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Volume 102, Issue 2 (2003)


 
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Annual Meeting

Wisconsin Medical Society Annual Meeting
2003 House of Delegates Action on Resolutions and Board Reports
(full text PDF)

Content from the 2003 Annual Meeting

Wisconsin Medical Society
Awards Presented at the 2003 Annual Meeting
(full text PDF)

Awards for the 2003 meeting

Wisconsin Medical Society
2003 Revised Wisconsin Medical Society Constitution and Bylaws
(full text PDF)

Content from the 2003 Annual Meeting

Focus On… Medical Education

Edith Burns, MD; Tovah Bates, PhD; Mary Cohan, MD; Kate Kowalski, MSSWl; G.Richard Olds, MD; Deborah Simpson, PhD; Edmund H. Duthie, Jr, MD
The Medical College of Wisconsin’s Program to Strengthen Geriatrics Education
(full text PDF)

Physicians must be facile in the care of elderly patients given the demographic realities of medical practice in the 21st century. However, medical students and residents demonstrate limited interest in geriatrics, highlighting the need for innovative and continuous exposure to geriatric-focused medical education. In response to this need, the Medical College of Wisconsin (MCW) successfully responded to requests for proposals from the John A. Hartford Foundation, in association with the American Association of Medical Colleges, and the Donald W. Reynolds Foundation to develop a longitudinal set of geriatric education initiatives for medical students, residents, and fellows. These awards have allowed MCW to focus on improving trainee attitudes, skills, and knowledge so that physicians, early in their careers, could be optimally prepared to render geriatric care. This article highlights the unique elements that comprise MCW’s geriatric initiatives (Table 1).

Nick W. Turkal, MD; Philip Farrell, MD, PhD; G. Edwin Howe
A View From the Clinical Campus: A Partnership of an Academic Medical Center with an Integrated Delivery System
(full text PDF)

As the medical profession rapidly changes, many new approaches are being developed in medical education. Several novel strategies are designed to enhance community-based, primary care education. Consequently, the Association of American Medical Colleges (AAMC) has strengthened the organization and role of “clinical branch campuses.” In Milwaukee, an excellent educational model with unique characteristics has been offered for more than 25 years to University of Wisconsin medical students. While this clinical campus has evolved extensively, its fundamental mission has not changed. This article examines the progress in the development of a clinical campus model consisting of a partnership between the University of Wisconsin Medical School and Aurora Health Care. Discussion includes advantages, disadvantages, effectiveness, and directions for the future.

Mahendr S. Kochar, MD, MS, MBA; Russell G. Robertson, MD; Mark A. Mone, PhD, MBA
A Faculty Leadership Development Program at the Medical College of Wisconsin
(full text PDF)

A faculty leadership development program has been initiated at the Medical College of Wisconsin in collaboration with faculty from the University of Wisconsin, Milwau-kee, School of Business Administra-tion. The program’s goal is to impart business-related knowledge and develop leadership skills among the senior and selected junior faculty members. The course is given over nine days in segments of three days over a five-month period. So far it has been given three times. Course evaluations by attendees indicate that the course is highly regarded and they consider it very useful in developing their managerial and leadership skills. This article describes how a free-standing medical school can collaborate with a business school to develop and offer a program customized to meet the management and leadership training needs of its faculty.

Editorials

Thomas C. Meyer, MD, WMJ Medical Editor
Developments in Medical Education
(full text PDF)

The last time the Journal published an issue on Medical Education was early 1998. Curious, I looked into the content of that issue. There were, indeed, several items of interest. Deans Dunn and Farrell and their associates described several plans for their schools. This issue of WMJ reports on the implementation and evolution of some of those plans. Perhaps the most striking relates to the introduction of Information Technology as a required part of the teaching program. Berling and his associates describe how third-year students at the Medical College of Wisconsin (MCW) are now provided with a Personal Digital Assistant (PDA) that has multiple functions, one of which consists of programmed guidance in the management of such common entities as hypertension, a “cardiac murmur form,” and community health resources. At the same time, the PDA contains the Medical Student Clinical Experience Log, designed to monitor the clinical experiences students have in their widely separated and differing clerkship situations.

William E. Scheckler, MD
It’s more than a computer can deliver: Gross Anatomy—A rite of passage and a right to learning
(full text PDF)

Forty years have passed since I was a first year medical student, but the beginning of medical education has remained stable. First-year students are introduced to their cadaver. They are arranged in teams of four or five students. They begin as medical students have begun for over 100 years, by dissecting and exploring the easily visible, so-called “gross” anatomy of the human body. The first look at the face, the hands, give the same panoply of reactions as those looks always have—a combination of trepidation, wonder and curiosity.

John W. Beasley, MD
A celebration of education—Wisconsin physicians and their Wisconsin Medical Society
(full text PDF)

Wisconsin’s physicians have an exemplary commitment to education—for the public and for physicians at all levels of training and practice. We are active in a number of programs, from those for pre-medical students to those for physicians in practice and even retired physicians. In my role as Chair of the Wisconsin Medical Society (Society) Council on Medical Education, I have a unique view of those activities.

Commentaries

Phiroze Hansotia, MD
Celebrate Spring
(full text PDF)

Poem

Original Research

Mark A. Albanese, PhD; Mikel Snow, PhD; Susan Skochelak, MD, MPH; Kathryn Huggett, PhD; Philip M. Farrell, MD, PhD
Matriculating Student Perceptions of Changes to the Admissions Interview Process at the University of Wisconsin Medical School: A Prospective, Controlled Comparison
(full text PDF)

Purpose: The purpose of this study was to assess whether changes in the admissions interview process improved matriculating students’ perceptions of the quality of the admissions interview process.

Methods: We surveyed matriculating medical students for a 3-year period. Over this period, the admissions process and procedures went through a review and then a re-engineering. The survey provided 1 year of baseline data (while the review was undertaken), 1 year of data as recommendations from the review were progressively implemented, and 1 year of data on full implementation of recommendations.

Results: From baseline to full implementation, there were statistically significant increases (p<.05) in the percentage of matriculating students who found the University of Wisconsin (UW) Medical School interview process useful (31% increase), thorough (50% increase) and better than that of other medical schools (28% increase). There was also a statistically significant decrease in the percentage of matriculating students who found the UW Medical School interview process to be less impressive than other schools (29% decrease) and in need of improvement (45% decrease). Educational Significance/Conclusions: Changes made in the UW Medical School’s interview process yielded significant increases in perceptions of the quality of the experience by matriculating students. Since interviewing is expensive for both the institution and the applicant, it should have a clear purpose. The manner in which interviews are conducted should be critically reviewed periodically to ensure that the interview continues to meet its intended needs. Jeffrey A. Morzinski, PhD; Charlene Gaebler-Uhing, MD; Ruric C. Anderson, MD
A New Program to Reward and Retain Volunteer Clinical Faculty at the Medical College of Wisconsin
(full text PDF)

Background and Problem: Volunteer clinical faculty (VCF) are vital to the educational mission of medical schools. At the Medical College of Wisconsin (MCW), VCF are increasingly relied upon to meet clinical training needs in medical student and resident education. However, many VCF receive little or no preparation to excel in their teaching roles, and they are under increasing time demands that limit their availability to teach.

Methods: Beginning in 2001, the primary care departments at MCW began a series of initiatives called “ExCEED” to promote VCF teaching excellence and efficiency through two main program components: Advisory Councils, made up of VCF leaders, and Support Services, such as web-based resources and teaching workshops.

Results: Preliminary ExCEED findings show that VCF have acquired important knowledge, skills, and tools that have better prepared them for their teaching roles.

Conclusion: ExCEED is a systematic, multi-method approach to engage VCF that is positively influencing the clinical education of MCW students and residents.

Mahendr S. Kochar, MD, MS, MBA; Deborah E. Simpson, PhD; Diane Brown
Graduate Medical Education at the Medical College of Wisconsin: New Initiatives to Respond to the Changing Residency Training Environment
(full text PDF)

Nationally, Graduate Medical Education (GME) is facing a series of challenges. These include cutbacks in Medicare funding, major changes in accreditation standards requiring education in and assessment of “general (core) competencies,” and reduction in housestaff work hours. GME at the Medical College of Wisconsin (MCW) is managed by a consortium called the Medical College of Wisconsin Affiliated Hospitals, Inc. (MCWAH), which is comprised of 13 health care institutions in Southeastern Wisconsin.

Kenneth B. Simons, MD; Tisha J. Palmer; Joan M. Bedinghaus, MD; Mary E. Cohan, MD; Dario Torre, MD
The Role and Future of Standardized Patients in the MCW Curriculum
(full text PDF)

One of the most important goals of the Medical College of Wisconsin (MCW), as for any medical school, is to prepare medical students for their successful entry into residency training and the future practice of medicine. To be prepared, students need to develop not only a solid foundation in the basic sciences, paying particular attention to pathophysiologic mechanisms, but also must gain familiarity and competence in a variety of basic clinical skills that they will utilize throughout their careers. These clinical skills lay the foundation for becoming a physician who meets the competencies set forth by the Accreditation Council of Graduate Medical Education (ACGME) and the National Board of Medical Examiners (NBME). Many of these fundamental competencies require standardization and repetition for the student to master the skills. Standardized Patients (SPs) have proven quite valuable in this regard and are utilized extensively at MCW.

Chad J. Bertling, MS; Deborah E. Simpson, PhD; Avery M. Hayes, MD; Dario Torre, MD; Diane L. Brown, BA; David B. Schubot, PhD
Personal Digital Assistants Herald New Approaches to Teaching and Evaluation in Medical Education
(full text PDF)

Since its arrival in 1994, the personal digital assistant (PDA) has made significant inroads in the handheld industry, with 50% of physicians anticipated as users by 2005 due to its functionality as a point-of-care medical informatics tool. However, its use in medical education is less well documented. Since 1998, PDAs have been used at Medical College of Wisconsin (MCW) as both a teaching and an evaluation tool for medical student and resident education. This article highlights the use of the PDA in medical education and describes current applications for monitoring clinical experiences of students/residents, and teaching resources for hypertension, cardiac auscultation, and community health. MCW’s experiences with the PDA as a real time teaching and data collection tool serves as a model for other medical schools and for our students who are educated in the importance of self-monitoring one’s clinical experiences and the need for continuous improvement as future physicians.

Neil Binkley, MD; Diane Krueger, BS; Zhanhai Li, PhD; Ronald E Gangnon, PhD; Marc K. Drezner, MD
Are Wisconsin Physicians Knowledgeable About Male Osteoporosis?
(full text PDF)

It is unknown if recent research defining the relatively frequent occurrence and pathophysiology of male osteoporosis has been conveyed to clinicians. To assess if physicians have incorporated such information, 5646 licensed Wisconsin physicians received a 1-page survey consisting of 14 statements regarding general knowledge, diagnosis, and treatment of osteoporosis in men. Twenty-six percent (1488) responded; 69% (1033) were family physicians or internists, 7% (106) orthopedic surgeons, and 5% (63) endocrinologists or rheumatologists. Of these physicians, 61% to 78% recognized that osteoporosis is not rare in men. Most (68%-97%) agreed that low-trauma fracture or corticosteroid therapy initiation are indications for bone mass measurement. Treating osteoporosis at a T-score of -2.5 was accepted by 79% to 89% of responders. Overall these physicians: (1) recognize osteoporosis as an important disease in men; (2) accept cortico-steroid therapy and prior low-trauma fracture as indications for bone mass measurement; and (3) utilize T-scores in treatment decisions. These data suggest that knowledge regarding male osteoporosis has been conveyed to practicing physicians. Evaluation of methods by which physicians will translate this knowledge into action, thereby optimizing patient care, are needed.

Your Practice

Daniel Gibson
College savings plans offer real savings opportunities
(full text PDF)

While the investment markets continue to provide the media with negative headlines, many investors have missed the good news about recently enacted college savings opportunities. For parents who have put off saving for their children’s education, now is the time to learn more about these financial options.

Jay A. Gold, MD, JD, MPH, and Dennis Spurlin, CPHQ
MetaStar’s Quality Initiatives for 2003-2006
(full text PDF)

MetaStar began its latest contract with the Centers for Medicare & Medicaid Services (CMS) in February. In addition to continuing its work with practitioners in the inpatient and outpatient settings, MetaStar also will undertake improvement projects with Wisconsin nursing homes and home health agencies over the next three years. CMS has chosen the topics and settings for the new contract based on their importance to Medicare beneficiaries, the strength of the evidence supporting the recommendations, data showing that the recommendations are not universally followed despite the strong evidence, and the feasibility of measuring and improving quality.

Your Profession

Michael J. Dunn, MD Dean and Executive Vice President, Medical College of Wisconsin
Dean’s Corner: Future physicians need hands-on education
(full text PDF)

Medical knowledge is growing exponentially, yet each rapid advance in medicine and technology must be integrated into medical school curricula. Amid the modern pace of discovery and education, we must uphold the value and necessity of training compassionate physicians capable of effective communication with patients.

Wisconsin Medical Society Task Force
Task Force report Part II: Barriers to Professionalism
(full text PDF)

Our profession needs serious recovery. Despite an awesome biomedical technology, few would yield, the people and their physicians have never been less satisfied. Charges and costs threaten bankruptcy. Errors undermine confidence. Systems of care function too often as barriers. Well-intended third party micro-management diverts resources and peaks frustration. Too often, physicians are perceived as greedy technocrats who inadequately care for, listen to, or teach their patients, and neglect civic and professional leadership. And yet, we all know thousands of times each day and all across Wisconsin compassionate and effective medical services—the ideal—are rendered. Can we identify these highly effective events, thoroughly understand them, and create conditions under which the ideal becomes common?

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