Although assessing professionalism poses many challenges, gauging and detecting changes in professionalism is impossible without measurement. This paper is a review of techniques used to assess professionalism during the past 20 years. The authors searched five electronic databases and reference lists from 1982 to 2002. Eighty-eight assessments were retained and organized into content area addressed (i.e. ethics, personal characteristics, comprehensive professionalism, diversity) and type of outcome examined (i.e. affective, cognitive, behavioral, environmental). Instead of creating new professionalism assessments, existing assessments should be improved. Also, more studies on the predictive validity of assessments and their use as part of formative evaluation systems are recommended. Based on the review, suggestions are presented for assessing medical students, resident physicians and practicing physicians.
Purpose-The purpose of this descriptive study was to document the experience of wearing a continuous glucose monitoring (CGM) device in women with type 2 diabetes (T2DM). The availability of CGM has provided patients and clinicians with the opportunity to describe the immediate effects of diet, exercise, and medications on blood glucose levels; however, there are few data examining patients' experiences and acceptability of using CGM.Methods-Thirty-five women with T2DM wore a CGM for 3 days. Semistructured interviews were conducted to capture the self-described experience of wearing a CGM. Three open-ended questions were used to guide the participants' self-reflection. Interviews were transcribed and analyzed.Results-The women verbalized both positive and negative aspects of needing to check their blood glucose more frequently and wearing the monitor. After viewing the results, most women were surprised by the magnitude and frequency of blood glucose excursions. They immediately examined their behaviors during the time they wore the CGM. Independent problem-solving skills became apparent as they attempted to identify reasons for hyperglycemia by retracing food intake, physical activity, and stress experiences during the period of CGM. Most important, the majority of women stated they were interested in changing their diabetes-related self-care behaviors, especially eating and exercise behaviors, after reviewing their CGM results.Conclusions-CGM is generally acceptable to women with T2DM and offers patients and their health care practitioners a possible alternative to routine glucose monitoring for assessing the effects of real-life events on blood glucose levels.Continuous glucose monitoring (CGM) is a novel method for continuously monitoring blood glucose levels. The earlier CGM monitors did not provide real-time blood glucose data. These meters were downloaded in a clinic office, where trends in blood glucose levels were evaluated and treatment decisions made. Real-time CGM (rt-CGM) systems provide immediate visual feedback about blood glucose levels to the patient. Both non-rt-CGM and rt-CGM methods provide visual graphs of blood glucose results over the period of CGM. In particular, CGM has successfully been used in clinical trials aimed at reducing A1C in children and adults with type 1 diabetes in which the subjects could make immediate adjustments to insulin dosages.1 -4 Only 3 studies have included CGM as a method to improve glucose control in patients with type 2 diabetes (T2DM).1 , 5 , 6 In a study examining
“Character counts at Central High” is the message frequently exhibited on the curbside marquee outside our local secondary school. Its meaning, however, is left to interpretation by those who happen to drive by the electronic display. More than likely, the deceptively simple declaration implies that Central's curriculum and associated activities are value laden, that they somehow address the collective and somewhat ambiguous set of traits we label “character.” It is a hopeful message to those who consider forming the character of the country's future workforce and citizenry to be an important goal of schooling.
Before exploring the projected future of Sponsoring Institutions (SIs), it is important to understand their origins and development. Graduate medical education (GME) has relied on diverse learning communities to educate residents for unsupervised practice. As 1 such learning community, the SI has contributed to the education of residents and fellows by ensuring the provision of support systems, resources, and administrative structures. Through their oversight of GME, SIs have fostered clinical learning and working environments in which residents and fellows achieve educational milestones that indicate their ability to provide high-quality, safe patient care upon completion of their programs and throughout their professional lives. What follows is a brief history of institutional accreditation by the Accreditation Council for Graduate Medical Education (ACGME), the process by which we have come to recognize the SI as that community necessary to form physicians.
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