David W Musick | Virginia Tech (original) (raw)

Papers by David W Musick

Muscle & Nerve, 2005

Ln 1993, the American Association of Electrodiagnostic Medicine formed an Ethics and Peer Review ... more Ln 1993, the American Association of Electrodiagnostic Medicine formed an Ethics and Peer Review Committee in concert with a renewed initiative by organized medicine to emphasize ethical standards. Guidelines for ethical behavior relating to clinical practice issues in electrodiagnostic medicine were developed to formalize the standards of professional behavior for electrodiagnostic medical consultants and were approved by the AAEM Board of Directors in April 1994. The guidelines are modeled after the Code of Professional Conduct of the American Academy of Neurology and are consistent with the Guidelines in Electrodiagnostic Medicine of the American Association of Electrodiagnostic Medicine and Principles of Medical Ethics as adopted by the American Medical Association. The Guidelines may provide grounds for discipliary action under Article X of the AAEM Bylaws.

American Journal of Physical Medicine & Rehabilitation, Mar 1, 2000

Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for American Journal ... more Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for American Journal of Physical Medicine & Rehabilitation. Enter your Email address: Wolters Kluwer Health may email you for journal alerts and ...

Academic Psychiatry, Jun 1, 2003

The authors sought to examine attitudes about spirituality in medicine among medical students in ... more The authors sought to examine attitudes about spirituality in medicine among medical students in psychiatric clerkships and determine whether instruction on concepts of spirituality in medicine had an effect on students' clinical performance in related tasks. A total of 192 students entering psychiatric clerkships were randomly assigned to one of two groups; both groups received identical didactic instruction on spirituality in medicine. One group worked on a problem-based learning case that featured spirituality as a prominent theme, whereas the other group worked on problem-based learning cases that made no mention of it. Students completed pre- and posttest questionnaires, and their examination at the end of rotation included a standardized patient encounter requiring them to elicit a spiritual history. Among the 131 students who completed and returned both questionnaires, a significant difference (p=0.001) was noted between groups on students' self-reported knowledge of taking a spiritual history. However, students in the two groups received identical scores on the component of the examination requiring them to write a spiritual history. Although students who were exposed to material on spirituality in medicine reported greater understanding of the issue, no difference in clinical performance was observed.

Academic Medicine, Aug 1, 2006

The author provides (1) a brief overview of the literature concerning program evaluation as appli... more The author provides (1) a brief overview of the literature concerning program evaluation as applied to medical education, (2) a task-oriented conceptual model for use by residency directors in planning for program evaluation of graduate medical education training programs, (3) an explanation of the term "outcomes evaluation" including distinguishing between types of educational outcomes, and (4) a description of a five-step process of implementing the conceptual model. Recent accreditation standards for graduate medical education programs require a shift from a process-oriented to an outcomes-oriented model of evaluation. Accordingly, residency program directors must ensure compliance by undertaking comprehensive program evaluation procedures that demonstrate educational outcomes. Such procedures include attention to the need and focus of the evaluation; the evaluation methods to be used; and the documentation and presentation of evaluation results to key constituents. Involving teaching faculty and residents in developing a comprehensive evaluation program is vital to success. Regardless of philosophic debates pertaining to the appropriateness of the outcomes model for medical education, this approach appears likely to predominate in the foreseeable future particularly as related to the six general competencies of the physician. A practical, task-oriented approach will assist program directors in ensuring compliance with program evaluation standards.

Journal of Complementary and Integrative Medicine, Jan 8, 2010

This paper examines the theoretical literature on the influence of spirituality on general health... more This paper examines the theoretical literature on the influence of spirituality on general health and relevance to patient care. The literature suggests that the recognition of spirituality as the basis of meaning in life can lead to fruitful insights for the care and support of many patients who suffer from a variety of health conditions.

Southern Medical Journal, Oct 1, 2018

American Journal of Surgery, 2007

While much research has addressed physician competency, the development of confidence has not bee... more While much research has addressed physician competency, the development of confidence has not been studied. We sought to identify which elements of internship residents feel most contributed to building their confidence. By anonymous survey, University of Pennsylvania residents rated 104 internship elements for contribution to building physician confidence and reported their subjective confidence during and since internship. Two hundred ten residents in 18 specialties participated. Detailed ratings for all 104 elements are provided. Generally, independent decision-making items and good back-up support were equally highly valued, as was developing work efficiency. Poorly valued items included high patient loads, long hours, and abusive interactions. Surgical and medical residents agreed. Mean confidence increased during internship from 12 to 32 (1-100 scale) but remained in the 50s during residency for most specialties. Faculty should make informed, deliberate attempts to provide those elements identified as most fostering the development of physician confidence.

Journal of Pain and Symptom Management, Jun 1, 1998

Inadequate training of physicians contributes to the undertreatment of cancer pain. To address th... more Inadequate training of physicians contributes to the undertreatment of cancer pain. To address these concerns, the University of Kentucky has introduced a 4-week course for final-year medical students that teaches the principles of clinical pharmacology and pain management. The purposes of this study are to assess the knowledge deficits of final-year medical students about the use of morphine for cancer pain and to assess the efficacy of a short course on cancer pain management. Eighty-six final-year medical students completed a 22-item questionnaire assessing their knowledge and attitudes toward the use of morphine for cancer pain. Students indicated their agreement with each statement on a four-point scale (one, strongly disagree; four, strongly agree). All students then completed a compulsory short course on pain management. The course content included a 1-hr lecture on chronic nonmalignant pain, a 1-hr lecture on acute pain management, and a 1-hr lecture on cancer pain management. In addition, students completed small-group, problem-based learning modules on several aspects of pain management. After the course, all students completed the same 22-item survey. The alpha reliability score of the pretest instrument was 0.55, and the posttest reliability was 0.86. Upon course completion, students agreed most strongly (mean Ϯ SEM) that morphine should be given on a regular schedule for cancer pain (3.41 Ϯ 0.08), that cancer pain management frequently requires co-analgesics (3.36 Ϯ 0.06), and that patients with good pain relief function better than those with continuing pain (3.39 Ϯ 0.08). A comparison of pretest and posttest means on specific items suggested that the greatest amount of learning took place in the following content areas: morphine is a good oral analgesic; increases in cancer pain should be treated by increasing the morphine dose; respiratory depression is not a concern for cancer pain patients; and morphine can be used over a wide range of doses. The regular use of morphine was recognized as the treatment drug of choice for cancer pain. The students showed improved knowledge scores on ten of the 22 items on the posttest survey. A significant increase in learning occurred on six knowledge and attitude items. On only one item (nausea as a side effect of morphine) did the knowledge scores decrease on the posttest. A significant minority (40%) of senior medical students had deficits in knowledge about the use of morphine for cancer pain. The risk of addiction, respiratory depression, and tolerance were misunderstood by a significant minority (25%) of students.

American Journal of Physical Medicine & Rehabilitation, Mar 1, 1999

Academic Medicine, Apr 1, 1997

North Carolina medical journal, May 1, 2005

Muscle & Nerve, Sep 21, 2010

The American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) developed the fo... more The American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) developed the following guidelines to formalize the ethical standards that neuromuscular and electrodiagnostic (EDX) physicians should observe in their clinical and scientific activities. Neuromuscular and EDX medicine is a subspecialty of medicine that focuses on evaluation, diagnosis, and comprehensive medical management, including rehabilitation of individuals with neuromuscular disorders. Physicians working in this subspecialty focus on disorders of the motor unit, including muscle, neuromuscular junction, axon, plexus, nerve root and anterior horn cell, and the peripheral nerves (motor and sensory). The neuromuscular and EDX physician's goal is to diagnose and treat these conditions so as to mitigate their impact and improve the patient's quality of life. The guidelines were originally modeled after the Code of Professional Conduct of the American Academy of Neurology, and are consistent with the Principles of Medical Ethics as adopted by the American Medical Association, and represent a revision of previous guidelines of the AANEM. Violation of these guidelines may provide grounds for disciplinary action as outlined in Article 10.0 of the AANEM bylaws and the AANEM's Disciplinary Policies and Procedures.

Anesthesiology, Sep 1, 1997

Medical Teacher, 2002

This paper describes the process used to introduce a service-learning course into the medical cur... more This paper describes the process used to introduce a service-learning course into the medical curriculum at the University of Kentucky College of Medicine. The rationale for taking the initiative to begin such a project is outlined and curriculum planning considerations are reviewed, including how to identify project team members, choose community agency partners, develop the instructional plan, and define roles and responsibilities of the participants. The importance of understanding the philosophy of service learning and taking time for reflection are underscored. Also discussed are program evaluation issues and strategies are suggested for evaluating service learning, obtaining information relevant to the continuation of the project, and disseminating information about the service learning outcomes.

BMC Medical Education, Mar 27, 2014

Background: Professionalism has been an important tenet of medical education, yet defining it is ... more Background: Professionalism has been an important tenet of medical education, yet defining it is a challenge. Perceptions of professional behavior may vary by individual, medical specialty, demographic group and institution. Understanding these differences should help institutions better clarify professionalism expectations and provide standards with which to evaluate resident behavior.

American Journal of Physical Medicine & Rehabilitation, Mar 1, 1999

Academic Medicine, Sep 1, 2010

Date of Application:_____________ Application for the Entering Year: ___________ Position Desired... more Date of Application:_____________ Application for the Entering Year: ___________ Position Desired: 1 yr. ___ 2 year___ Name: (First, Middle, Last)) _____________________________________________________________(Maiden)___________________ Mailing Address: ________________________________________________________________________________________________ (Street, City, State, Zip) Permanent Address: _____________________________________________________________________________________________ (Street, City, State, Zip) Current Home Telephone: ______________ Work/Daytime Telephone: __________________ Cell Phone: ___________________ Pager Number: _________________________________ E-mail Address: _______________________________________________ Age: ______ Date of Birth: ________________ Sex: ___Male ___Female Birthplace: ___________________________ Military Status or Previous Experience:______________________________________________________________________________ Eligibility Requirements: Note: H Visas are not accepted. Applicants must comply with one of the following: I am (check one of the following): ______ A citizen or national of the United States ______ Permanent Resident – Alien # A_______________ ______ Have a J-1 Visa ______ Applying for a J-1 Visa ______ Pending Permanent Resident ______ Political Asylum With valid Employment Authorization Card with valid Employment Authorization Card ______ Refugee with valid Employment Authorization Card ECFMG Certification Number:________________ Date Issued: ___________________

Archives of Physical Medicine and Rehabilitation, Dec 1, 2001

Typically, protection of human subjects is a shared responsibility involving the local institutio... more Typically, protection of human subjects is a shared responsibility involving the local institutional review board (IRB) and the clinical investigator, guided by federal and state law as well as local organizational policy. The IRB screens protocols to ensure subjects' safety by making sure that risks are acceptable and do not outweigh benefits. However, the recruitment of subjects, as well as obtaining consent, is the principal investigator's responsibility. Through the process of informed consent, the clinical investigator is obliged to ensure that each subject understands all treatments proposed and their potential benefits and risks. Achieving truly informed consent from people with major developmental, physical, sensory, communicative, or cognitive disabilities may be particularly difficult. Spurred on by increasing research of relevance to rehabilitation medicine and the patients served, we review legal, ethical, and moral issues surrounding the processes of obtaining informed consent and offer specific recommendations for protecting people with disabilities.

Global journal of transfusion medicine, 2020

Background and Objectives: Excessive packed red blood cell (pRBC) transfusions are associated wit... more Background and Objectives: Excessive packed red blood cell (pRBC) transfusions are associated with worse clinical outcomes and unnecessary costs. While multi-faceted continuing medical education (CME) approaches have been shown to be effective methods for changing physician practice, few studies have evaluated this approach as a method for changing blood transfusion practices. Methods: In this prospective cohort study sought to use a multi-faceted CME platform to modify physician transfusion practices. In this prospective cohort study, the authors implemented a multi-faceted CME intervention including didactic presentations, distribution of educational materials, educational posters, and electronic medical record clinical decision support. Primary outcomes were number of pRBC transfusions prior to and after intervention and associated costs. Secondary outcomes included knowledge acquisition, satisfaction, self-reported improvement in knowledge, and intent to change behavior. The intervention targeted physicians from four departments: Surgery, Internal Medicine, Obstetrics and Gynecology, and Emergency Medicine. Results: Fifty-eight physicians participated in the experimental group and seventy-three physicians in the control group. There was a 26% decrease (P<.0001) in pRBC transfusions monthly when comparing the year prior to intervention to post-intervention year. Clinicians reported improved knowledge acquisition regarding transfusion risks and indications (P<.001). Adjusted transfusion practices saved the primary teaching hospital $722,950 following the intervention. Conclusion: This study supports the use of a multi-faceted CME intervention to align clinical practice with evidencebased transfusion guidelines. Future studies should investigate the effectiveness of individual components of multi-faceted CME interventions regarding improved physician knowledge and clinical practice, patient outcomes, and cost-benefit.

Page 1. JIAMSE © IAMSE 2008 Volume 18 1S 8 MONOGRAPH An Overview on Educating Future Physicians C... more Page 1. JIAMSE © IAMSE 2008 Volume 18 1S 8 MONOGRAPH An Overview on Educating Future Physicians Concerning Professionalism L. Lorraine Basnight, MD, Virginia D. Hardy, Ph.D., Richard H. Ray, Ph.D., Randall H. Renegar, Ph.D., David W. Musick, Ph.D. ...

Muscle & Nerve, 2005

Ln 1993, the American Association of Electrodiagnostic Medicine formed an Ethics and Peer Review ... more Ln 1993, the American Association of Electrodiagnostic Medicine formed an Ethics and Peer Review Committee in concert with a renewed initiative by organized medicine to emphasize ethical standards. Guidelines for ethical behavior relating to clinical practice issues in electrodiagnostic medicine were developed to formalize the standards of professional behavior for electrodiagnostic medical consultants and were approved by the AAEM Board of Directors in April 1994. The guidelines are modeled after the Code of Professional Conduct of the American Academy of Neurology and are consistent with the Guidelines in Electrodiagnostic Medicine of the American Association of Electrodiagnostic Medicine and Principles of Medical Ethics as adopted by the American Medical Association. The Guidelines may provide grounds for discipliary action under Article X of the AAEM Bylaws.

American Journal of Physical Medicine & Rehabilitation, Mar 1, 2000

Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for American Journal ... more Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for American Journal of Physical Medicine & Rehabilitation. Enter your Email address: Wolters Kluwer Health may email you for journal alerts and ...

Academic Psychiatry, Jun 1, 2003

The authors sought to examine attitudes about spirituality in medicine among medical students in ... more The authors sought to examine attitudes about spirituality in medicine among medical students in psychiatric clerkships and determine whether instruction on concepts of spirituality in medicine had an effect on students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; clinical performance in related tasks. A total of 192 students entering psychiatric clerkships were randomly assigned to one of two groups; both groups received identical didactic instruction on spirituality in medicine. One group worked on a problem-based learning case that featured spirituality as a prominent theme, whereas the other group worked on problem-based learning cases that made no mention of it. Students completed pre- and posttest questionnaires, and their examination at the end of rotation included a standardized patient encounter requiring them to elicit a spiritual history. Among the 131 students who completed and returned both questionnaires, a significant difference (p=0.001) was noted between groups on students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-reported knowledge of taking a spiritual history. However, students in the two groups received identical scores on the component of the examination requiring them to write a spiritual history. Although students who were exposed to material on spirituality in medicine reported greater understanding of the issue, no difference in clinical performance was observed.

Academic Medicine, Aug 1, 2006

The author provides (1) a brief overview of the literature concerning program evaluation as appli... more The author provides (1) a brief overview of the literature concerning program evaluation as applied to medical education, (2) a task-oriented conceptual model for use by residency directors in planning for program evaluation of graduate medical education training programs, (3) an explanation of the term "outcomes evaluation" including distinguishing between types of educational outcomes, and (4) a description of a five-step process of implementing the conceptual model. Recent accreditation standards for graduate medical education programs require a shift from a process-oriented to an outcomes-oriented model of evaluation. Accordingly, residency program directors must ensure compliance by undertaking comprehensive program evaluation procedures that demonstrate educational outcomes. Such procedures include attention to the need and focus of the evaluation; the evaluation methods to be used; and the documentation and presentation of evaluation results to key constituents. Involving teaching faculty and residents in developing a comprehensive evaluation program is vital to success. Regardless of philosophic debates pertaining to the appropriateness of the outcomes model for medical education, this approach appears likely to predominate in the foreseeable future particularly as related to the six general competencies of the physician. A practical, task-oriented approach will assist program directors in ensuring compliance with program evaluation standards.

Journal of Complementary and Integrative Medicine, Jan 8, 2010

This paper examines the theoretical literature on the influence of spirituality on general health... more This paper examines the theoretical literature on the influence of spirituality on general health and relevance to patient care. The literature suggests that the recognition of spirituality as the basis of meaning in life can lead to fruitful insights for the care and support of many patients who suffer from a variety of health conditions.

Southern Medical Journal, Oct 1, 2018

American Journal of Surgery, 2007

While much research has addressed physician competency, the development of confidence has not bee... more While much research has addressed physician competency, the development of confidence has not been studied. We sought to identify which elements of internship residents feel most contributed to building their confidence. By anonymous survey, University of Pennsylvania residents rated 104 internship elements for contribution to building physician confidence and reported their subjective confidence during and since internship. Two hundred ten residents in 18 specialties participated. Detailed ratings for all 104 elements are provided. Generally, independent decision-making items and good back-up support were equally highly valued, as was developing work efficiency. Poorly valued items included high patient loads, long hours, and abusive interactions. Surgical and medical residents agreed. Mean confidence increased during internship from 12 to 32 (1-100 scale) but remained in the 50s during residency for most specialties. Faculty should make informed, deliberate attempts to provide those elements identified as most fostering the development of physician confidence.

Journal of Pain and Symptom Management, Jun 1, 1998

Inadequate training of physicians contributes to the undertreatment of cancer pain. To address th... more Inadequate training of physicians contributes to the undertreatment of cancer pain. To address these concerns, the University of Kentucky has introduced a 4-week course for final-year medical students that teaches the principles of clinical pharmacology and pain management. The purposes of this study are to assess the knowledge deficits of final-year medical students about the use of morphine for cancer pain and to assess the efficacy of a short course on cancer pain management. Eighty-six final-year medical students completed a 22-item questionnaire assessing their knowledge and attitudes toward the use of morphine for cancer pain. Students indicated their agreement with each statement on a four-point scale (one, strongly disagree; four, strongly agree). All students then completed a compulsory short course on pain management. The course content included a 1-hr lecture on chronic nonmalignant pain, a 1-hr lecture on acute pain management, and a 1-hr lecture on cancer pain management. In addition, students completed small-group, problem-based learning modules on several aspects of pain management. After the course, all students completed the same 22-item survey. The alpha reliability score of the pretest instrument was 0.55, and the posttest reliability was 0.86. Upon course completion, students agreed most strongly (mean Ϯ SEM) that morphine should be given on a regular schedule for cancer pain (3.41 Ϯ 0.08), that cancer pain management frequently requires co-analgesics (3.36 Ϯ 0.06), and that patients with good pain relief function better than those with continuing pain (3.39 Ϯ 0.08). A comparison of pretest and posttest means on specific items suggested that the greatest amount of learning took place in the following content areas: morphine is a good oral analgesic; increases in cancer pain should be treated by increasing the morphine dose; respiratory depression is not a concern for cancer pain patients; and morphine can be used over a wide range of doses. The regular use of morphine was recognized as the treatment drug of choice for cancer pain. The students showed improved knowledge scores on ten of the 22 items on the posttest survey. A significant increase in learning occurred on six knowledge and attitude items. On only one item (nausea as a side effect of morphine) did the knowledge scores decrease on the posttest. A significant minority (40%) of senior medical students had deficits in knowledge about the use of morphine for cancer pain. The risk of addiction, respiratory depression, and tolerance were misunderstood by a significant minority (25%) of students.

American Journal of Physical Medicine & Rehabilitation, Mar 1, 1999

Academic Medicine, Apr 1, 1997

North Carolina medical journal, May 1, 2005

Muscle & Nerve, Sep 21, 2010

The American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) developed the fo... more The American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) developed the following guidelines to formalize the ethical standards that neuromuscular and electrodiagnostic (EDX) physicians should observe in their clinical and scientific activities. Neuromuscular and EDX medicine is a subspecialty of medicine that focuses on evaluation, diagnosis, and comprehensive medical management, including rehabilitation of individuals with neuromuscular disorders. Physicians working in this subspecialty focus on disorders of the motor unit, including muscle, neuromuscular junction, axon, plexus, nerve root and anterior horn cell, and the peripheral nerves (motor and sensory). The neuromuscular and EDX physician's goal is to diagnose and treat these conditions so as to mitigate their impact and improve the patient's quality of life. The guidelines were originally modeled after the Code of Professional Conduct of the American Academy of Neurology, and are consistent with the Principles of Medical Ethics as adopted by the American Medical Association, and represent a revision of previous guidelines of the AANEM. Violation of these guidelines may provide grounds for disciplinary action as outlined in Article 10.0 of the AANEM bylaws and the AANEM's Disciplinary Policies and Procedures.

Anesthesiology, Sep 1, 1997

Medical Teacher, 2002

This paper describes the process used to introduce a service-learning course into the medical cur... more This paper describes the process used to introduce a service-learning course into the medical curriculum at the University of Kentucky College of Medicine. The rationale for taking the initiative to begin such a project is outlined and curriculum planning considerations are reviewed, including how to identify project team members, choose community agency partners, develop the instructional plan, and define roles and responsibilities of the participants. The importance of understanding the philosophy of service learning and taking time for reflection are underscored. Also discussed are program evaluation issues and strategies are suggested for evaluating service learning, obtaining information relevant to the continuation of the project, and disseminating information about the service learning outcomes.

BMC Medical Education, Mar 27, 2014

Background: Professionalism has been an important tenet of medical education, yet defining it is ... more Background: Professionalism has been an important tenet of medical education, yet defining it is a challenge. Perceptions of professional behavior may vary by individual, medical specialty, demographic group and institution. Understanding these differences should help institutions better clarify professionalism expectations and provide standards with which to evaluate resident behavior.

American Journal of Physical Medicine & Rehabilitation, Mar 1, 1999

Academic Medicine, Sep 1, 2010

Date of Application:_____________ Application for the Entering Year: ___________ Position Desired... more Date of Application:_____________ Application for the Entering Year: ___________ Position Desired: 1 yr. ___ 2 year___ Name: (First, Middle, Last)) _____________________________________________________________(Maiden)___________________ Mailing Address: ________________________________________________________________________________________________ (Street, City, State, Zip) Permanent Address: _____________________________________________________________________________________________ (Street, City, State, Zip) Current Home Telephone: ______________ Work/Daytime Telephone: __________________ Cell Phone: ___________________ Pager Number: _________________________________ E-mail Address: _______________________________________________ Age: ______ Date of Birth: ________________ Sex: ___Male ___Female Birthplace: ___________________________ Military Status or Previous Experience:______________________________________________________________________________ Eligibility Requirements: Note: H Visas are not accepted. Applicants must comply with one of the following: I am (check one of the following): ______ A citizen or national of the United States ______ Permanent Resident – Alien # A_______________ ______ Have a J-1 Visa ______ Applying for a J-1 Visa ______ Pending Permanent Resident ______ Political Asylum With valid Employment Authorization Card with valid Employment Authorization Card ______ Refugee with valid Employment Authorization Card ECFMG Certification Number:________________ Date Issued: ___________________

Archives of Physical Medicine and Rehabilitation, Dec 1, 2001

Typically, protection of human subjects is a shared responsibility involving the local institutio... more Typically, protection of human subjects is a shared responsibility involving the local institutional review board (IRB) and the clinical investigator, guided by federal and state law as well as local organizational policy. The IRB screens protocols to ensure subjects' safety by making sure that risks are acceptable and do not outweigh benefits. However, the recruitment of subjects, as well as obtaining consent, is the principal investigator's responsibility. Through the process of informed consent, the clinical investigator is obliged to ensure that each subject understands all treatments proposed and their potential benefits and risks. Achieving truly informed consent from people with major developmental, physical, sensory, communicative, or cognitive disabilities may be particularly difficult. Spurred on by increasing research of relevance to rehabilitation medicine and the patients served, we review legal, ethical, and moral issues surrounding the processes of obtaining informed consent and offer specific recommendations for protecting people with disabilities.

Global journal of transfusion medicine, 2020

Background and Objectives: Excessive packed red blood cell (pRBC) transfusions are associated wit... more Background and Objectives: Excessive packed red blood cell (pRBC) transfusions are associated with worse clinical outcomes and unnecessary costs. While multi-faceted continuing medical education (CME) approaches have been shown to be effective methods for changing physician practice, few studies have evaluated this approach as a method for changing blood transfusion practices. Methods: In this prospective cohort study sought to use a multi-faceted CME platform to modify physician transfusion practices. In this prospective cohort study, the authors implemented a multi-faceted CME intervention including didactic presentations, distribution of educational materials, educational posters, and electronic medical record clinical decision support. Primary outcomes were number of pRBC transfusions prior to and after intervention and associated costs. Secondary outcomes included knowledge acquisition, satisfaction, self-reported improvement in knowledge, and intent to change behavior. The intervention targeted physicians from four departments: Surgery, Internal Medicine, Obstetrics and Gynecology, and Emergency Medicine. Results: Fifty-eight physicians participated in the experimental group and seventy-three physicians in the control group. There was a 26% decrease (P<.0001) in pRBC transfusions monthly when comparing the year prior to intervention to post-intervention year. Clinicians reported improved knowledge acquisition regarding transfusion risks and indications (P<.001). Adjusted transfusion practices saved the primary teaching hospital $722,950 following the intervention. Conclusion: This study supports the use of a multi-faceted CME intervention to align clinical practice with evidencebased transfusion guidelines. Future studies should investigate the effectiveness of individual components of multi-faceted CME interventions regarding improved physician knowledge and clinical practice, patient outcomes, and cost-benefit.

Page 1. JIAMSE © IAMSE 2008 Volume 18 1S 8 MONOGRAPH An Overview on Educating Future Physicians C... more Page 1. JIAMSE © IAMSE 2008 Volume 18 1S 8 MONOGRAPH An Overview on Educating Future Physicians Concerning Professionalism L. Lorraine Basnight, MD, Virginia D. Hardy, Ph.D., Richard H. Ray, Ph.D., Randall H. Renegar, Ph.D., David W. Musick, Ph.D. ...