PPC IV & V Practice Based Learning and Improvement Presentation Guide: Home

Kris Baughman, Ph.D.

Professor of Family and Community Medicine

Contact Information:

Office: G-126
Phone: 330.325.6161
Email: kbaughma@neomed.edu

At the end of this session, students will be able to:

• Use PPICO to create a clinical question about their patient from the HxPx session. 
• Perform an effective literature search to find a research article/clinical guideline that is relevant to their patient's care
• Evaluate a research article/clinical guideline for it's research design, methods, statistical results, and conclusions.
• Evaluate a research article/clinical guideline for it's relevance, validity, and level of evidence
• Calculate the NNT or discuss why it is not appropriate to calculate it.
• Discuss whether the article/guideline has outcomes/endpoints that are POEMs (clinical outcomes), DOEs (surrogate outcomes), or both.
• Apply a research article/clinical guideline to patient care and communicate your answer to the clinical question to a colleague/clinical faculty member
• Apply a research article/clinical guideline to your patient's care and discuss how you counsel your patient.
• Practice giving an oral presentation with professional looking slides

At the end of this session, students will be able to:

• Use PPICO to create a clinical question about their patient from their PACE visit
• Perform an effective literature search to find a research article/clinical guideline that is relevant to their patient's care
• Evaluate a research article/clinical guideline for it's research design, methods, statistical results, and conclusions.
• Evaluate a research article/clinical guideline for it's relevance, validity, and level of evidence
• Calculate the NNT or discuss why it is not appropriate to calculate it.
• Discuss whether the article/guideline has outcomes/endpoints that are POEMs (clinical outcomes), DOEs (surrogate outcomes), or both.
• Apply a research article/clinical guideline to patient care and communicate your answer to the clinical question to a colleague/clinical faculty member
• Apply a research article/clinical guideline to your patient's care and discuss how you counsel your patient.
• Practice giving an oral presentation with professional looking slides

Goals:         

• To investigate and evaluate patient care practices
• To appraise and assimilate scientific evidence
• To improve patient care practices
• To practice asking and answering clinical questions

Rationale:          

Practice-Based Leaning and Improvement (PBLI), simply put, is how a physician improves him or herself in the practice of medicine.  PBLI is important because physicians should monitor the quality of their own work, improve their work, and keep up with developments in medicine.  The broader rationale for PBLI is based on the belief that physicians should be leaders in making change rather than reacting to changes made by others, and the belief that positive changes in one’s own practice behavior can have positive effects on large systems.  Specific examples in medical education include:  increasing preventive care, improving chronic disease management, and enhancing patient safety.

The approach to PBLI includes the following:

• Thinking about practice patterns/beliefs.
• Analyzing practice patterns/beliefs to identify learning/improvement areas.
• Developing a learning plan for improvement.
• Applying the learning plan to improve practice patterns.
• Monitoring the impact of the learning plan on outcomes or behaviors.

Information for this guide was provided by:

• LuAnne Stockton, BS, BA
• Stephanie Henderson, MLS
• Heather McEwen, MS, MLIS
• Jessica Ferrell, Ph.D.

EBM content also provided by:

• Michelle Cudnik, Pharm.D.

Biostatistics, Epidemiology/Population Health, & Interpretation of the Medical Literature

• Study design, types and selection of studies (includes dependent/independent variables)
  • Various study designs
  • Obtaining and describing samples, matching, inclusion/exclusion criteria, selecting appropriate controls for studies, lack of controls, concealed allocation, randomization, stratification
  •  Methods to handle noncompliance
    • loss to follow-up; intention-to-treat analysis
• Measures of association
  • Other measures of association
    • number needed to treat/harm
• Study interpretation, drawing conclusions from data
  • Internal vs external validity
    • generalizability (external validity); efficacy vs effectiveness
  • Statistical vs clinical significance; clinical and surrogate outcome/end point
• Clinical decision making, interpretation and use of evidence-based data and recommendations

Social Sciences

• Communication and interpersonal skills, including health literacy and numeracy, cultural competence
  • Patient interviewing, consultation, and interactions with the family (patient- centered communication skills)
    • making decisions (eg, eliciting patient's perspectives)
    • enabling patient behaviors (eg, education and counseling)

AAMC Core Entrustable Professional Activities for Entering Residency

• EPA 6: Provide an Oral Presentation of a Clinical Encounter
• EPA 7: Form Clinical Questions and Retrieve Evidence to Advance Patient Care