Browsing by Author "Torbeck, Laura J."

Now showing 1 - 6 of 6
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    Clinical Assessment and Management Examination—Outpatient (CAMEO): Its Validity and Use in a Surgical Milestones Paradigm
    (Elsevier, 2015-01) Wilson, Adam B.; Choi, Jennifer N.; Torbeck, Laura J.; Mellinger, John D.; Dunnington, Gary L.; Williams, Reed G.; Department of Surgery, IU School of Medicine
    Objectives Clinical Assessment and Management Examination—Outpatient (CAMEO) is a metric for evaluating the clinical performance of surgery residents. The aim of this study was to investigate the measurement characteristics of CAMEO and propose how it might be used as an evaluation tool within the general surgery milestones project. Design A total of 117 CAMEO evaluations were gathered and used for analysis. Internal consistency reliability was estimated, and item characteristics were explored. A Kruskal-Wallis procedure was performed to discern how well the instrument discriminated between training levels. An exploratory factor analysis was also conducted to understand the dimensionality of the evaluation. Setting CAMEO evaluations were collected from 2 departments of surgery geographically located in the Midwestern United States. Combined, the participating academic institutions graduate approximately 18 general surgery residents per year. Participants In this retrospective data analysis, the number of evaluations per resident ranged from 1 to 7, and evaluations were collected from 2006 to 2013. For the purpose of data analysis, residents were classified as interns (postgraduate year 1 [PGY1]), juniors (PGY2-3), or seniors (PGY4-5). Results CAMEO scores were found to have high internal consistency (Cronbach’s α = 0.96), and all items were highly correlated (≥0.86) to composite CAMEO scores. Scores discriminated between senior residents (PGY4-5) and lower level residents (PGY1-3). Per an exploratory factor analysis, CAMEO was revealed to measure a single dimension of “clinical competence.” Conclusions The findings of this research aligned with related literature and verified that CAMEO scores have desirable measurement properties, making CAMEO an attractive resource for evaluating the clinical performance of surgery residents.
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    Impact of a Competency-Based Curriculum on Medical Student Advancement
    (2010) Brokaw, James J.; Torbeck, Laura J.; Bell, Mary Alice; Deal, Dennis W.
    BACKGROUND In 1999, the Indiana University School of Medicine implemented a new curriculum based on 9 core competencies. We sought to document how the Student Promotions Committee (SPC) has adjudicated students’ competency-related deficiencies in the past decade. METHODS Using SPC records, we determined the frequency of competency-related deficiencies reported to the SPC over time, the nature of those deficiencies, and how the deficiencies were remediated. RESULTS From 1999-2009, 191 students (138 males, 53 females) were referred to the SPC for one or more competency-related deficiencies in 8 performance domains: effective communication; basic clinical skills; lifelong learning; self-awareness, self-care, and personal growth; social and community contexts of health care; moral reasoning and ethical judgment; problem solving; and professionalism and role recognition. For the purposes of this study, students with traditional academic performance issues like course failures were excluded from analysis. Collectively, the 191 students were cited for 317 separate competency-related deficiencies (1.66 per student). Of these 317 deficiencies, the most prevalent were in the competencies of professionalism (29.3%), basic clinical skills (28.4%), and self-awareness (17.7%). Each of the remaining competencies constituted less than 10% of the total. Successful remediation utilized 12 methods ranging from a simple warning letter to being required to repeat the year under close monitoring. Remediation was unsuccessful for 17 students (8.9%) who were dismissed from medical school. CONCLUSIONS Based on our School’s experience, we believe that unprofessional behaviors and other competency-related deficiencies can be identified and remediated in most cases.
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    Optimizing the integration of advanced practitioners in a department of surgery: An operational improvement model
    (Elsevier, 2018) Torbeck, Laura J.; Hockaday, Melissa; Smith, Cecelia; Dunnington, Gary; Surgery, School of Medicine
    Physician assistants (PAs) and nurse practitioners (NPs) have established themselves as key members of the healthcare team to supplement practicing physicians in patient care. PAs and NPs are collectively referred to as “advanced providers” (APs) and work not only in primary care but in general surgery and surgical subspecialties. Studies have addressed AP integration into the profession of medicine and have examined cost and efficacy of APs, attitudes about APs among residents, and educational impact of APs, but very little literature exists that describes a formalized approach to AP integration into a department of surgery, specifically with AP/resident integration. The purpose of this paper is to describe an initiative for developing an operational improvement model for APs working with residents on surgical inpatient services in a large academic health center. The model consists of four components and each component is described in detail from discovery state towards continuous improvement. Formal professional development opportunities for APs as well as appointing a Clinical Director for Surgical APs have positively impacted AP integration into the department of surgery.
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    Ranking Surgical Residency Programs: Reputation Survey or Outcomes Measures?
    (Elsevier, 2015-11) Wilson, Adam B.; Torbeck, Laura J.; Dunnington, Gary L.; Department of Surgery, IU School of Medicine
    Objective The release of general surgery residency program rankings by Doximity and U.S. News & World Report accentuates the need to define and establish measurable standards of program quality. This study evaluated the extent to which program rankings based solely on peer nominations correlated with familiar program outcomes measures. Design Publicly available data were collected for all 254 general surgery residency programs. To generate a rudimentary outcomes-based program ranking, surgery programs were rank-ordered according to an average percentile rank that was calculated using board pass rates and the prevalence of alumni publications. A Kendall τ-b rank correlation computed the linear association between program rankings based on reputation alone and those derived from outcomes measures to validate whether reputation was a reasonable surrogate for globally judging program quality. Results For the 218 programs with complete data eligible for analysis, the mean board pass rate was 72% with a standard deviation of 14%. A total of 60 programs were placed in the 75th percentile or above for the number of publications authored by program alumni. The correlational analysis reported a significant correlation of 0.428, indicating only a moderate association between programs ranked by outcomes measures and those ranked according to reputation. Seventeen programs that were ranked in the top 30 according to reputation were also ranked in the top 30 based on outcomes measures. Conclusions This study suggests that reputation alone does not fully capture a representative snapshot of a program’s quality. Rather, the use of multiple quantifiable indicators and attributes unique to programs ought to be given more consideration when assigning ranks to denote program quality. It is advised that the interpretation and subsequent use of program rankings be met with caution until further studies can rigorously demonstrate best practices for awarding program standings.
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    Three-Dimensional Visualization Technology in the Medical Curriculum: Exploring Faculty Use in Preclinical, Clinical, and Postgraduate Anatomy Education
    (2021-01) Helbling, Shannon Amara; Torbeck, Laura J.; Byram, Jessica N.; Deane, Andrew S.; Nelson Laird, Thomas F.
    Background: The advancement of three-dimensional visualization technology provides exciting new opportunities in medical education, including new methods for teaching complex anatomical relationships and promising tools for the training of postgraduate physicians. Information on how faculty use three-dimensional visualization technology for anatomy education is essential for informed discussions surrounding their effectiveness as a teaching tool and use in the medical curriculum, yet the current literature lacks necessary contextual details on how faculty integrate these technologies into actual medical curricula. Methods: Fifteen medical educators from North American medical schools and teaching hospitals completed semi-structured interviews and discussed how they use three-dimensional visualization technology for teaching in preclinical courses, clinical clerkships, and postgraduate programs. Transcripts were analyzed using the constant comparative method and resulting themes were used to inform the creation of a questionnaire. Results: The resulting themes of analysis were organized according to a curricular framework that describes how faculty use these technologies as an instructional resource and how this use is related to the purposes, content, sequence, instructional processes and evaluation of medical curricula. The results demonstrate how three-dimensional visualization technology is being is implemented in a variety of ways in the curriculum and revealed numerous similarities of use across the levels of medical education. Analyses revealed minimal use of three-dimensional visualization technology for assessment and indicated faculty face significant challenges in designing such assessment. Conclusions: Results suggest continuing assessment of the effectiveness of these technologies as a teaching tool needs to encompass broader aspects of use, such as those described in this study. Additionally, results showing similarities of use across levels suggest that educators and administrators should consider how threedimensional visualization technology can be thoughtfully integrated to address the changing needs of learners as they progress through medical education. Findings also suggest that administrators who want to support the integration of three-dimensional visualization technology into the curriculum need to provide adequate support and training to help faculty overcome time limitations and difficulties designing assessment methods.
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    Understanding interprofessional education : a multiple-case study of students, faculty, and administrators
    (2013-07) Henkin, Katherine; Helfenbein, Robert J.; Ebright, Patricia R.; Shew, Ronald L.; Torbeck, Laura J.; Wilbur, Lee G.
    Although interprofessional education (IPE) opportunities can help prepare students for future practice and patient-centered care, many health professions students in the country are not educated in an environment with opportunities to learn with, from, or about students from other health professions. With upcoming curricular changes at the Indiana University School of Medicine (IUSM) and the Indiana University School of Nursing (IUSN), IPE remains at the forefront of these changes in both schools. To date, few studies have explored student, faculty, and administrators’ conceptualizations of IPE prior to formal implementation. Additionally, previous studies have not compared IPE conceptualizations across these groups. This multiple-case study explores and compares how groups of stakeholders from the IUSM (Indianapolis) and the IUSN (Indianapolis) conceptualize IPE. Data collection included the examination of discipline-specific public documents and one-on-one interviews (N=25) with pre-licensure students, clinical faculty, and administrators from each school. Coding and extraction of themes transpired through within-case and cross-case analysis and data supported the following findings: the ‘business of medicine’ may prevent IPE from becoming a priority in education; stakeholders’ conceptualizations of IPE are shaped through powerful experiences in education and practice; students desire more IPE opportunities at the institution; stakeholders at the IUSN have a long-standing investment in IPE; and the institution requires a ‘culture shift’ in order to sustain IPE efforts. The findings suggest that IPE belongs in all education sectors and IPE efforts deserve reward and reimbursement. The findings also insinuate that leadership, roles, and team training education belong in IPE and IPE culture requires all individuals’ (e.g., student, faculty, administrators, patients) commitment. Importantly, the institution must continue IPE development, research, and dissemination. These findings can help shape curricula as time progresses, increase the likelihood of developing a successful new curriculum, and prompt ongoing reflection about IPE. This information can influence how institutions approach IPE and may lead to a more successful and informed IPE curriculum in the first years of implementation. And, hopefully what is learned through IPE will be translated into healthcare practice environments.