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AmaçTıp eğitiminde iyi hekimler yetiştirmede görsel sanatların katkısı olduğu iddia edilmektedir. Probleme dayalı öğrenim yapan tıp fakültelerinde oturumlarda kullanılan yazılı senaryoların ilk sayfalarında genellikle konu ile ilgili görsel eserler (resim, fotoğraf, çizim) bulunmaktadır. Bu çalışmanın amacı, senaryolarının ilk sayfasında yer alan görsel sanat eserleri hakkında tıp öğrencilerinin düşüncelerini araştırmak ve iyi hekimlik ilkeleri ile karşılaştırmaktır.Gereç ve yöntemBu çalışmada veriler nitel veri toplama tekniği kullanıldı ve veriler odak grup görüşmesi ile elde edildi. Amaçlı örneklem yöntemine uygun olarak seçilen dönem üç öğrencilerine senaryo tanıtım resimleri hakkındaki düşünceleri soruldu. Verilerin analizi aşamasında betimsel analiz ve içerik analizi yöntemlerinden yararlanıldı. BulgularToplam 10 öğrenci ile tamamlanan çalışmada katılımcıların senaryo kapak sayfasındaki görsel ürünler hakkındaki görüşleri dört ana başlık altında toparlandı: yansıtma, empati, farkındalık ve yaratıcılık.Yapılan analizlerde öğrencilerin resimlerde yer alan hastaların kendi hastalık deneyimlerini hatırlattığını ve kendi sağlık-hastalık tecrübeleri ile benzerlik kurduklarını saptadık. Öğrencilerin resimlerdeki hastalara bakarak hastaların duyguları, amaçları, beklentileri olan insanlar olduklarını anladıklarını belirledik. Bu konuda kendilerini eksik hissettiklerini ve buna hazırlıklı olmadıklarını anladıklarını ortaya koyduk. Öğrenciler hastaların yüzlerinden bir şeyler okumanın mümkün olduğunu ve bu resimlerin buna yardımcı olduğunu fark ettiler. Hastaları bir resim gibi okuyup, uyarıları fark etmek için resimlerin faydalı olabileceğini bildirdiler. Öğrenciler resimlerin yorumlanması ile aydınlandıklarını ve bu farklı bakış açısının hastalarda da işe yarayabileceğini anladılar. Sonuç Bu çalışma tıp eğitiminde görsel sanatların iyi hekimlik ilkeleri ile uyumlu olduğunu desteklemektedir. Senaryo kapak resimlerinin uygun şekilde ele alınması ve aktif olarak kullanılması öğrencilerin yansıtma, empati, farkındalık ve yaratıcılık konularında gelişmelerine katkı sağlayabilir ve iyi hekimlik konusunda yardımcı olabilir.

Hospitalists provide a significant amount of direct clinical care in both academic and community hospitals. Peer feedback is a potentially underutilized and low resource method for improving clinical performance, which lends itself well to the frequent patient care handoffs that occur in the practice of hospital medicine. We review current literature on peer feedback to provide an overview of this performance improvement tool, briefly describe its incorporation into multi-source clinical performance appraisals across disciplines, highlight how peer feedback is currently used in hospital medicine, and present practical steps for hospital medicine programs to implement peer feedback to foster clinical excellence among their clinicians.

This article was migrated. The article was marked as recommended. Clinical excellence is the goal in healthcare delivery, at both the provider and system level. At Johns Hopkins University School of Medicine, The Miller Coulson Academy of Clinical Excellence (MCACE) was established to celebrate and promote clinical excellence in hopes of optimizing the care experienced by patients. The MCACE describes clinical excellence as achieving a level of mastery in several areas including, but not limited to, communication and interpersonal skills, professionalism and humanism, diagnostic acumen, and negotiation of the healthcare system. The Academy's definition also puts an emphasis on teaching others to serve our patients and being a role model for clinical excellence. To have a positive influence on those beyond their immediate reach at Hopkins, the MCACE team launched CLOSLER, a free and open access medical education website (closler.org). With the goal of sharing thoughtful clinical stories and perspectives to stimulate reflection about providing exceptional care to every patient, CLOSLER takes its name from William Osler, the founder of academic medicine in the United States and an early champion of patient-centered care worldwide. CLOSLER offers articles written by healthcare professionals relaying pearls and lessons from practice for all, organized into four sections: Connecting with Patients, Clinical Reasoning, Passion in the Medical Profession, and Lifelong Learning in Clinical Excellence. CLOSLER has ushered in a new era of education that can help to move us closer to Osler and clinical excellence; it pushes the perspectives of outstanding role models to all who are interested in developing in this realm.

Wolter Paans, Inge Wijkamp, Egbert Wiltens, Marca V Wolfensberger Research and Innovation Group Talent Development in Higher Education and Society, Hanze University of Applied Sciences, Groningen, The Netherlands. Background: Determining what constitutes an excellent allied health care professional (AHCP) is important, since this is what will guide the development of curricula for training future physical therapists, oral hygienists, speech therapists, diagnostic radiographers, and dietitians. This also determines the quality of care. Aim: To describe perspectives of AHCPs on which characteristics are commonly associated with an excellent AHCP. Methods: AHCPs' perspectives were derived from three focus group discussions. Twenty-one health care professionals participated. The final analysis of the focus group discussions produced eight domains, in which content validity was obtained through a Delphi panel survey of 27 contributing experts. Results: According to the survey, a combination of the following characteristics defines an excellent AHCP: (1) cognizance, to obtain and to apply knowledge in a broad multidisciplinary health care field; (2) cooperativity, to effectively work with others in a multidisciplinary context; (3) communicative, to communicate effectively at different levels in complex situations; (4) initiative, to initiate new ideas, to act proactively, and to follow them through; (5) innovative, to devise new ideas and to implement alternatives beyond current practices; (6) introspective, to self-examine and to reflect; (7) broad perspective, to capture the big picture; and (8) evidence-driven, to find and to use scientific evidence to guide one's decisions. Conclusion: The AHCPs perspectives can be used as a reference for personal improvement for supervisors and professionals in clinical practice and for educational purposes. These perspectives may serve as a guide against which talented students can evaluate themselves. Keywords: clinical excellence, focus group, health care, honors programs, multidisciplinary care

Excellence in clinical care should be recognized and rewarded. A recent paradigm defined clinical excellence through seven key domains. This work examines ID clinical excellence in these domains, and in doing so highlights the important skill sets of ID physicians., Clinical excellence should be recognized, particularly in the current climate that appropriately prioritizes relationship-centered care. In order to develop a recognition model, a definition of clinical excellence must be created and agreed upon. A paradigm recently suggested by C. Christmas describes clinical excellence through the following domains: diagnostic acumen, professionalism and humanism, communication and interpersonal skills, skillful negotiation of the healthcare system, knowledge, taking a scholarly approach to clinical practice, and having passion for clinical medicine. This work references examples of infectious disease (ID) clinical excellence across Christmas' domains and, in doing so, both examines how the definition of clinical excellence applies to ID practice and highlights the importance of ID physicians. Emphasizing such aspirational standards may not only inspire trainees and practicing physicians to pursue their own fulfilling clinical ID careers, it may also encourage health systems to fully value outstanding ID physicians who labor tirelessly to provide patients with exceptional care.

Objectives To inform the rational deployment of assessor resource in the evaluation of applications to the UK Advisory Committee on Clinical Excellence Awards (ACCEA). Setting ACCEA are responsible for a scheme to financially reward senior doctors in England and Wales who are assessed to be working over and above the standard expected of their role. Participants Anonymised applications of consultants and senior academic GPs for awards were considered by members of 14 regional subcommittees and 2 national assessing committees during the 2014–2015 round of applications. Design It involved secondary analysis of complete anonymised national data set. Primary and secondary outcome measures We analysed scores for each of 1916 applications for a clinical excellence award across 4 levels of award. Scores were provided by members of 16 subcommittees. We assessed the reliability of assessments and described the variance in the assessment of scores. Results Members of regional subcommittees assessed 1529 new applications and 387 renewal applications. Average scores increased with the level of application being made. On average, applications were assessed by 9.5 assessors. The highest contributions to the variance in individual assessors9 assessments of applications were attributable to assessors or to residual variance. The applicant accounted for around a quarter of the variance in scores for new bronze applications, with this proportion decreasing for higher award levels. Reliability in excess of 0.7 can be attained where 4 assessors score bronze applications, with twice as many assessors being required for higher levels of application. Conclusions Assessment processes pertaining in the competitive allocation of public funds need to be credible and efficient. The present arrangements for assessing and scoring applications are defensible, depending on the level of reliability judged to be required in the assessment process. Some relatively minor reconfiguration in approaches to scoring might usefully be considered in future rounds of assessment.

Background Clerkship provides a unique way of transferring the knowledge and skills gathered during medical school’s curriculum into real-ward clinical care environment. The annual program evaluation has indicated that the training of clerks in diagnostic and clinical reasoning skills needed to be enhanced. Recently, “clinical excellence” program have been promoted in our institution to augment the excellence in clinical care of new clerks. Current study aims to evaluate whether this pilot program improve the “clinical excellence” of new clerks. Methods In a pilot study, groups of new clerks in years 2013 and 2014 voluntarily attended either a small-group brainstorming course or a didactic classroom tutoring courses as part of their 3-month internal medicine clinical rotation block. A third group of new clerks did not join either of the above courses and this group served as the control group. Pre-block/post-block self-assessment and post-block 5-station mini-Objective Subjective Clinical Examinations (OSCEs) were used to evaluate the effectiveness of these two additional courses that trained diagnostic and clinical reasoning skills. Results Overtime, the percentages of new clerks that attended voluntarily either the small-group brainstorming or classroom tutoring courses were increased. Higher post-block self-assessed diagnostic and clinical reasoning skill scores were found among individuals who attended the small-group brainstorming courses compared to either the didactic group or the control group. In a corresponding manner, the small-group brainstorming group obtained higher summary OSCEdiag and OSCEreason scores than either the didactic group or control group. For all basic images/laboratory OSCE stations, the individual diagnostic skill (OSCEdiag) scores of the small-group brainstorming group were higher than those of the didactic group. By way of contrast, only the clinical reasoning skill (OSCEreason) scores of the basic electrocardiogram and complete blood count + biochemistry OSCE station of thesmall-group brainstorming group were higher than those of the didactic group. Among the small-group brainstorming group, clerks with higher cumulative learning hours (>30-h) had significant higher OSCEdiag and OSCEreason scores (>400) than those with less cumulative learning hours. Conclusion Our pilot study provides a successful example of the use of a small-group tutoring courses for augmenting the diagnostic and clinical reasoning skills of new clerks. The positive results obtained during the initial 2-year long pilot “clinical excellence” program have encouraged the formal implementation of this course as part of the clerkship curriculum. Electronic supplementary material The online version of this article (doi:10.1186/s12909-016-0843-6) contains supplementary material, which is available to authorized users.

Background Provision of exceptional medical care is a goal for the medical profession because this is what the public needs and deserves. Academic medical centers that value excellent clinicians may have the best chance to recruit and retain these faculty members. When our institution hoped to launch the Miller Coulson Academy of Clinical Excellence to measure and reward master clinicians, a critical first step was to use rigorous methods to develop a definition of clinical excellence. Published papers have illustrated that this general definition of clinical excellence is applicable to fields of psychiatry, cardiology, and pediatrics. Summary In this manuscript, we apply the definition of clinical excellence to nephrology. Using the same framework, we reviewed the literature to find clinical cases and exemplary nephrologists that highlight the specific domains. This collection of reports in nephrology illustrates that the definition of clinical excellence set forth by the Miller Coulson Academy is highly applicable to physicians caring for individuals with kidney disease. Relating the definition of clinical excellence to renal medicine is worthwhile in that it can help to exemplify the model to which physicians and trainees may seek to aspire. Key message Many examples of clinical excellence in renal medicine can be found in the published medical literature. The domains of clinical excellence, described by the Miller-Coulson Academy of Clinical Excellence, apply very well to the field of nephrology.