Browsing by Subject "clinical decision making"

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    Design and Implementation of Antidepressant Decision Making Aids
    (University of Minnesota, College of Pharmacy, 2012-07) DeJongh, Beth; Haight, Robert
    Objectives: To create easy to understand, antidepressant medication decision making aids and describe the process used to develop the aids for patients diagnosed with depression. Methods: In collaboration with the Institute for Clinical Systems Improvement (ICSI), antidepressant medication decision making aids were developed to enhance patient and physician communication about medication selection. The final versions of the aids were based on design methods created by Dr. Victor M. Montori (Mayo Clinic) and discussions with patients and providers. Five physicians used prototype aids in their outpatient clinics to assess their usefulness. Results: Six prototype antidepressant medication decision making aids were created to review potential side-effects of antidepressant medications. The side effects included were those patients feel are most bothersome or may contribute to premature discontinuation of antidepressant treatment, including: weight changes, sexual dysfunction, sedation, and other unique side effects. The decision aids underwent several revisions before they were distributed to physicians. Physicians reported patients enjoyed using the decision aids and found them useful. The sexual dysfunction card was considered the most useful while the daily administration schedule card was felt to be the least useful. Conclusions: Physicians found the antidepressant decision making aids helpful and felt they improved their usual interactions with patients. The aids may lead to more patient-centered treatment choices and empower patients to become more directly involved in their treatment. Whether the aids improve patient’s medication adherence needs to be addressed in future studies.
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    Using a model board examination and a case study assessing clinical reasoning to evaluate curricular change
    (Education in the Health Professions, 2018) Root Kustritz, Margaret V; Rendahl, Aaron; Molgaard, Laura K; Malone, Erin
    Background: This study compared student ability to integrate basic science and clinical information before and after implementing a curriculum revision that introduced a problem‑oriented case approach as required coursework. Materials and Methods: Student knowledge and competence were assessed just before entry into clinical training by completion of 100 multiple‑choice questions mirroring the breadth and type of questions on the national licensing examination (Part I) and by completion of 10 cases to discern clinical decision‑making (Part II). Scores from students from the classes of 2015 and 2016 (previous curriculum) were compared to those from students from the classes of 2017 and 2018 (current curriculum). Results: Part I scores were not significantly different between any classes in the previous and current curriculum. Part II scores for 3rd‑year students in the current curriculum were higher than those for comparable students in the past 2 years of the previous curriculum. Mean scores for the class of 2016, the last year of the previous curriculum, were significantly lower than all other classes. Conclusion: Students benefit from measured and repetitive practice in clinical reasoning.