Curricular innovations such as multiprofessional education (MPE) sensitise healthprofessionals towards the role of other health professionals and inculcate team spirit.This is a preliminary report on MPE in practice in the preclinical phase of dental andmedical undergraduate courses at B.P. Koirala Institute of Health Sciences, Nepal.The preclinical curriculum of the undergraduate courseis integrated, organ systembased and partially problem based. There is an emphasis on early exposure of studentsto patients and to community. The undergraduate course in medicine started in 1994and in dental surgery in 1999 based on the core curriculum developed at variousworkshops. The course duration and structure is similar in bot
Driving commercial vehicles requires intact visuo-cognitive skills. Approximately 13% of all fatal motor vehicle crashes in the United States involve commercial drivers. The ability to accurately predict risk factors for unsafe commercial driving is essential for public safety. Accurate prediction tools will advance the field of commercial driver science, provide policy guidance for driver testing and assist healthcare providers during testing. Prior studies have correlated clinical tools to roadway safety; translating these results to commercial drivers has not yet been done.This study aimed to identify specific demographic, driving history and visuo-cognitive test results that correlate with driving simulator performance. Using the Cumulative Simulator Score (CSS) as a surrogate for driving ability, the objective was to correlate both sets of data (self-reported and visuo-cognitive testing) with the CSS to identify screening tools for unsafe driving in commercial drivers.Baseline assessments of 120 variables were collected from October 2020 to January 2022. Of the 31 participants, 3 were female and 28 were male with a mean age of 53 years. Average BMI was 32, blood pressure 136/84, 32 years of CDL driving experience, 36,500 annual CDL mileage, 11,000 annual personal mileage, 14 years of education, average number of medications: 2, average number of medical conditions: 2, six participants with personal and/or commercial crashes or tickets in past five years, MOCA 27/30, Trails B time 66 s, UFOV Speed of Processing 15 ms, Stroke Disease Severity Assessment pass rate 94 %. The Cumulative Simulator Score (CSS), correlated significantly with education (r = 0.42; p = 0.02), commercial driving experience (r = 0.42; 0 = 0.02), and number of tickets as a commercial driver (Spearman rho = 0.40; p = 0.02). In a stepwise multivariable linear regression analysis, the number of tickets as a CDL driver in the past five years and years of education were retained as significant variables in the multivariable linear regression model, explaining 38 % of the variance of total scores on the CSS.Descriptive and self-reported driving characteristics correlate better with the Cumulative Simulator Score in CDL drivers than visuo-cognitive tests. Since simulator performance has been shown to be a reliable surrogate for driving performance, the number of tickets as a CDL driver in the past five years and years of education can be considered as additions to annual physicals for policy makers and health care providers to help assess their on-the-road safety.
Abstract Date Presented 4/18/2015 Understanding client perceptions of interprofessional (IP) student teams in a primary care setting informs occupational therapy clinicians and educators about whether clients desire the IP model in meeting their primary care needs. The majority of participants viewed the student-led IP clinic visits positively.
Introducing health policy to interprofessional graduate students, anchoring health policy to older adult health needs, while conveying how current policy issues will affect their individual careers is challenging, yet essential, for health profession education. This novel program integrated graduate level health profession learners from medicine, nurse practitioner, pharmacy, psychology, social work, physical therapy and occupational therapy disciplines. The aim was to embed health policy into an existing interprofessional (IP) geriatrics course at an academic medical center. Selection of disciplines was based on prior collaborative work and faculty interest. The objectives were to 1. Introduce current health policies that affect older adults; 2. Understand the effects of health policy and social determinants of health on the older adults in their future practice; 3. Challenge learners to apply their knowledge and develop health advocacy strategies for older adults; and 4) Teach the importance of teamwork in interprofessional practice within a geriatric population.The health policy curriculum impacted 487 learners for 12 sessions over three years. Four themes emerged with the sessions: health policy awareness, interprofessional appreciation, patient care “pearls,” and pharmacological considerations in geriatrics. Each of the eight modules generated thoughtful recommendations by the learners, providing a glimpse into future workforce priorities.
BACKGROUND: The older adult population is the fastest growing cohort in Kansas, resulting in a growing number of older drivers. With age, changes in the ability to drive can compromise safety. Although it is challenging for health care providers to identify unsafe older drivers, it would be helpful to know what common driving habits they share. This exploratory study evaluated differences in the self-reported driving behaviors of older drivers in urban and rural settings of Kansas. METHODS: A one-page, 19-item survey was administered to patients over age 65 in the waiting rooms of two physician medical offices in urban Kansas City and rural Junction City, Kansas. RESULTS: A total of 105 surveys were completed. Rural drivers reported they were involved in approximately 9% more accidents than the urban drivers (p = 0.166). Rural drivers were more likely to drive in poor weather conditions, such as snow, ice, fog, and rain (p = 0.032). Eyeglasses were worn by 10% of the rural cohort compared to 37.8% of the urban cohort (p = 0.0044). More urban drivers reported they did not want to make changes to their current driving habits (71% vs 40%; p = 0.004). Urban drivers drove a longer distance to reach their destinations. Drivers from both environments avoided unfamiliar roads and did not use cell phones or global positioning system (GPS) devices while driving. CONCLUSIONS: By understanding the habits of older drivers, healthcare providers can tailor safe driving messages to support safe driving and enhance patient safety. Physicians could benefit from knowing that older rural drivers wore their glasses less frequently, trended towards having more accidents, and were more prone to drive during inclement weather. Urban Kansas drivers drove further to get to their destinations than their rural Kansas counterparts. Understanding these driving habits and tailoring their prevention messages accordingly may help health care providers in Kansas improve older patient’s safe driving behaviors.
This communication presents verses from the Bhagavad Gita which help define a good clinician's skills and behavior. Using the teachings of Lord Krishna, these curated verses suggest three essential skills that a physician must possess: Excellent knowledge, equanimity, and emotional attributes. Three good behaviors are listed (Pro-work ethics, Patient-centered care, and Preceptive leadership) and supported by thoughts written in the Gita.
Introduction: Interprofessional patient care is a well-recognized path that health care systems are striving toward. The Veteran's Affairs (VA) system initiated interprofessional practice (IPP) models with their Geriatric Evaluation and Management (GEM) programs. GEM programs incorporate a range of specialties, including but not limited to, medicine, nursing, social work, physical therapy and pharmacy, to collaboratively evaluate veterans. Despite being a valuable resource, they are now faced with significant cut-backs, including closures. The primary goal of this project was to assess how the GEM model could be optimized at the Pittsburgh, Pennsylvania VA to allow for the sustainability of this important IPP assessment. Part 1 of the study evaluated the IPP process using program, patient, and family surveys. Part 2 examined how well the geriatrician matched patients to specialists in the GEM model. This paper describes Part 1 of our study. Methods: Three strategies were used: 1) a national GEM program survey; 2) a veteran/family satisfaction survey; and 3) an absentee assessment. Results: Twenty-six of 92 programs responded to the GEM IPP survey. Six strategies were shared to optimize IPP models throughout the country. Of the 34 satisfaction surveys, 80% stated the GEM clinic was beneficial, 79% stated their concerns were addressed, and 100% would recommend GEM to their friends. Of the 24 absentee assessments, the top three reasons for missing the appointments were transportation, medical illnesses, and not knowing/remembering about the appointment. Absentee rate diminished from 41% to 19% after instituting a reminder phone call policy. Discussion: Maintaining the sustainability of IPP programs is crucial for the health of our veterans. This project uncovered tools to improve the GEM IPP model for our veterans that can be incorporated nationally. Despite the lengthy nature of IPP models, patients and families appreciated the thoroughness, requested transportation and food, and responded well to reminder phone calls. A keen eye on these issues and concomitant medical complexity needs to be observed when planning IPP models to ensure sustainability. Keywords: interprofessional practice, veterans, geriatric evaluation and management
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