Sandy Cook | Duke-NUS Graduate Medical School (original) (raw)

Papers by Sandy Cook

MedEdPORTAL, 2005

Abstract This is a workshop assessment tool designed to help faculty publish their educational ma... more Abstract This is a workshop assessment tool designed to help faculty publish their educational materials via MedEdPORTAL. This interactive, hands-on workshop can be presented as a 2-hour interactiv...

Gerontology & Geriatrics Education, Mar 8, 2004

The purpose of this project was to develop, implement, evaluate, and disseminate an educational p... more The purpose of this project was to develop, implement, evaluate, and disseminate an educational program on ethics and the primary care of patients with dementia for residents. Pre/post-rotation self-confidence measure, a post-rotation assessment of the importance of and achievement of the program's goals, and a post-rotation evaluation of the program were administered. Significant increases in residents' confidence in performing the programmatic clinical goals and in overall confidence were found. Program goals were met, and components of the program were rated highly. We found that a well-designed ethics curriculum can be successfully implemented within a clinical rotation for medicine residents and have a positive impact on the quality of the educational experience as well as on their confidence in performing relevant clinical management behaviors.

Sex Education, Feb 1, 2008

PubMed, 1978

The purpose of this study was to determine how allied health professionals felt about their jobs ... more The purpose of this study was to determine how allied health professionals felt about their jobs in general and about specific job facets in particular. Four groups were investigated: (1) medical dietitians; (2) physical therapists; (3) occupational therapists; and (4) medical technologists. When national norms were applied to the median scores obtained on the Job Descriptive Index (JDI), low levels of job satisfaction were revealed. Differences were found between professions.

Annals Academy of Medicine Singapore, Mar 15, 2014

Perspectives on medical education, Apr 18, 2019

Faculty development programs have tended to focus on low levels of evaluation such as participant... more Faculty development programs have tended to focus on low levels of evaluation such as participant satisfaction rather than assess the actual changes that training has brought about in the workplace. This has prompted scholars to suggest using social network analysis as a means to provide a more rigorous method of evaluating the impact of faculty development. To test the feasibility of such a suggestion, we used the social network analysis concepts of social cohesion to assess the impact of a year-long fellowship program conducted by Duke-NUS Medical School's Academic Medicine Education Institute (AM•EI). Specifically, we used the key metrics of connectedness and betweenness centrality to assess the changes in the AM•EI fellows' information and collaboration networks post-fellowship. We invited three cohorts of AM•EI fellows (2013-2016; n = 74) to participate in a branched survey. The response rate was 64%; n = 47. Results showed that in terms of connectedness, the largest connected set more than doubled in size, and pair level reachability grew threefold. Betweenness centrality among the AM•EI fellows also increased, with more individuals reporting that they sought advice from the fellows as well as trusted the advice the fellows provided. In sum, this study suggests that it is indeed viable to use social network analysis to identify changes in social cohesion. As such, social network analysis serves as another tool for scholars to use to assess the impact of their faculty development efforts.

The Diabetes Educator, 2002

The purpose of this pilot study was to test the hypothesis that adolescents with type 1 diabetes ... more The purpose of this pilot study was to test the hypothesis that adolescents with type 1 diabetes can learn to become better problem solvers in diabetes self-care and thereby improve their metabolic control. METHODS Fifty-three adolescents aged 13 to 17 with type 1 diabetes were randomly assigned to either a 6-week problem-solving diabetes education program or to a control group (usual care). Al C levels were obtained as well as assessments of problem solving, frequency of behavior, level of responsibility, and 24-hour behavior recall at baseline and 6 months. RESULTS The experimental group participants showed significantly improved problem-solving test scores and Al C values from baseline to 6 months, changes not evident in the control group. At 6 months, the experimental group participants were doing blood glucose testing more often than those in the control group. However, there was no significant difference in problem-solving test scores or Al C values. CONCLUSIONS This 6-week intervention for adolescents with diabetes resulted in better problem-solving skills, more frequent blood glucose testing, and improved Al C values. The results suggest that a diabetes problem-solving program for adolescents can be effective in improving metabolic control.

The Asia Pacific Scholar, May 7, 2019

Aim: To describe residents' expectations of faculty using the One-Minute Preceptor (OMP) in micro... more Aim: To describe residents' expectations of faculty using the One-Minute Preceptor (OMP) in microskills and their ratings of faculty performing them during clinical sessions. Methods: Prior to the start of residency, residents were invited to participate in a survey on residents' expectations of faculty performing the OMP microskills in clinical teaching activities using a 4-point Likert scale. At the end of Year 1, they rated faculty on their use of the OMP microskills using a 4-point Likert scale using a second survey. Results: Sixteen Year 1 residents completed the first survey and 15 residents completed the second survey. Prior to residency, correcting mistakes with feedback was the highest rated microskill (3.78) and obtaining a commitment was the lowest rated (3.15). At the end of Year 1, residents rated faculty performing getting a commitment as the highest (3.63) and giving feedback the lowest (3.17). Conclusion: In this small cohort of residents, expectations were high around the OMP microskills. Residents felt faculty performed them well in their first year of residency. However, residents view of the importance of the five OMP microskills by faculty differed from their perception of how well the faculty demonstrated them. Future studies could explore if residents' perceptions of importance changed over time or were related to their view on the quality of performance by faculty. Faculty will be further encouraged to employ the five OMP microskills to maximise their teaching moments with residents managing patients in busy outpatient clinics in National Dental Centre Singapore.

Journal of Computing in Higher Education, Sep 1, 2006

Proceedings of Singapore healthcare, Jan 14, 2016

Something about the beginning of a new year compels us to peer into the crystal ball of prophecie... more Something about the beginning of a new year compels us to peer into the crystal ball of prophecies and to wax prophetic about the changes we foresee coming. This year is no different, and, in fact, the New Year represents an opportune time for us to reflect on our fundamental educational approach, Team Based Learning, as well as to envision the future of medical education. However, before we begin to conjure our inner Nostradamuses, it is important for us to understand our past and how we have arrived in the present. To do so, we provide here an abbreviated historical perspective.

Academic Emergency Medicine, Aug 1, 2003

Objective: To introduce and assess the time savings from and effectiveness of assessment-oriented... more Objective: To introduce and assess the time savings from and effectiveness of assessment-oriented (AO) oral case presentation as a model of interphysician communication. Methods: This was a prospective, interventional study of all 10 on-site faculty and 36 residents in a postgraduate year 1 to 3 format emergency medicine residency training program. Residents were requested to perform all oral case presentations in either the traditional or AO formats. Presentations were timed, and residents and faculty rated essential measures of oral case presentation effectiveness: data content, expression of decision making, organization, and overall satisfaction. Results: A total of 199 oral case presentations were sampled-112 traditional and 87 AO. Mean length of presentation for traditional presentations was 117 seconds versus 71 seconds for AO presentations (p \ 0.001), a clinically significant difference, without significant differences in the essential measures of case presentation effectiveness. Conclusions: AO oral case presentation may provide a means for emergency medicine residents to ''get to the point'' and to communicate effectively and efficiently.

Journal of medical education and curricular development, 2021

Background:Heralded as a teaching, assessment and reflective tool, and increasingly as a longitud... more Background:Heralded as a teaching, assessment and reflective tool, and increasingly as a longitudinal and holistic perspective of the educator’s development, medical educator’s portfolios (MEP)s are increasingly employed to evaluate progress, assess for promotions and career switches, used as a reflective tool and as a means of curating educational activities. However, despite its blossoming role, there is significant dissonance in the content and structure of MEPs. As such, a systematic scoping review (SSR) is proposed to identify what is known of MEPs and its contents.Methods:Krishna’s Systematic Evidenced Based Approach (SEBA) was adopted to structure this SSR in SEBA of MEPs. SEBA’s constructivist approach and relativist lens allow data from a variety of sources to be considered to paint a holistic picture of available information on MEPs.Results:From the 12 360 abstracts reviewed, 768 full text articles were evaluated, and 79 articles were included. Concurrent thematic and content analysis revealed similar themes and categories including: (1) Definition and Functions of MEPs, (2) Implementing and Assessing MEPs, (3) Strengths and limitations of MEPs and (4) electronic MEPs.Discussion:This SSR in SEBA proffers a novel 5-staged evidence-based approach to constructing MEPs which allows for consistent application and assessment of MEPs. This 5-stage approach pivots on assessing and verifying the achievement of developmental milestones or ‘micro-competencies’ that facilitate micro-credentialling and effective evaluation of a medical educator’s development and entrust-ability. This allows MEPs to be used as a reflective and collaborative tool and a basis for career planning.

Proceedings of Singapore healthcare, Jul 31, 2016

Introduction: Singapore's postgraduate medical education underwent a transition in 2010, moving a... more Introduction: Singapore's postgraduate medical education underwent a transition in 2010, moving away from the House staff model to the American Residency model. Teaching was defined as a core competency for SingHealth Residency programs. This study sought to determine how this transition impacted medical students' perception of Residents as teachers. Methods: A 19-item Likert-type questionnaire comprising three domains-(1) quality, (2) frequency and (3) engagementwas given to all Duke-NUS medical students at the end of each clerkship from the academic year (AY) 2009-10 through 2013-14. The first two academic years were classified as the pre-initiation stage of the Residency, and the latter three, the post-initiation stage. Students rated Residents they encountered in their most recent clerkship. Results: Student ratings have gradually improved, with the largest improvement occurring after the initiation of Residency, and after the introduction of Residents as Future Teachers courses. Student ratings in the post-initiation Residency years combined were significantly higher than the pre-initiation of Residency years combined, for all three domains. Analysis of individual items revealed significant improvement in student ratings on all items in all domains, except for the quality of teaching in performing procedural skills. Conclusion: Findings from this study indicate a positive shift in the teaching culture with the transition of Singapore's postgraduate medical education from the House staff model to the Residency program.

Journal of Health Care for the Poor and Underserved, 2006

American Journal of Health Behavior, Jul 1, 2007

To develop medical students&a... more To develop medical students' skills in interacting with individuals who have limited health literacy. Described are 2 novel approaches to health literacy curriculum design. Efforts at both schools have been implemented to improve medical student awareness of health literacy, as well as specific skills in clear communication and strategies that ensure patient understanding. Preliminary data from one school suggest an increase in use of health literacy behaviors. Curriculum development at both schools is ongoing. The ultimate goal of these curricula is for students to develop the core skills necessary for effective communication with all patients.

Medical Education, Oct 18, 2012

Medical science educator, Apr 1, 2011

The Diabetes Educator, Sep 1, 2001

... DOI: 10.1177/014572170102700505 2001 27: 643 The Diabetes Educator Michael T. Quinn, Sandy Co... more ... DOI: 10.1177/014572170102700505 2001 27: 643 The Diabetes Educator Michael T. Quinn, Sandy Cook, Kyle Nash and Marshall H. Chin Addressing Religion and Spirituality in African Americans With Diabetes Published by: http://www.sagepublications.com On behalf of: ...

Elements, Oct 29, 2021

Faculty development programs have tended to focus on low levels of evaluation such as participant... more Faculty development programs have tended to focus on low levels of evaluation such as participant satisfaction rather than assess the actual changes that training has brought about in the workplace. This has prompted scholars to suggest using social network analysis as a means to provide a more rigorous method of evaluating the impact of faculty development. To test the feasibility of such a suggestion, we used the social network analysis concepts of social cohesion to assess the impact of a year-long fellowship program conducted by Duke-NUS Medical School's Academic Medicine Education Institute (AM•EI). Specifically, we used the key metrics of connectedness and betweenness centrality to assess the changes in the AM•EI fellows' information and collaboration networks post-fellowship. We invited three cohorts of AM•EI fellows (2013-2016; n = 74) to participate in a branched survey. The response rate was 64%; n = 47. Results showed that in terms of connectedness, the largest connected set more than doubled in size, and pair level reachability grew threefold. Betweenness centrality among the AM•EI fellows also increased, with more individuals reporting that they sought advice from the fellows as well as trusted the advice the fellows provided. In sum, this study suggests that it is indeed viable to use social network analysis to identify changes in social cohesion. As such, social network analysis serves as another tool for scholars to use to assess the impact of their faculty development efforts.

MedEdPORTAL, 2005

Abstract This is a workshop assessment tool designed to help faculty publish their educational ma... more Abstract This is a workshop assessment tool designed to help faculty publish their educational materials via MedEdPORTAL. This interactive, hands-on workshop can be presented as a 2-hour interactiv...

Gerontology & Geriatrics Education, Mar 8, 2004

The purpose of this project was to develop, implement, evaluate, and disseminate an educational p... more The purpose of this project was to develop, implement, evaluate, and disseminate an educational program on ethics and the primary care of patients with dementia for residents. Pre/post-rotation self-confidence measure, a post-rotation assessment of the importance of and achievement of the program's goals, and a post-rotation evaluation of the program were administered. Significant increases in residents' confidence in performing the programmatic clinical goals and in overall confidence were found. Program goals were met, and components of the program were rated highly. We found that a well-designed ethics curriculum can be successfully implemented within a clinical rotation for medicine residents and have a positive impact on the quality of the educational experience as well as on their confidence in performing relevant clinical management behaviors.

Sex Education, Feb 1, 2008

PubMed, 1978

The purpose of this study was to determine how allied health professionals felt about their jobs ... more The purpose of this study was to determine how allied health professionals felt about their jobs in general and about specific job facets in particular. Four groups were investigated: (1) medical dietitians; (2) physical therapists; (3) occupational therapists; and (4) medical technologists. When national norms were applied to the median scores obtained on the Job Descriptive Index (JDI), low levels of job satisfaction were revealed. Differences were found between professions.

Annals Academy of Medicine Singapore, Mar 15, 2014

Perspectives on medical education, Apr 18, 2019

Faculty development programs have tended to focus on low levels of evaluation such as participant... more Faculty development programs have tended to focus on low levels of evaluation such as participant satisfaction rather than assess the actual changes that training has brought about in the workplace. This has prompted scholars to suggest using social network analysis as a means to provide a more rigorous method of evaluating the impact of faculty development. To test the feasibility of such a suggestion, we used the social network analysis concepts of social cohesion to assess the impact of a year-long fellowship program conducted by Duke-NUS Medical School's Academic Medicine Education Institute (AM•EI). Specifically, we used the key metrics of connectedness and betweenness centrality to assess the changes in the AM•EI fellows' information and collaboration networks post-fellowship. We invited three cohorts of AM•EI fellows (2013-2016; n = 74) to participate in a branched survey. The response rate was 64%; n = 47. Results showed that in terms of connectedness, the largest connected set more than doubled in size, and pair level reachability grew threefold. Betweenness centrality among the AM•EI fellows also increased, with more individuals reporting that they sought advice from the fellows as well as trusted the advice the fellows provided. In sum, this study suggests that it is indeed viable to use social network analysis to identify changes in social cohesion. As such, social network analysis serves as another tool for scholars to use to assess the impact of their faculty development efforts.

The Diabetes Educator, 2002

The purpose of this pilot study was to test the hypothesis that adolescents with type 1 diabetes ... more The purpose of this pilot study was to test the hypothesis that adolescents with type 1 diabetes can learn to become better problem solvers in diabetes self-care and thereby improve their metabolic control. METHODS Fifty-three adolescents aged 13 to 17 with type 1 diabetes were randomly assigned to either a 6-week problem-solving diabetes education program or to a control group (usual care). Al C levels were obtained as well as assessments of problem solving, frequency of behavior, level of responsibility, and 24-hour behavior recall at baseline and 6 months. RESULTS The experimental group participants showed significantly improved problem-solving test scores and Al C values from baseline to 6 months, changes not evident in the control group. At 6 months, the experimental group participants were doing blood glucose testing more often than those in the control group. However, there was no significant difference in problem-solving test scores or Al C values. CONCLUSIONS This 6-week intervention for adolescents with diabetes resulted in better problem-solving skills, more frequent blood glucose testing, and improved Al C values. The results suggest that a diabetes problem-solving program for adolescents can be effective in improving metabolic control.

The Asia Pacific Scholar, May 7, 2019

Aim: To describe residents' expectations of faculty using the One-Minute Preceptor (OMP) in micro... more Aim: To describe residents' expectations of faculty using the One-Minute Preceptor (OMP) in microskills and their ratings of faculty performing them during clinical sessions. Methods: Prior to the start of residency, residents were invited to participate in a survey on residents' expectations of faculty performing the OMP microskills in clinical teaching activities using a 4-point Likert scale. At the end of Year 1, they rated faculty on their use of the OMP microskills using a 4-point Likert scale using a second survey. Results: Sixteen Year 1 residents completed the first survey and 15 residents completed the second survey. Prior to residency, correcting mistakes with feedback was the highest rated microskill (3.78) and obtaining a commitment was the lowest rated (3.15). At the end of Year 1, residents rated faculty performing getting a commitment as the highest (3.63) and giving feedback the lowest (3.17). Conclusion: In this small cohort of residents, expectations were high around the OMP microskills. Residents felt faculty performed them well in their first year of residency. However, residents view of the importance of the five OMP microskills by faculty differed from their perception of how well the faculty demonstrated them. Future studies could explore if residents' perceptions of importance changed over time or were related to their view on the quality of performance by faculty. Faculty will be further encouraged to employ the five OMP microskills to maximise their teaching moments with residents managing patients in busy outpatient clinics in National Dental Centre Singapore.

Journal of Computing in Higher Education, Sep 1, 2006

Proceedings of Singapore healthcare, Jan 14, 2016

Something about the beginning of a new year compels us to peer into the crystal ball of prophecie... more Something about the beginning of a new year compels us to peer into the crystal ball of prophecies and to wax prophetic about the changes we foresee coming. This year is no different, and, in fact, the New Year represents an opportune time for us to reflect on our fundamental educational approach, Team Based Learning, as well as to envision the future of medical education. However, before we begin to conjure our inner Nostradamuses, it is important for us to understand our past and how we have arrived in the present. To do so, we provide here an abbreviated historical perspective.

Academic Emergency Medicine, Aug 1, 2003

Objective: To introduce and assess the time savings from and effectiveness of assessment-oriented... more Objective: To introduce and assess the time savings from and effectiveness of assessment-oriented (AO) oral case presentation as a model of interphysician communication. Methods: This was a prospective, interventional study of all 10 on-site faculty and 36 residents in a postgraduate year 1 to 3 format emergency medicine residency training program. Residents were requested to perform all oral case presentations in either the traditional or AO formats. Presentations were timed, and residents and faculty rated essential measures of oral case presentation effectiveness: data content, expression of decision making, organization, and overall satisfaction. Results: A total of 199 oral case presentations were sampled-112 traditional and 87 AO. Mean length of presentation for traditional presentations was 117 seconds versus 71 seconds for AO presentations (p \ 0.001), a clinically significant difference, without significant differences in the essential measures of case presentation effectiveness. Conclusions: AO oral case presentation may provide a means for emergency medicine residents to ''get to the point'' and to communicate effectively and efficiently.

Journal of medical education and curricular development, 2021

Background:Heralded as a teaching, assessment and reflective tool, and increasingly as a longitud... more Background:Heralded as a teaching, assessment and reflective tool, and increasingly as a longitudinal and holistic perspective of the educator’s development, medical educator’s portfolios (MEP)s are increasingly employed to evaluate progress, assess for promotions and career switches, used as a reflective tool and as a means of curating educational activities. However, despite its blossoming role, there is significant dissonance in the content and structure of MEPs. As such, a systematic scoping review (SSR) is proposed to identify what is known of MEPs and its contents.Methods:Krishna’s Systematic Evidenced Based Approach (SEBA) was adopted to structure this SSR in SEBA of MEPs. SEBA’s constructivist approach and relativist lens allow data from a variety of sources to be considered to paint a holistic picture of available information on MEPs.Results:From the 12 360 abstracts reviewed, 768 full text articles were evaluated, and 79 articles were included. Concurrent thematic and content analysis revealed similar themes and categories including: (1) Definition and Functions of MEPs, (2) Implementing and Assessing MEPs, (3) Strengths and limitations of MEPs and (4) electronic MEPs.Discussion:This SSR in SEBA proffers a novel 5-staged evidence-based approach to constructing MEPs which allows for consistent application and assessment of MEPs. This 5-stage approach pivots on assessing and verifying the achievement of developmental milestones or ‘micro-competencies’ that facilitate micro-credentialling and effective evaluation of a medical educator’s development and entrust-ability. This allows MEPs to be used as a reflective and collaborative tool and a basis for career planning.

Proceedings of Singapore healthcare, Jul 31, 2016

Introduction: Singapore's postgraduate medical education underwent a transition in 2010, moving a... more Introduction: Singapore's postgraduate medical education underwent a transition in 2010, moving away from the House staff model to the American Residency model. Teaching was defined as a core competency for SingHealth Residency programs. This study sought to determine how this transition impacted medical students' perception of Residents as teachers. Methods: A 19-item Likert-type questionnaire comprising three domains-(1) quality, (2) frequency and (3) engagementwas given to all Duke-NUS medical students at the end of each clerkship from the academic year (AY) 2009-10 through 2013-14. The first two academic years were classified as the pre-initiation stage of the Residency, and the latter three, the post-initiation stage. Students rated Residents they encountered in their most recent clerkship. Results: Student ratings have gradually improved, with the largest improvement occurring after the initiation of Residency, and after the introduction of Residents as Future Teachers courses. Student ratings in the post-initiation Residency years combined were significantly higher than the pre-initiation of Residency years combined, for all three domains. Analysis of individual items revealed significant improvement in student ratings on all items in all domains, except for the quality of teaching in performing procedural skills. Conclusion: Findings from this study indicate a positive shift in the teaching culture with the transition of Singapore's postgraduate medical education from the House staff model to the Residency program.

Journal of Health Care for the Poor and Underserved, 2006

American Journal of Health Behavior, Jul 1, 2007

To develop medical students&a... more To develop medical students' skills in interacting with individuals who have limited health literacy. Described are 2 novel approaches to health literacy curriculum design. Efforts at both schools have been implemented to improve medical student awareness of health literacy, as well as specific skills in clear communication and strategies that ensure patient understanding. Preliminary data from one school suggest an increase in use of health literacy behaviors. Curriculum development at both schools is ongoing. The ultimate goal of these curricula is for students to develop the core skills necessary for effective communication with all patients.

Medical Education, Oct 18, 2012

Medical science educator, Apr 1, 2011

The Diabetes Educator, Sep 1, 2001

... DOI: 10.1177/014572170102700505 2001 27: 643 The Diabetes Educator Michael T. Quinn, Sandy Co... more ... DOI: 10.1177/014572170102700505 2001 27: 643 The Diabetes Educator Michael T. Quinn, Sandy Cook, Kyle Nash and Marshall H. Chin Addressing Religion and Spirituality in African Americans With Diabetes Published by: http://www.sagepublications.com On behalf of: ...

Elements, Oct 29, 2021

Faculty development programs have tended to focus on low levels of evaluation such as participant... more Faculty development programs have tended to focus on low levels of evaluation such as participant satisfaction rather than assess the actual changes that training has brought about in the workplace. This has prompted scholars to suggest using social network analysis as a means to provide a more rigorous method of evaluating the impact of faculty development. To test the feasibility of such a suggestion, we used the social network analysis concepts of social cohesion to assess the impact of a year-long fellowship program conducted by Duke-NUS Medical School's Academic Medicine Education Institute (AM•EI). Specifically, we used the key metrics of connectedness and betweenness centrality to assess the changes in the AM•EI fellows' information and collaboration networks post-fellowship. We invited three cohorts of AM•EI fellows (2013-2016; n = 74) to participate in a branched survey. The response rate was 64%; n = 47. Results showed that in terms of connectedness, the largest connected set more than doubled in size, and pair level reachability grew threefold. Betweenness centrality among the AM•EI fellows also increased, with more individuals reporting that they sought advice from the fellows as well as trusted the advice the fellows provided. In sum, this study suggests that it is indeed viable to use social network analysis to identify changes in social cohesion. As such, social network analysis serves as another tool for scholars to use to assess the impact of their faculty development efforts.