORTAL Publications, 2009
MedEdPORTAL Publications, 2009