Consensus-building Process Research Articles

Evidence-Based Process for Prioritizing Positive Behaviors for Promotion: Zika Prevention in Latin America and the Caribbean and Applicability to Future Health Emergency Responses.

Since the 2015 Zika outbreak in Latin America and the Caribbean, a plethora of behavior change messages have been promoted to reduce Zika transmission. One year after the United States Agency for International Development (USAID) initiated its Zika response, more than 30 variants of preventive behaviors were being promoted. This situation challenged social and behavior change (SBC) programming efforts that require a coordinated response and agreed upon set of focus behaviors to be effective. To support USAID implementing partners in harmonizing prevention efforts to reduce Zika infection, we developed an evidence-based process to identify behaviors with the highest potential to reduce Zika infection and transmission. We compiled a full list of behaviors and selected the most promising for a full evidence review. The review included systematic keyword searches on Google Scholar, extraction of all relevant published articles on Aedes-borne diseases between 2012 and 2018, review of seminal papers, and review of gray literature. We examined articles to determine each behavior's potential effectiveness in preventing Zika transmission or reducing the Aedes aegypti population. We also developed assessment criteria to delineate the ease with which the target population could adopt each behavior, including: (1) required frequency; (2) feasibility of the behavior; and (3) accessibility and cost of the necessary materials in the setting. These behaviors were refined through a consensus-building process with USAID's Zika implementing partners, considering contextual factors. The resulting 7 evidence-based preventive behaviors have high potential to strengthen SBC programming's impact in USAID's Zika response: (1) apply mosquito repellent, (2) use condoms during pregnancy, (3) remove standing water, (4) cover water storage containers, (5) clean/remove mosquito eggs from water containers, (6) seek antenatal care, and (7) seek family planning counseling. This case study documents a flexible process that can be adapted to inform the prioritization of behaviors when there is limited evidence available, as during many emergency responses.

Curated Collections for Educators: Five Key Papers about Receiving Feedback in Medical Education.

IntroductionFeedback is a complex, multi-component interaction that is essential for academic development and advancement. Successful feedback requires active involvement from both the giver and receiver. However, research and guidance on the subject mostly center on the role of the provider of feedback. But the receiver of feedback holds the true power in this interaction, choosing how to interpret the information and deciding whether or not to incorporate the feedback to instill behavioral change. In this article, the authors aim to summarize five key papers related to receiving feedback, in order to outline both relevant information for emerging clinician-educators and discern ways to use this information for faculty development.MethodsIn order to generate a list of key papers that describe the importance of receiving feedback, the authors conducted a consensus-building process informed by social media sources. Key articles on receiving feedback were aggregated through a literature search. This list was further augmented via an open call on Twitter for important papers regarding receiving feedback. Through these processes, a list of 43 papers was created on the topic of receiving feedback in medical education. After compiling this preliminary list, the authorship group engaged in a modified Delphi approach to build consensus on selecting papers that best described the process of receiving feedback.ResultsWe present the group’s five most highly rated papers on the topic of receiving feedback in medical education. These papers were deemed essential and have also been summarized based on their relevance to junior faculty members and faculty developers.ConclusionWhile giving and receiving feedback are both vital for growth and development, much of the research focuses solely on giving feedback. However, receiving feedback is equally, if not more, important for instilling change in the learner. We explore the power of receiving feedback in medical education through five key papers that analyze the subject. We believe these papers can serve as great learning resources for both junior faculty members and faculty developers. They can assist the junior faculty to cultivate the ability to receive feedback and also serve as resources to aid senior faculty in building faculty-development sessions.

Democracy-Assisting Judicial Review and the Challenge of Partisan Polarization

Democracy-assisting judicial review is a theme that has recently reemerged in normative constitutional scholarship. It asks the Supreme Court to use its power to vindicate the people’s views that have been stymied by a dysfunctional political process, a problem that has worsened in recent years. The main deficiency in this prescription is that it overstates the Court’s ability to compensate for problems like polarization and gridlock since it is a part of the interbranch strategies employed by partisan regimes. This was demonstrated in the area of reapportionment, typically seen as a classic example of democracy-assisting judicial review. It is also evident in recent Roberts Court decisions in the election-law field. This Article recommends abandoning the democracy-assisting idea and instead exploring ways to prevent the Court from being enlisted in extreme and unrepresentative causes. Reform ideas should focus on increasing and regularizing turnover on the Court and encouraging the selection of more representative Justices, an outcome made more likely by increasing the representativeness of the elected officials who choose the Justices. Absent a crisis, of course, it is highly unlikely that any such reforms will be adopted. Nonetheless, it is a worthwhile exercise to think about how to enhance representational and consensus-building processes in the presence of growing partisan polarization. And it is a more valuable exercise than simply imploring the Justices be less partisan or suggesting that they defer to today’s laws that represent such fragile legislative compromises. Institutions and processes, and the incentives they create, must be changed if behavior is to be changed. The best we can do for the Court and for American democracy in 2020 and beyond is to construct better electoral processes that produce more representative leaders who, in turn, select more representative Justices, which aids the quest for true constitutional consensus.

Identifying and Achieving Consensus on Health-Related Indicators of Climate Change in Nunavut

Indigenous peoples of the North are affected by climate change, and future changes in climate are likely to continue to pose serious challenges. Climate change and the resulting change in the environment and communities are believed to further compound existing health issues. There is considerable regional variation within the circumpolar world, and each area of the Canadian Arctic has its own unique environmental and societal characteristics. Therefore, to track the impacts on human health in Nunavut, a monitoring framework—one that takes into account the territory’s unique context—must be implemented. The objective of this study was to identify human health indicators of climate change on a global scale with a focus on indicators relevant to the Canadian Arctic atmosphere, habitats, and peoples. The Piliriqatigiinniq Community Health Research Model provided the guiding framework for this exploratory study. First, a scoping review of health-related indicators of climate change was conducted. From this review, an initial list of 30 indicators was produced. Second, individuals from multiple sectors were invited to participate in a consensus-building process to identify health-related indicators of climate change for Nunavut. Through individual selection and group discussion, a final set of 20 indicators was chosen by workshop participants. The indicators identified in both phases focused on four key themes: 1) environmental health; 2) morbidity and mortality; 3) population vulnerability; and 4) mitigation, adaptation, and policy. Participants felt these indicators would be useful in practice in Nunavut. Next steps are to implement and monitor the utility of the selected indicators.

Designing high-quality implementation research: development, application, feasibility and preliminary evaluation of the implementation science research development (ImpRes) tool and guide

BackgroundDesigning implementation research can be a complex and daunting task, especially for applied health researchers who have not received specialist training in implementation science. We developed the Implementation Science Research Development (ImpRes) tool and supplementary guide to address this challenge and provide researchers with a systematic approach to designing implementation research.MethodsA multi-method and multi-stage approach was employed. An international, multidisciplinary expert panel engaged in an iterative brainstorming and consensus-building process to generate core domains of the ImpRes tool, representing core implementation science principles and concepts that researchers should consider when designing implementation research. Simultaneously, an iterative process of reviewing the literature and expert input informed the development and content of the tool. Once consensus had been reached, specialist expert input was sought on involving and engaging patients/service users; and economic evaluation. ImpRes was then applied to 15 implementation and improvement science projects across the National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London, a research organisation in London, UK. Researchers who applied the ImpRes tool completed an 11-item questionnaire evaluating its structure, content and usefulness.ResultsConsensus was reached on ten implementation science domains to be considered when designing implementation research. These include implementation theories, frameworks and models, determinants of implementation, implementation strategies, implementation outcomes and unintended consequences. Researchers who used the ImpRes tool found it useful for identifying project areas where implementation science is lacking (median 5/5, IQR 4–5) and for improving the quality of implementation research (median 4/5, IQR 4–5) and agreed that it contained the key components that should be considered when designing implementation research (median 4/5, IQR 4–4). Qualitative feedback from researchers who applied the ImpRes tool indicated that a supplementary guide was needed to facilitate use of the tool.ConclusionsWe have developed a feasible and acceptable tool, and supplementary guide, to facilitate consideration and incorporation of core principles and concepts of implementation science in applied health implementation research. Future research is needed to establish whether application of the tool and guide has an effect on the quality of implementation research.

Core Content for Pediatric Emergency Medicine Ultrasound Fellowship Training: A Modified Delphi Consensus Study.

Pediatric emergency medicine (PEM) point-of-care ultrasound (POCUS) fellowships exist to provide learners with expertise in ultrasound (US) education, administration, and research oversight. Currently, there are no standardized goals or objectives for these programs, resulting in considerable variability in PEM POCUS fellowship training. A modified Delphi survey of PEM and general emergency medicine (EM) POCUS experts in Canada and the United States was conducted to obtain consensus regarding the most important curricular components of a PEM POCUS fellowship training program. Participants were solicited from the P2 Network mailing list and from PEM and EM POCUS fellowship directors listed on the Society of Clinical Ultrasound Fellowships and the Canadian Society of POCUS-EM Fellowships websites. Curricular components considered as part of the survey included US skills, educational skills, administrative skills, and research requirements. Consensus was considered to have been reached when ≥80% of respondents agreed to either include or exclude the component in fellowship training. Round 1 of the survey was sent to 311 participants. A total of 118 (37.9%) completed eligibility for the survey, and 92 (78.0%) met eligibility criteria. Of those, 80 (67.8% of eligible participants) completed the first round of the survey. Round 2 of the survey was sent to those who completed part 1, and 64 (80.0%) completed that round. During Round 1, consensus was achieved for 15 of 75 US applications, seven of seven educational skills, nine of 11 administrative skills, and four of six research requirements. In Round 2 of the survey, consensus was reached on two additional US skills, but no additional administrative skills or research requirements. With a consensus-building process, the core content for PEM POCUS fellowship training was defined. This can help POCUS educators formulate standardized curricula to create consistent training in POCUS fellowship graduates.

A Modified Communication and Optimal Resolution Program for Intersystem Medical Error Discovery: Protocol for an Implementation Study.

BackgroundPreventable medical errors represent a major public health problem. To prevent future errors, improve disclosure, and mitigate malpractice risks, organizations have adopted strategies for transparent communication and emphasized quality improvement through peer review. These principles are incorporated into the Agency for Healthcare Research and Quality (AHRQ) Communication and Optimal Resolution (CANDOR) Toolkit, which facilitates (1) transparent communication, (2) error prevention, and (3) achieving optimal resolution with patients and families; however, how medical errors should be addressed when they are discovered between systems—intersystem medical error discovery (IMED)—remains unclear. Without mechanisms for disclosure and feedback on the part of the discovering provider, uncertainty remains as to the extent to which IMED is communicated with patients or responsible providers. Furthermore, known barriers to disclosure and reporting one’s own error may not be relevant or may be replaced by other unknown barriers when considering scenarios of IMED.ObjectiveThis study aims to develop and test implementation of a modified CANDOR process for application to IMED scenarios.MethodsWe plan a series of studies following an implementation framework. First, we plan a participatory, consensus-building stakeholder panel process to develop the modified CANDOR process. We will then conduct a robust preimplementation analysis to identify determinants of implementation of the modified process. Using the Consolidated Framework for Implementation Research as a theoretical framework, we will assess organizational readiness by key informant interviews and individual-level behaviors by a survey. Findings from this analysis will inform the implementation toolkit that will be developed and pilot-tested at 2 cancer centers, sites where IMED is hypothesized to occur more frequently than other settings. We will measure 5 implementation outcomes (acceptability, appropriateness, reach, adoption, and feasibility) using a combination of key informant interviews and surveys over the pre- and postimplementation phases.ResultsThis protocol was funded in August 2018 with support from the AHRQ. The University of Michigan Medical School Institutional Review Board has reviewed and approved the scope of activities described. As of April 2019, step 1 of aim 1 is underway, and aim 1 is projected to be completed by April 2020. Data collection is projected to begin in January 2020 for aim 2 and in August 2020 for aim 3.ConclusionsProviding a communication and resolution strategy applicable to IMED scenarios will help address the current blind spot in the patient safety movement. This work will provide important insights into the potential utility of an implementation toolkit to improve transparent communication and optimal resolution of IMED scenarios. The natural progression of this work will be to test the toolkit more broadly, understand the feasibility and barriers of implementation on a broader scale, and pilot the implementation in new organizations.International Registered Report Identifier (IRRID)PRR1-10.2196/13396

The evolving 5G case study in spectrum management and industrial policy

Even before the International Telecommunication Union (“ITU”) reaches consensus on spectrum allocations for fifth generation wireless technologies (“5G”), commercial ventures scramble to offer new equipment and services. Expediting 5G wireless service can benefit consumers and businesses at the risk of stressing the traditional process of spectrum planning that combines study, dialogue and consensus building at ITU conferences.This paper explains why most nations refused to endorse key United States 5G spectrum allocation proposals at the ITU’s, 2015 World Radio Conference. U.S. representatives underestimated the time needed for consensus building, despite increasing demand for wireless video and the evolving Internet of Things. Other contributing factors include U.S. support for treating spectrum like property, use of “incentive auctions” to clear broadcast television spectrum with unprecedented speed and enough existing wireless spectrum allocations in most nations.The paper concludes that the U.S. cannot expect faster frequency reallocations, particularly when it and other nations pursue matters having little to do with spectrum optimization. The paper offers recommendations on best practices for improving the consensus building process.

Consensus Recommendations for the Conduct, Training, Implementation, and Research of Perioperative Handoffs.

Consensus Recommendations for the Conduct, Training, Implementation, and Research of Perioperative Handoffs.

Essential Elements for Core Required Advanced Pharmacy Practice Experiences

Since 2004, concerns and calls for greater quality assurance in experiential education have been published. The Accreditation Council for Pharmacy Education (ACPE) "Standards 2016" provide limited differentiation across the four required practice experiences, and, as such, schools interpret them differently. Both schools and accreditation site visit teams would benefit from a common set of guidance for the required Advanced Pharmacy Practice Experiences (APPEs), so that they can ensure consistency and quality in student experiences across practice sites. To address this need for greater standardization, a taskforce of the American Association of Colleges of Pharmacy (AACP) Experiential Education (EE) Section conducted a peer-reviewed, consensus-building process, including experiential faculty and staff across multiple colleges and schools of pharmacy, to determine a common set of elements that could be used to bring consistency to the experiences and expectations for student learning in practice. Over a two year period, the taskforce reviewed the relevant literature and then drafted and revised the elements through an iterative process which allowed for established EE consortia and members of the EE section to review the draft and provide input for revision. The resulting essential elements presented here can be used to guide faculty and staff within experiential education programs in their quality assurance processes in ensuring students receive consistent experience as part of their education prior to graduation.

Horizon scanning for invasive alien species with the potential to threaten biodiversity and human health on a Mediterranean island

Invasive alien species (IAS) are one of the major drivers of change that can negatively affect biodiversity, ecosystem functions and services and human health; islands are particularly vulnerable to biological invasions. Horizon scanning can lead to prioritisation of IAS to inform decision-making and action; its scale and scope can vary depending on the need. We focussed on IAS likely to arrive, establish and affect biodiversity and human health on the Mediterranean island of Cyprus. The scope of the horizon scanning was the entire island of Cyprus. We used a two-step consensus-building process in which experts reviewed and scored lists of alien species on their likelihood of arrival, establishment and potential to affect biodiversity, ecosystems and/or human health in the next 10 years. We reviewed 225 alien species, considered to be currently absent on Cyprus, across taxa and environments. We agreed upon 100 species that constituted very high, high or medium biodiversity risk, often arriving through multiple pathways of introduction. The remaining 125 species were ranked as low risk. The potential impacts on human health were documented for all 225 species; 82 species were considered to have a potentially negative impact on human health ranging from nuisance to disease transmission. The scope of the horizon scanning was the entire island of Cyprus, but the thematic groups also considered the relevance of the top 100 species to the Sovereign Base Areas of Cyprus, given their differing governance. This horizon scan provides the first systematic exercise to identify invasive alien species of potential concern to biodiversity and ecosystems but also human health within the Mediterranean region. The process and outcomes should provide other islands in the region and beyond with baseline data to improve IAS prioritisation and management.

Why the 1987 Constitution has Endured for 32 Years Without Amendment

Initiatives to change a constitution is part and parcel of being a constitutional democracy. Resisting such an initiative, provided it is supported by a rational public consensus-building process, is an integral component of constitutional democracy as well. As a constitutional democracy, the Philippines finds itself perfectly within this constitutional reform context. As such, this paper will analyze the long history of charter change initiatives in the country and attempt to draw out the reasons why the 1987 Philippine Constitution continues to remain immune from reform and amendment. This paper also examines how these reasons will affect the Duterte administration’s efforts to change the constitution that will support a federal form of government.

Reconciling intergenerational conflicts with imaginary future generations: evidence from a participatory deliberation practice in a municipality in Japan

Coping with intergenerational conflicts is one of the fundamental keys to building a sustainable society. However, current decision-making systems tend to be inclined towards the preferences of present generations, simply because future generations do not yet exist and therefore cannot participate in present-day negotiating processes. In this paper, with an aim towards reconciling possible intergenerational conflicts, we present the first attempt at creating a participatory intergenerational deliberation practice by creating “imaginary future generation” groups to represent future generations and negotiate with present-generation groups regarding future visions and associated decision making. To accomplish this, a series of workshops were organized in a local municipality in Japan in which participating imaginary future-generation groups and present-generation groups first deliberated separately, and then worked together, to form a consensus over prioritizing policy measures associated with their separate visions of the municipality in 2060. We then analyzed deliberation and consensus-building processes used and observed a stark contrast in deliberation styles and priorities between the groups. For example, imaginary future-generation-group measures were primarily characterized by utilizing existing local resources, while the present-generation groups aimed more at solving current problems. Notably, the consensus-building processes resulted in choosing more than half of the measures originally proposed by the imaginary future-generation groups, thereby indicating that decision-making preferences had shifted to future generations. We contend that our approach, which is based on introducing imaginary future-generation groups as stakeholders, could provide indicators towards coping with intergenerational conflicts via present-day decision-making processes.

Occupational health physicians' interventions based on the decision-making process for corporate health policies and company-employee needs: An exploratory study

The topic of occupational health physicians' specific interventions for deciding on corporate health measures has not been researched. Such interventions are necessary in corporate decision-making and for considering the needs of the company and its employees. We examined the aspects and methods of occupational health services that facilitate corporate decision-making regarding health measures. We conducted semi-structured interviews with 11 certified occupational health physicians involved in the planning of health measures at 10 companies. Data were analyzed qualitatively and inductively using Berelson's content analysis method. We divided 144 items corresponding to the research theme into three categories: organizational decision-making process in health measures, occupational health physician interventions, and complementary factors concerning interventions. The interventions were further categorized as follows: building relationships, promoting mutual understanding; consensus-building process, coordination; visualization company needs based on hypotheses; and integrated planning and proposals. The study identified specific intervention methods of each category. Aspects and methods that facilitate decision-making in occupational health services were as follows: 1) understanding the scope of consensus formation and its impact based on the characteristics of corporate decision-making regarding health measures and premises of decision maker; 2) improving awareness about occupational health by consistently presenting information on occupational health, translating it to be necessary for corporate management. Occupational health professionals, mainly occupational health physicians, are expected to contribute to health policy decisions while utilizing the method clarified in this study.

Re-establishment of post-accident procedures for setting emergency dose limits based on the lessons learned in the 2011 Fukushima nuclear accident.

In response to the accident at the Fukushima Daiichi atomic power plant in 2011, the Ministry of Health, Labor and Welfare issued an exemption ordinance to increase the dose limits for emergency workers temporarily from 100 mSv to 250 mSv from 14 March to 16 December 2011. However, there were many problems with setting and applying the dose limits as well as radiation protection. Based on the lessons learned, in 2015, the Government of Japan deliberated setting emergency radiation protection standards to ensure preparedness for future nuclear emergencies. This paper aims to describe and share the experience gained in that decision-making and social consensus-building process of setting emergency dose limits. It outlines issues relating to the setting and application of emergency dose limits, restricting these to emergency workers and training them accordingly, and mid-to-long-term dose control. When deliberating on emergency dose criteria, the Government of Japan had to harmonize its efforts with international guidance documents and find a way to balance the protection of emergency workers with the prompt implementation of a crisis management plan to maintain control over the nuclear accident. The fact that leading countries have a wide range of emergency dose criteria means that the establishment of emergency dose limits requires not just a scientific basis as prescribed in international documents but also social consensus-building. Further case studies on the decision-making process for setting radiation protection standards in other countries are thus warranted.

Consensus Core Point-of-care Ultrasound Applications for Pediatric Emergency Medicine Training.

Pediatric emergency medicine (PEM) physicians have variably incorporated point-of-care ultrasound (POCUS) into their practice. Prior guidelines describe the scope of POCUS practice for PEM physicians; however, consensus does not yet exist about which applications should be prioritized and taught as fundamental skills for PEM trainees. Members of the PEM POCUS Network (P2Network) conducted a consensus-building process to determine which applications to incorporate into PEM fellowship training. A multinational group of experts in PEM POCUS was recruited from the P2Network and greater PEM POCUS community if they met the following criteria: performed over 1,000 POCUS scans and had at least 3 years of experience teaching POCUS to PEM fellows, were a local academic POCUS leader, or completed a formal PEM POCUS fellowship. Experts rated 60 possible PEM POCUS applications for their importance to include as part of a PEM fellowship curriculum using a modified Delphi consensus-building technique. In round 1, 66 of 92 (72%) participants responded to an e-mail survey of which 48 met expert criteria and completed the survey. Consensus was reached to include 18 items in a PEM fellowship curriculum and to exclude two items. The 40 remaining items and seven additional items were considered in round 2. Thirty-seven of 48 (77%) experts completed round 2 reaching consensus to include three more items and exclude five. The remaining 39 items did not reach consensus for inclusion or exclusion. Experts reached consensus on 21 core POCUS applications to include in PEM fellowship curricula.

The Evolving 5G Case Study in Spectrum Management and Industrial Policy

Even before national governments reach consensus on frequencies for the fifth generation (“5G”) of wireless radio, carriers and equipment manufacturers in the United States tout benefits and scramble to accelerate ready for service dates. Remarkably, most nations meeting a forum organized by the International Telecommunication Union (“ITU”) did not embrace the need to expedite 5G spectrum planning and management. At the 2015 World Radio Conference (“WRC-15”), the United States partially failed to secure consensus support for expanding global spectrum allocations to include more bandwidth near existing allocations in the Ultra High Frequency (“UHF”) band and at extremely high frequencies in both single and double digit GigaHertz. This paper will identify the numerous factors that contributed to the refusal of most nations, including customary allies, to endorse some United States 5G spectrum allocations proposals. Reasons for the lack of shared concerns for timely action include unreasonable expectations about the speed with which the ITU can reach consensus; the lack of full consensus even within the U.S. delegation to WRC 15; inaction by most nations in starting the process for reallocating UHF broadcast television spectrum for terrestrial wireless; the FCC’s incentive auctions that shared revenues with broadcasters; and the absence of an immediate and acute shortage of wireless spectrum in many of the 193 countries participating in the ITU. The paper also will consider whether industrial policies and concerns about cybersecurity also affected strategies and articulated positions at the ITU forum, as well as the likelihood for reaching consensus. More broadly, the paper will assess whether the ITU has become increasingly less able to forge compromises and consensus, particularly when nations consider whether and how to promote national carriers and equipment manufacturers – so-called national heroes — and the duty to safeguard citizens and government agencies from espionage. The paper concludes with recommendations on how governments and the ITU can achieve better and more timely outcomes in the consensus building process.

Guidelines and recommendations for ensuring Good Epidemiological Practice (GEP): a guideline developed by the German Society for Epidemiology

ObjectiveTo revise the German guidelines and recommendations for ensuring Good Epidemiological Practice (GEP) that were developed in 1999 by the German Society for Epidemiology (DGEpi), evaluated and revised in 2004, supplemented in 2008, and updated in 2014.MethodsThe executive board of the DGEpi tasked the third revision of the GEP. The revision was arrived as a result of a consensus-building process by a working group of the DGEpi in collaboration with other working groups of the DGEpi and with the German Association for Medical Informatics, Biometry and Epidemiology, the German Society of Social Medicine and Prevention (DGSMP), the German Region of the International Biometric Society (IBS-DR), the German Technology, Methods and Infrastructure for Networked Medical Research (TMF), and the German Network for Health Services Research (DNVF). The GEP also refers to related German Good Practice documents (e.g. Health Reporting, Cartographical Practice in the Healthcare System, Secondary Data Analysis).ResultsThe working group modified the 11 guidelines (after revision: 1 ethics, 2 research question, 3 study protocol and manual of operations, 4 data protection, 5 sample banks, 6 quality assurance, 7 data storage and documentation, 8 analysis of epidemiological data, 9 contractual framework, 10 interpretation and scientific publication, 11 communication and public health) and modified and supplemented the related recommendations. All participating scientific professional associations adopted the revised GEP.ConclusionsThe revised GEP are addressed to everyone involved in the planning, preparation, execution, analysis, and evaluation of epidemiological research, as well as research institutes and funding bodies.

Curated Collections for Educators: Eight Key Papers about Feedback in Medical Education.

Feedback is an essential part of learning, growth, and academic success. Junior faculty members are often unfamiliar with the grounding literature that defines feedback. Many times they receive little education on providing and receiving feedback, resulting in unhelpful “feedback” for both learners and program leadership alike. This article aims to summarize eight key papers on feedback, to outline relevant information for emerging clinician educators, and identify ways to use these resources for the faculty development. In order to generate a list of key papers that describes the importance and significance of feedback, the authors conducted a consensus-building process to identify the top papers. In August and September, 2018, the 2018-2019 Academic Life in Emergency Medicine (ALiEM) Faculty Incubator program discussed the topic of feedback in medical education. A number of papers on the topic was highlighted. This list of papers was further augmented using the suggestions and expertise of guest experts who are leaders in the field of medical education and feedback. The authors also used social media to conduct an open call on Twitter for important papers regarding feedback (utilizing #meded, #Feedback hashtags). Via this process, a list of 88 key papers was identified on the topic of feedback in medical education. After compiling these papers, the authorship group engaged in a modified Delphi approach to build consensus on the top eight papers on feedback. These papers were deemed essential by the authors and have been summarized with respect to their relevance to junior faculty members and to faculty developers.In this manuscript, we present eight key papers addressing feedback in medical education with discussions and applications for junior faculty members and faculty developers. This list of articles that can serve to help junior clinician educators grow in their ability to give effective feedback and also serve as resources upon which senior faculty can design the faculty development sessions.

The Shared Principles of Primary Care: A Multistakeholder Initiative to Find a Common Voice.

As America's health care system continues to transform, the foundational importance of primary care becomes more clear. The Joint Principles of the Patient Centered Medical Home are now more than a decade old. As delivery reform continues, the importance of seven essential shared principles have emerged from a dynamic, collaborative, and iterative process of consensus building across multiple stakeholders. These seven principles will help the public, policy makers, payers, physicians, and other clinical providers speak with a unified voice about these core principles that define the enduring essence and value of primary care. The seven shared principles of primary care consist of: (1) person and family centered, (2) continuous, (3) comprehensive and equitable, (4) team based and collaborative, (5) coordinated and integrated, (6) accessible, and (7) high value. When used together, these shared principles provide a solid platform on which to build all further health care reform.