Clinical Faculty Members Research Articles

Medical Students’ Progress in Detecting and Interpreting Visual and Auditory Clinical Findings

Phenomenon: Detection of visual and auditory clinical findings is part of medical students’ core clinical performance abilities that a medical education curriculum should teach, assess, and remediate. However, there is a limited understanding of how students develop these skills. While training physical exam technical skills has received significant attention and emphasis, teaching and assessing medical students’ ability to detect and interpret visual and auditory clinical findings skills has been less systematic. Therefore, the purpose of this study is to investigate how medical students’ visual and auditory clinical findings skills progress and develop over their four years of undergraduate medical education. This study will provide educators insights that can guide curriculum refinements that lead to improving students’ abilities in this area. Approach: A computer-based progress exam was created to measure the longitudinal development of students’ abilities to detect and interpret visual and auditory findings. After pilot testing, sixty test items were developed in collaboration with six clinical faculty members and two medical education researchers. The exam includes detection and description of ECG, x-ray, heart sounds, breath sounds, skin lesions, and movement findings. The exam was administered to students at the beginning of each training year since 2014. Additionally, the exam was administered to the Class of 2017 prior to their graduation. Measurement validity and reliability tests were conducted. Descriptive statistics and ANOVA were used to determine progress. Findings: More than 98% of students in four years of training completed the exam each year. The exam instrument had high reliabilities and demonstrated acceptable concurrent validity when compared with other academic performance data. Findings showed that students’ visual and auditory clinical findings skills increased each training year until their fourth year. There was no performance improvement between incoming Year 4 students and graduating Year 4 students. While group means increased, class performance did not become more homogeneous across four years. Longitudinal data showed the same performance patterns as the cross-sectional data. Performance of the bottom quartile of graduating fourth-year students was not significantly higher than the performance of the top quartile of incoming first-year students who had not had formal medical training. Insights: A longitudinal study to follow learners’ performance in detecting and interpreting visual and auditory clinical findings can provide meaningful insights regarding the effects of medical training programs on performance growth. The present study suggests that our medical curriculum is not effective in bringing all students to a higher level of performance in detecting and interpreting visual and auditory clinical findings. This study calls for further investigation how medical students can develop visual and auditory detection and interpretation skills in undergraduate medical education. There is a need for planned curriculum and assessment of medical students’ skills in detecting and interpreting visual and auditory clinical findings.

Improving Understanding of Immunology for First Year Medical Students

BackgroundImmunology is a complex field of basic science. Understanding numerous concepts and details is necessary for pre‐clinical medical students to be able to apply immunological concepts to clinical cases and patient care. Faculty in the Hematology and Lymphatics course collaborated to change the way primary immunodeficiencies were taught in an effort to increase comprehension and integration of basic and clinical sciences.MethodsIn previous years, all immunology in the course was taught by basic sciences faculty. To change this approach, we added a lecture by a clinical faculty member which covered important/notable manifestations of primary immunodeficiencies. The basic sciences faculty member continued to emphasize underlying cellular defects that give rise to clinical presentations. We also included a new integrated event (a TBL session) taught by both clinical and basic sciences faculty, in which students were presented with clinical cases and asked to come up with differential diagnoses, explain their rationale and defend their choices, and explain the causes of patient symptoms.ResultsThe average score on immunology exam items increased by more than 10 percentage points. Average scores on the exam which included this material increased, while number of exam failures decreased. Student feedback also indicated that this approach was helpful for understanding the material.ConclusionsEmphasizing clinical correlations in teaching immunology to pre‐clinical medical students resulted in course improvements indicated by both quantitative and qualitative measures.

Facilitation of a multisite student topic discussion series using web-based conferencing technology

IntroductionWhile technology's use and impact in the classroom setting is well-documented in literature, use during experiential education is less defined. Our objectives were to assess the change in clinical knowledge and application skills following a multisite topic discussion (TD) series using web-based conferencing technology during ambulatory care advanced pharmacy practice experiences (APPEs) and to assess student perceptions of learning through use of this modality. MethodsA multisite TD series was created using web-based conferencing technology for students assigned to a clinical faculty member's ambulatory care APPE. Five topic discussions were conducted during each five-week rotation block covering disease states integral to ambulatory care practice. Pre- and post-assessments were administered to assess student learning and a survey was administered to assess student perceptions of learning. ResultsA total of 151 students were invited to participate in the study with 114 (75.5%) included in the final analysis. Overall student performance improved significantly from 53.3 ± 12.7% on the pre-assessment to 65.8 ± 14.3% on the post-assessment, with student performance on the post-assessment improving significantly in all topic areas. Students perceived that the TD series enhanced their learning and ability to apply clinical information while creating an online learning community. ConclusionsThe addition of a multisite TD series using web-based conferencing technology successfully enhanced student knowledge. Student perceptions of this new web-based learning community were positive overall, despite some technological limitations. The results of this study support the use of web-based conferencing technology to enhance student learning during APPEs.

Dental Faculty, Student, and Alumni Perceptions of Happiness and Life Satisfaction in Dental School: Foundations for Resilience and Well-Being.

This study examined happiness and satisfaction as possible foundations for long-term well-being and resilience in dental education. Psychological research has found that respect, camaraderie, and trust help define well-being and that resilience is built with these supportive influences. The aims of this study were to assess if happiness and life satisfaction reported by one U.S. dental school's faculty, students, and alumni also enhanced their perceived well-being and resilience and to determine the factor that most affected the participants' happiness. Email and hard copy surveys were distributed in 2018 and 2019 to all 71 full-time preclinical and clinical faculty members, 572 students in all four years, and 143 alumni who graduated in 2018 (total N = 786). Overall, 471 responded; response rates by group were as follows: faculty 87.3% (N = 62), students 65.9% (N = 377), and graduates 22.4% (N = 32). Of the three groups, responding faculty members reported having the highest levels of happiness in life (92.0%) and job satisfaction (90.3%). In the highest percentage reported, 90.2% of D4 students reported that the level of trust and respect they received from clinical faculty members contributed most to their happiness. The lowest level of happiness among the groups (71.0%) was reported by the D2 students. These results suggested that perceived well-being translated to happiness among the participants in our study. More research is needed to understand the relationship among positive environments, well-being, and provider resilience in dental education.

Development and Implementation of a Clinical Dental Faculty Evaluation Instrument.

The aim of this study was to develop and test the reliability of an instrument to evaluate the quality of clinical teaching among dental school faculty. Fourth-year dental students' perspectives on effective clinical teaching were first collected in focus group meetings. An 11-item questionnaire to assess seven domains of clinical teaching was developed based on the collected student perspectives and a medical model. All 374 third- and fourth-year dental students at one U.S. dental school in 2015 were invited to evaluate four clinical instructors whom they felt were strong role models and four clinical instructors whom they felt would benefit from constructive criticism. The survey was completed by 139 students (37.2% response rate); they evaluated 96 dental instructors. The results showed that the survey demonstrated strong internal reliability, with Cronbach's alpha values of >0.95 for each of the seven domains. In addition, there was significant agreement between groups: the interclass correlation (ICC) ranged from 0.97 to 0.99. These results suggest that the clinical faculty evaluation instrument developed in this study is a reliable method that can be used to evaluate dental faculty members. This system can be a valuable guide for clinical faculty members and administrators in assessing and improving clinical teaching effectiveness.

Combating pharmacist burnout: A model for critical care clinical pharmacy faculty

AbstractBurnout is a growing phenomenon among health care professionals in whom the prevalence has been estimated at greater than 50%. The adverse outcomes of burnout affect individuals, institutions, and patients. Although burnout literature in the profession of pharmacy is somewhat lacking, emerging data suggest a similar prevalence. Pharmacists who experience burnout typically suffer from emotional exhaustion and/or a reduced sense of personal accomplishment. The critical care setting introduces several elements that increase the risk of burnout in health care providers, including pharmacists, who practice in this area prompting professional organizations to call for action to address burnout. Critical care pharmacists with faculty appointments have additional responsibilities that may precipitate burnout. In response to anecdotal symptoms of burnout, four critical care pharmacy faculty members at the University of Illinois at Chicago developed and implemented an off‐service rotation model designed to provide clinical track faculty members protected, off‐service time to fully engage in academic responsibilities utilizing a tenured clinical faculty member, and a rotating schedule of clinical coverage to assure continuity in patient care in each of the areas (medical intensive care unit, cardiac care unit, and emergency department). Compared with the 24 months prior to implementation, academic output increased during the 24‐month period following implementation of the model. Importantly, there was no evidence of burnout from the personal accomplishment domain of the Maslach Burnout Inventory‐Health Services Survey for Medical Professionals, although high levels of emotional exhaustion and depersonalization were present.

Anxiety in nursing students: The impact of using mobile technology with quick response codes

BackgroundPre-licensure nursing students often experience anxiety, especially during their clinical learning experiences. High levels of anxiety can be disruptive to both clinical learning and safe patient care. Providing students with educational resources via mobile devices to review prior to performing psychomotor skills with real patients may help reduce their anxiety. ObjectivesThe purpose of this study was to evaluate the effect of using mobile devices with a scanning application for quick response codes in the clinical setting on students' anxiety levels in the clinical setting. A secondary aim was to explore the clinical faculty experience with and perceptions of the technology. DesignA one-group, repeated measures, quasi-experimental design was used. SettingThe intervention occurred at 6 rehabilitation centers used for first semester clinical learning experiences at a School of Nursing in the southeast United States. ParticipantsConvenience sampling was used and 42 first semester nursing students participated. MethodsThe State Trait Anxiety Inventory was used to measure self-reported anxiety prior to and following the use of mobile devices with quick response codes during an 8-week clinical learning experience. One focus group was conducted with the 4 clinical faculty members who taught the students. ResultsThe State Trait items indicated reduced anxiety for performing psychomotor skills. Median scores for positive feelings items significantly increased from 22.74 to 30.49 (p < .001), while median scores for negative feelings items decreased from 31.83 to 13.71 (p < .001). The faculty expressed that student anxiety was reduced with technology and they recommended integration throughout the curriculum. ConclusionsStudent anxiety for performing psychomotor skills was reduced following use of mobile technology with quick response codes. More research is needed; however, clinical faculty may consider integrating this technology into students' clinical learning experiences to assist with reducing their anxiety.

Education and Training in Substance Use Disorders and Addictions: The University of New Mexico Integrated Training Model.

This paper describes SUD/addictions training at the University of New Mexico. Coordinated and integrated academic, research, and clinical training resources are described, with an emphasis on the integration of resources across multiple training domains. Academic training resources in the Psychology Department include core clinical courses, basic science courses, and opportunities for students to develop expertise in health or quantitative psychology. Other academic resources come from affiliated departments and colleges such as Sociology, the College of Population Health, the College of Education, and Health Sciences. Research training resources are available within the Psychology Department, affiliated Departments and Colleges, and specialized research centers including the Center on Alcoholism, Substance Abuse, and Addictions, and the Mind Research Network. A network of community partners provides additional research sites. Clinical training resources are provided through a specialized alcohol treatment clinic and a diversity clinic within the Department, opportunities for students to serve as research clinicians, and community practicum sites supervised by on-site doctoral level psychologists or Departmental faculty. The UNM training program provides one model for graduate training in SUD/addictions. Keys to the program are the presence of multiple SUD/addictions clinical faculty member with active research programs, willingness to mentor students in research and clinical work, and basic science faculty whose research is relevant to addictive behaviors. Other critical elements include systematic development of clinical training opportunities, effective collaborations with community agencies for research and clinical training, meaningful research partnerships with other academic departments and specialized research centers, and external funding for training activities.

Implementation of the Pharmacists’ Patient Care Process in a Medicinal Chemistry Course

Objective. To implement the Pharmacists' Patient Care Process (PPCP) in a medicinal chemistry course. Methods. Doctor of Pharmacy students in a medicinal chemistry course were challenged to apply the PPCP in a lesson on cholinesterase inhibitors and NMDA receptor antagonist in the treatment of Alzheimer's disease. A clinical faculty member with expertise in the topic reviewed the clinical information provided to ensure applicability to patient care. A pre- and post-course survey was administered to assess students' understanding of the PPCP and the effectiveness of the strategies used. Students' pre- and post-course responses were analyzed, and qualitative themes were identified. Results. Of the 141 students enrolled in the course, 96% and 97% completed the pre- and post-course surveys, respectively. Students' post-course responses were higher than pre-course answers to the question that they knew all the steps of the PPCP (96% vs 66%, respectively). Ninety one percent in the post-course survey compared to 62% in the pre-course survey listed the PPCP steps correctly. In addition, more than 90% of the students indicated that the strategies used in the class helped them understand and relate to the PPCP. Qualitative responses revealed themes with positive responses related to the course, course activities, PPCP goals and curriculum design based on the implementation of the PPCP. Conclusion. The introduction of the PPCP as a framework for all pharmacy practitioners is a worthy endeavor. Purposeful strategies to introduce the PPCP in a medicinal course were positively received by students. Formalized efforts to implement the PPCP in clinical, social and administrative, and science courses are critical to introduce the PPCP as a framework for all future pharmacy practitioners.

“Practice Educators’ Academy”: A fundamental step to experiential training success in Qatar

Background: Experiential learning is the backbone of many healthcare professional education programs, and the quality of experiential learning is dependent on the skills, experiences, and proficiency of the clinical preceptors who largely contribute to this experience. Preceptors should ideally possess both clinical practice and teaching skills; however, preceptors often do not possess formal training as educators. This research was conducted at Qatar University with the aims of identifying preceptors’ educational needs and developing the skills by designing an educational professional development program called: “The Practice Educators’ Academy”. Methods: A mixed-methods triangulation study design was applied to identify preceptors’ educational needs quantitatively through a validated survey sent to preceptors (n = 325), and qualitatively by conducting 11 focus groups with preceptors (n = 20), students (n = 42), and clinical faculty members (n = 7). Quantitative and qualitative data in addition to an extensive literature review were used in designing the academy by an inter-professional healthcare and educational team. Results: Principles of learning theories, planning for experiential learning, teaching strategies, students’ assessment and feedback, and communication skills for effective preceptorship and conflict resolution were the key domains expressed as preceptors’ educational needs. A five-module program syllabus was designed to meet these needs while benchmarking it with international preceptors’ educational development programs to achieve generalizability. The designed syllabus was critically examined and validated by national and international health professional education scholars. demonstrates the validated syllabus. Conclusion: “The Practice Educators’ Academy” syllabus is the first intervention nationally and regionally for preceptors to be better equipped with skills and knowledge required for their role as clinical educators, which will enrich the internship experiences of students. With that, preceptors can better prepare competent health profession graduates that will advance healthcare outcomes and meet the healthcare needs of Qatar society and ultimately contribute to achieving Qatar National Vision 2030.

Job Involvement Among Faculty Members of Kermanshah University of Medical Sciences and Its Relationships with Professional Variables

Background: Job involvement is one of the psychological constructs of organizational behavior and is considered as an important variable in organizational productivity. Understanding the status and the determinants affecting job involvement may enhance organizational efficiency. Objectives: The purpose of this study was to determine job involvement status of faculty members of Kermanshah University of Medical Sciences and its relationship with some professional variables. Methods: This descriptive-analytical cross-sectional study was performed among 150 faculty members of Kermanshah University of Medical Sciences who were selected by simple random sampling with probability proportional to the size of each faculty. Data were collected using Lodahl and Kejnar job involvement, demographic and professional characteristics questionnaires and analyzed by SPSS-16 software using descriptive and analytical tests such as independent t-test, one-way ANOVA and Pearson correlation at significance level of 0.05. Results: Job involvement mean score was 65.11 ± 7.84, of which 81.25% was obtained from the maximum achievable score (high job involvement). Job involvement had a positive and significant correlation with age (r = 0.213) and job history (r = 0.170), but not with sex (P = 0.272, academic rank (P = 0.400), employment status (r = 902), and place of work (r = 0.141). Conclusions: It is suggested that job involvement and promotion conditions be improved for young faculty members with patience and some bylaws be passed specific to working conditions of clinical faculty members.

Peak Performance: A Communications-Based Leadership and Teamwork Simulation for Fourth-Year Medical Students.

Background:Medical education has traditionally been rooted in the teaching of health and disease processes, with little attention to the development of teamwork and leadership competencies.Objective:In an era of value-based health care provided by high-functioning teams, new approaches are needed to develop communication, leadership, and teamwork skills for medical students.Design:We designed and piloted a simulation-based educational activity called Peak Performance that linked a workbook, which focused on self-reflection on communication and leadership skills, with professional coaching. The simulation scenario placed students in the role of an upper-level resident on an inpatient service, followed by a small group debrief with students, a clinical faculty member, and a professional executive coach. After the debriefing session, students were invited to complete a self-reflection workbook within 1 week of the initial simulation. The final element of the curriculum was an individualized session with an executive coach. Peak Performance was offered to all fourth-year medical students enrolled in the Social and Health Systems Science required course at the University of North Carolina School of Medicine.Results:Pre-/post-self-assessments of leadership competencies were completed by students. Pre-simulation self-assessment scores ranged from 3.72 to 4.33 on a 5-point scale. The lowest scores were in “Managing Conflict” and “Managing Others.” The highest score was in “Self-Awareness.” The post-simulation scores decreased in every competency, with “Managing Others” dropping significantly from 3.72 pre-simulation to 3.36 post-simulation (0.31, P < .05). Satisfaction with the curriculum was high, as reflected by a Net Promoter Score of 91% (“excellent” > 50%).Conclusions:A novel simulation-based educational activity linked to professional coaching is a feasible and impactful strategy to develop leadership, communication, and teamwork skills in medical students. Student insight and self-awareness increased as evidenced by a decrease in competency self-assessment after guided reflection and individualized coaching.

A Conceptual Framework of the Characteristics of the Clinical Faculty Members in Medicine

Introduction: Providing an exact definition of the characteristics of effective clinical faculty members in medicine is challenging. The purpose of the present study is to determine the characteristics of the clinical teacher. Material and Methods: Primarily, 1750 full texts of scientific resource, were determined after reviewing, and having in-depth and detailed reviewed, 30 scientific resource were selected for review. Finally a conceptual framework was developed for the characteristics of the clinical faculty members in medicine. Results: Five themes and subjects including: human and individual, being a physician, being a teacher, being a researcher and academic executive management and educational leadership dimensions of clinical faculty members in medicine and 33 components and 966 elements, were extracted. The characteristics that were extractable for the clinical teacher under each of the main content themes in any of the newer literatures gain more components and elements by passing time. Conclusion: Scientific identification of the essential characteristics of clinical faculty members in medicine, and its theoretical foundations is necessary, consequently the results are used for developing the recruitment, employment, evaluation and empowerment policies of clinical faculty members in medicine, as well as developing the tools for measuring the characteristics and abilities of clinical faculty members in medicine.

Exploring the challenges of professional identity formation in clinical education environment: A qualitative study.

Introduction: This study aimed to explore the challenges of professional identity formation at clinical education environments from the faculty members’ viewpoints. Methods: This is a qualitative study. The population consisted of clinical faculty members of Tehran University of Medical Sciences. In this study, 39 faculty members participated in an in-depth semi-structured interview. To analyze the data, conventional content analysis approach was used. Open coding was extracted from the participants’ statements that represented their experiences. Then, based on their similarities, the codes were classified. Subcategories were emerged and after arranging, they were classified into categories based on their relationshipsResults: Instability of professional commitment, patient-centeredness as the missing loop care and treatment, and inappropriate conductive context were explored as the challenges of professional identity in clinical educational environment. Conclusion: According to the results of the study, the formation of professional identity among the providers is not an easy task because many factors affect the formation of professional identity. Therefore, a comprehensive shift towards forming the professional identity at individual and organizational level should be planned.

Personal Manuscript Acceptance Rates: Metrics for Self-assessment in Scholarship.

There is no established baseline for how frequently clinical researchers personally encounter manuscript rejection, making it difficult for faculty to put their own evolving experience in context. The purpose of this study was to determine the feasibility of obtaining personal acceptance per submission (APS) and acceptance per manuscript (APM) rates for individual faculty members. We performed a cross-section survey pilot study of clinical faculty members of two departments (family medicine and pediatrics), in one academic health center in the academic year 2017-2018. The survey asked participants to report the number of attempted submissions required per journal article they have had accepted in the prior 2 years as well as any submissions that did not lead to publication. Sixty-eight of 136 eligible faculty (50%) completed the questionnaire. Academic clinicians in the sample eventually published 80% of the manuscripts submitted, with 39% of papers rejected per submission attempt. Associate professors had the highest APS (0.71) and APM (0.88). In this pilot, we demonstrated the feasibility of retrospectively collecting data that could identify baseline manuscript acceptance rates and were able to generate department averages and rank specific averages for manuscript acceptance and rejection. We confirmed that rejection is common among academic clinicians. The APS and APM can be used by academic clinicians to track their own progress from day one of their publishing careers as a method of self-assessment, rather than having to wait for citations to accumulate.

Academic Clinicians' Workload Challenges and Burnout Analysis.

Academic clinicians have high expectations to meet in their academic institutions. Accomplishments are to be expected in multiple domains for their positions’ sustainability and promotions. In addition to excelling in their clinical practice, they are expected to maintain productive scholarly activities and meet the required educational and administrative responsibilities. Striking a balance between clinical, educational, research, and administrative duties is highly challenging and could lead to emotional exhaustion and burnout. Lately, the ever-growing patient population, competitive academic environment, and resident work hour restrictions have led to increased strain and demand on academic physicians and predisposing them to burnout.Despite the numerous studies looking at burnout in various professions, fewer studies have looked at burnout, specifically in clinical faculty members. Little is known about academic job satisfaction, stress, and rates of burnout, or how these factors affect scholarly success and productivity. Clinician faculty educators may be at significant risk of burnout. There is some evidence that clinically burned-out faculty had less confidence in their teaching skills and had fewer life-long learning habits. These results suggest that burnout may influence not only the quality of care but also the quality of training provided to others.

Implementation of Mock Acute Care Advance Pharmacy Practice Experience Simulations and an Assessment Rubric

Objective. To implement a mock acute care advanced pharmacy practice experience series into the didactic training of second-year pharmacy students and validate an accompanying assessment rubric. Methods. Three 90-minute acute care patient simulation laboratory sessions were developed with input from clinical specialists, preceptors, students, and faculty members. An accompanying student evaluation rubric was also developed. The assessment rubric was validated using pairs of preceptor raters to determine inter-rater reliability, along with predictive validity on advanced pharmacy practice experience (APPE) acute care scores. A student survey was also conducted. Results. The mock acute care APPEs were successfully implemented into the didactic curriculum. The assessment rubric had good inter-rater reliability and good predictive validity with acute care APPEs. Survey results indicated that students found the mock acute care APPE simulation laboratories useful. Conclusion. Other schools seeking to enhance their students' preparedness for and performance in acute care APPEs should consider implementing acute care APPE simulations in the didactic curriculum.

Evaluation of a journal club preparatory session on student confidence for a graded journal club

IntroductionThe purpose of this project was to describe and assess the impact of a journal club preparatory session on advanced pharmacy practice experience (APPE) student confidence pre- and post-graded journal club. MethodsA two-hour journal club preparatory session was implemented for APPE students on rotation with two clinical faculty members. The pre-assessment instructional activity was conducted the first week of each rotation; faculty members took turns working through a randomized-controlled clinical trial, highlighting and discussing key points based on their backgrounds and training. In week three, each student completed a graded journal club assignment that required a written critique and verbal presentation. Student confidence was evaluated pre-and post-activities; the pre-survey was completed prior to the journal club preparatory session and the post-survey was completed in week six. ResultsThirty-two APPE rotation students participated in journal club activities, with 26 students providing complete data (81% response rate). Mean scores on confidence across all 11 items improved on the post-survey and were statistically significant (p < 0.05). There were no statistically significant differences on change in confidence based on gender, age, with or without an acute care rotation, and with or without previous journal club experience. ConclusionA journal club preparatory session that walks students through a process prior to a graded activity helps to increase student self-reported confidence.

Factors Affecting the Number of Medical Faculty Members Required in Iranian Medical Sciences Universities: An Exploratory Factor Analysis

Background: Because of an increased demand for clinical faculty members in medical departments and no comprehensive model, identifying the affecting factors could be effective in planning in this area. So in this study we aimed to identify the key variables (and their weight) influencing the number of medical faculty members required in Iranian medical sciences universities. Methods: This study was an applied analytical descriptive one. It was a cross-sectional survey and done in Iran using the exploratory factor analysis. The main data collection instrument was a questionnaire and SPSS software version 20 was used for statistical analysis. We used expert opinions to assess the questionnaire’s validity and Cronbach’s coefficient alpha to confirm its reliability. The statistical population consisted of faculty members and directors of medical departments of Iranian medical sciences universities and experts of medical education. The sample size was determined to be 320. Results: Exploratory factor analysis indicated that in an optimal system, nine factors (consisted of 40 variables) titled “research/scholarship services” (14.3%) ,“specialty training” (12.9%), “clinical services” (9.5%), “features of faculty members” (7.5%), “undergraduate training” (6.8%), “university development level” (6.1%), “other characteristics of the university or the region” (5.1%), “desertion rate among faculty members” (4.5%), and “the nature and scope of the specialty” (2.9%) could explain 69.623% of total variance of the rrequired number for medical faculty members. Conclusion: Some of the factors like the volume of “research services” and “undergraduate training” should be considered in estimating the staffing requirements of medical faculty members. Keywords: FACULTY, MEDICAL, REQUIRED WORKFORCE, IRAN, FACTOR ANALYSIS

Impact of pharmacist-led heart failure tool kits on patient-reported self-care behaviors in a primary care–based accountable care organization

ObjectiveThe goal of this project is to evaluate the impact of a pharmacist-led heart failure (HF) intervention, using an educational toolkit, on patient-reported self-care maintenance, management, and confidence at 30 days. SettingThree Accountable Care Organization (ACO) primary care provider offices in South Florida from January to March 2018. Practice descriptionEach primary care clinic was staffed with at least 1 physician, nurse practitioners, a clinical pharmacy faculty member, pharmacy residents and students, and ancillary staff. Pharmacists spent approximately 2 days per week in clinic. Practice innovationAt the time of this project, no formalized management program for HF patients existed within the clinics. An educational toolkit was designed, reviewed, and approved by the team of pharmacists and ACO providers before use within the clinics, and included educational material outlining common causes of HF exacerbation, symptoms of HF, symptom management strategies, medication action plan, self-management instructions, medication adherence tips, and a weight-management log sheet. EvaluationA prospective, pretest and posttest observational project was conducted at the 3 clinical sites for eligible patients. The Self-Care for Heart Failure Index (SCHFI, v.6.2) tool was used to evaluate self-care practices and adequacy of maintenance, management, and confidence at baseline as compared with 30 days. ResultsTwelve participants completed the initial interview and 30-day follow-up. SCHFI scores for self-maintenance (63–68, P = 0.04) and self-management (38–58, P = 0.01) significantly improved from baseline, whereas self-confidence scores showed an increase, but was not statistically significant (80–82, P = 0.58). All self-care behaviors saw a nonstatistically significant improvement in percentage of patients achieving adequacy. ConclusionPharmacists and educational toolkits in the ACO primary care setting may improve self-maintenance, self-management, and self-confidence behaviors in patients with HF.