SMART - is it practical in the United States?

Norris, Matthew; Modi, Sunjay; Al‐Shaikhly, Taha

doi:10.1097/mcp.0000000000000862

Cited by 11 publications

(2 citation statements)

References 34 publications

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“…Access to specialty pulmonary services versus primary care may mediate this relationship (Sokol, Sharma, Lin, & Goldblum, 2015 ). Additionally, access to the single maintenance and rescue therapy inhalers based on pharmacy availability under different insurance plans is an example of how physical structure interacts with economy (Norris, Modi, & Al-Shaikhly, 2022 ). The trainee-patient interaction might focus on education including risk factors for developing different types of obstructive lung disease, exacerbating factors beyond smoke inhalation including indoor biomass fuel and inhalant toxins in the work setting (Kaji et al, 2014 ), and exploration of how clinicians may better assist patients in mitigating these exposures.…”

Section: Domain 2 Societal Contextmentioning

confidence: 99%

Leveraging the health equity implementation framework to foster an equity focus in medical education

Ramadurai,

Shea

2023

Adv in Health Sci Educ

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Teaching equitable clinical practice is of critical importance, yet how best to do so remains unknown. Educators utilize implementation science frameworks to disseminate clinical evidence-based practices (EBP). The Health Equity Implementation Framework (HEIF) is one of these frameworks, and it delineates how health equity may be concomitantly assessed and addressed in planning the implementation of an EBP. The HEIF therefore lays a strong foundation to understand and explain barriers and facilitators to implementation through an equity lens, making it well-suited for use by medical educators. Three equity-focused frames of reference within the model include (1) the clinical encounter, (2) societal context, and (3) culturally relevant factors, herein referred to as domains. The HEIF provides a structure for prospective and retrospective assessment of how EBP are taught and ultimately incorporated into clinical practice by trainees, with specific attention to delivering equitable care. We present three examples of common topics in internal medicine, contextualized by the three equity domains of the HEIF. We additionally acknowledge the limitations of this framework as a research tool with complex features that may not be suitable for brief teaching in the clinical environment. We propose a 360-degree learner assessment to ensure implementation of this framework is successful. By encouraging trainees to explore the narrative experiences of their patients and examine their own implicit biases, the HEIF provides a structure to address gaps in knowledge about delivering equitable care.

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Section: Domain 2 Societal Contextmentioning

confidence: 99%

Leveraging the health equity implementation framework to foster an equity focus in medical education

Ramadurai,

Shea

2023

Adv in Health Sci Educ

View full text Add to dashboard Cite

show abstract

“…Even among those with adequate health insurance coverage, implementation of recommended regimens such as single maintenance and reliever therapy (MART) can be difficult. We remind readers that there is no current U.S. Food and Drug Administration approval for MART dosing of an inhaled corticosteroid–formoterol combination, thus limiting its widespread adoption in clinical practice ( 7 ).…”

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confidence: 99%