Resident research using a logic model to design implement and evaluate a program
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Resident Research Using a Logic Model to Design, Implement and Evaluate a Program. Mary Jo Knobloch, MPH, CPH WREN Conference 2009. Association of American Medical Colleges Study.

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Resident research using a logic model to design implement and evaluate a program

Resident Research Using a Logic Model to Design, Implement and Evaluate a Program

Mary Jo Knobloch, MPH, CPH

WREN Conference 2009


Association of american medical colleges study

Association of American Medical Colleges Study

  • Primary healthcare professionals need more training in basic research skills and increased opportunities to become involved in research

  • Research education in the early years of medical training associated with continued interest in scholarly activity


Objectives

Objectives

  • To demonstrate use of a logic model as a framework for program development, implementation and evaluation

  • To present preliminary results of 2008 and 2009 assessment of first year residents


Current setting

Current Setting

  • Marshfield Clinic Residency Program

    • Each program different in research learning approach

  • 5 Dermatology

  • 11 General Surgery

  • 19 Internal Medicine

  • 8 Medicine/Pediatric

  • 11 Pediatric

  • 2 Pharmacy


Logic model framework

Logic Model Framework

  • Basic Framework

    • A living document

  • Inputs

  • Outputs – Activities and Participation

  • Outcomes-Impact

    • Short

    • Medium

    • Long


Uwex logic model site

UWEX Logic Model Site

  • http://www.uwex.edu/ces/pdande/evaluation/evallogicmodel.html


Short term outcome measures using resident research database

Short-term Outcome Measures Using Resident Research Database

THE NUMBERS -

  • Number of resident projects

  • Completed resident projects

  • Abstracts, posters, manuscripts

  • Number of active research mentors

  • Diversity of project study designs

    • QI and public health or advocacy projects


Resident research database tracking the short term outcomes

Resident Research DatabaseTracking the Short-Term Outcomes


Medium and long term outcomes using assessment tool

Medium and Long-term OutcomesUsing Assessment Tool

  • Increase in knowledge and skill level related to basic research methods and processes

  • Increase in knowledge related to identification of study design and statistical methods

  • Increase in skill level related to literature searches

  • Change in confidence level related to understanding and implementation of research


Medium long term outcomes

Medium-Long Term Outcomes

  • Continued interest in scholarly activity

  • Use of evidence to guide practice

  • Ongoing provision of multiple training opportunities


Results to date

Results to Date

  • Projects (the numbers)

  • Assessment results (the learning)


Projects

Projects

  • Incidence of Eosinophilic Esophagitis in MESA

  • Relationship of Urine Cotinine Levels and Wound Implications in Patients Undergoing Reduction Mammoplasty

  • Effects of HMR Weight Loss Intervention Program on Cardiovascular Disease Risk Factors

  • Effect of Hyperglycemia on Outcomes in Acute Exacerbation of COPD


Projects1

Projects

  • CNS Blastomycosis in Marshfield Clinic System: A Case Series

  • A Pilot Project to Promote Early Literacy

  • Cardiovascular Morbidity and Mortality among SLE Patients in a Rural Population-based Cohort – ICTR project

  • Severely Suppressed Bone Turnover and Atypical Skeletal Fragility

  • Maja Visekruna, MD, Medicine/Pediatrics

  • Faculty and Resident Perspectives on the Dermatology Integrative Competency Curriculum

  • Modeling Clearance of Warfarin


Projects2

Projects

  • Implementation of a Resident Well-Being Survey

  • Hamman-Rich Syndrome (Idiopathic Acute Interstitial Pneumonitis)

  • Evaluating Clinical Compliance with IDSA Guidelines for Diagnosis and Management of Lyme Disease

  • Incidence and Description of Anaplasmosis

  • Rapunzel Syndrome in a 5 Year-Old (Case Report)

  • Risk Factors Related to Recurrence of Umbilical Hernia


Projects3

Projects

  • Renal Cell Carcinoma – Incidence Rates in Wisconsin

  • A Retrospective Review of Patients Diagnosed with Stenosing Tenosynovitis (Trigger Finger and Thumb)

  • Comparison of Wounds Before and After Sharp Debridement Using 16S DNA Sequencing

  • Identification of Drug Therapy Problems through Medication Reconciliation in Heart Failure Patients

  • The Role of Pharmacist Evaluation in Activation of Adult Asthma Patients (ICTR project).

  • A Public Awareness Campaign about Insulin Dependent Diabetes


Projects4

Projects

  • Natural History of Idiopathic Neonatal Hypertension and the Long Term End Organ Effects in Children with Neonatal Hypertension

  • Do Clinicians Document the AAP Recommended Clinical Information Used to Diagnose and Manage Otitis Media with Effusion?

  • Defining Services and Referral Patterns for Infants with Positional Plagiocephaly within the Marshfield Clinic System

  • Implementing a Pharmacy Continuing Professional Development (CPD) Project at Marshfield Clinic

  • Factors Associated with Successful Matching and Residency Matriculation by Non-traditional Applicants to Dermatology Residency Programs

  • Effects of Metabolic Syndrome on Disease State and Long-Term Outcomes in Patients with Colorectal Cancer


Projects5

Projects

  • Are Lytic Bacteriophages against Staph Aureus Found in the Anterior Nares of Humans?

  • A Rare Presentation of Painless Aortic Dissection as Seizures

  • Analysis of Dermatology Resident Self-Reported Successful Learning Styles and Implications for Core Competency Curriculum Development

  • Caustic Ingestion in a 2-year old (Case Report)

  • Assessment of Medical Residents’ Knowledge of Drug Interactions after an Educational Intervention


Combined results for 2008 and 2009 first year residents the learning

Combined Results for 2008 and 2009 First-Year Residents(the learning)

  • Assessment of attitude, confidence level and knowledge

    • 33 residents


Attitude questions

Attitude Questions

  • To be an intelligent reader of the literature, it is necessary to know something about statistics

    • 100% agree or strongly agree


Attitude questions1

Attitude Questions

  • I often use statistical information in forming opinions or making decisions

    • 51% disagree or strongly disagree

  • Given the chance, I would like to learn more about biostatistics

    • 75% agree or strongly agree


Level of confidence questions

Level of Confidence Questions

  • Finding clinical practice guidelines for patient care questions

    • 57% say they have fair or little amount of confidence

    • Exploring evidence using Cochrane Database

      • 39% say little or no confidence


Confidence questions

Confidence Questions

  • Identifying factors that influence a study’s statistical power

    • 78% say fair, little or no confidence


Confidence questions1

Confidence Questions

  • Interpreting P-value for a given result

    • 70% say fair, little or no confidence

    • 30% say a lot or complete confidence


Knowledge questions

Knowledge Questions

  • Which of the following is true regarding p-values?

    • 27% correct

    • 73% incorrect

  • Which of the following is NOT considered a vulnerable population?

    • 38% correct

    • 62% incorrect


Knowledge questions1

Knowledge Questions

  • Which of the following is an example of a testable null hypothesis

    • 40% correct

    • 60% incorrect


Knowledge questions2

Knowledge Questions

  • Which of the following is true with regard to the differences between efficacy and effectiveness

    • 33% correct

    • 66% incorrect

  • Which one of the following measures of central tendency is least affected by outliers?

    • 37% correct

    • 63% incorrect


Knowledge questions3

Knowledge Questions

  • Which statement is not true about confidence intervals?

    • 36% correct

    • 63% incorrect

  • The purpose of a double-blind or double-masked study

    • 97% correct

    • 3% incorrect


Knowledge

Knowledge

  • These 2008/2009 first year residents had difficulty answering questions related to

    • Study design

    • Identifying discrete versus continuous variables

    • Differences between efficacy and effectiveness

    • Definition of bias

    • Differences between mean, median, mode

    • Sensitivity and specificity

    • Definition of prevalence


Conclusions

Conclusions

  • A program planning tool usually used for public health or intervention planning or grant planning can be used to set up and evaluate a resident research program

  • Tracking systems must be in place

  • Preliminary assessment of resident attitude and knowledge of basic epidemiology and biostatistics demonstrates the need for continued work in teaching research methods and skills


Questions

Questions?


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