Last data update: Jul 01, 2024. (Total: 47134 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Maeshiro R [original query] |
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Public and population health in U.S. medical education: A review of guidance in extraordinary times
Maeshiro R , Jarris YS , Prunuske J , Carney JK , Strelnick AH , Townsend JM , Krane NK , Johnson SB , Howley LD , Cashman SB , Deyton LR , Ortega LA , Lebwohl B , Fair M . Acad Med 2023 98 (12) 1366-1380 Generations of medical educators have recommended including public and population health (PPH) content in the training of U.S. physicians. The COVID-19 pandemic, structural racism, epidemic gun violence, and the existential threats caused by climate change are currently unsubtle reminders of the essential nature of PPH in medical education and practice. To assess the state of PPH content in medical education, the authors reviewed relevant guidance, including policies, standards, and recommendations from national bodies that represent and oversee medical education for physicians with MD degrees. Findings confirm that guidance across the medical education continuum, from premedical education to continuing professional development, increasingly includes PPH elements that vary in specificity and breadth. Graduate medical education policies present the most comprehensive approach in both primary care and subspecialty fields. Behavioral, quantitative, social, and systems sciences are represented, although not uniformly, in guidance for every phase of training. Quantitative PPH skills are frequently presented in the context of research, but not in relation to the development of population health perspectives (e.g., evidence-based medicine, quality improvement, policy development). The interdependence between governmental public health and medical practice, environmental health, and the impact of structural racism and other systems of oppression on health are urgent concerns, yet are not consistently or explicitly included in curricular guidance. To prepare physicians to meet the health needs of patients and communities, educators should identify and address gaps and inconsistencies in PPH curricula and related guidance. Re-examinations of public health and health care systems in the wake of the COVID-19 pandemic support the importance of PPH in physician training and practice, as physicians can help to bridge clinical and public health systems. This review provides an inventory of existing guidance (presented in the appendices) to assist educators in establishing PPH as an essential foundation of physician training and practice. |
Integration of public health into medical education: an introduction to the supplement
Maeshiro R , Koo D , Keck CW . Am J Prev Med 2011 41 S145-8 Twelve years ago, the Association of American Medical Colleges (AAMC) and the CDC established a formal relationship through a cooperative agreement “to strengthen collaborations between academic medicine and public health.” A consistent focus of cooperative agreement activities has been improving the public health, population health, and prevention aspects of medical education. Historically, these subjects were often omitted from the training of physicians. Contemporary medical educators continue to struggle to secure the time and resources to effectively integrate this content into the curricula, despite the urgent need for physicians with a better appreciation for these issues to help address complex public health challenges that include rising chronic disease burdens, persistent health disparities, and healthcare financing that encourages treatment over prevention. | The cooperative agreement has supported the Regional Medicine–Public Health Education Centers (RMPHECs)1 initiative, an effort to integrate public/population and prevention education into medical school and residency curricula through partnerships with local and state public health agencies and other public health partners, as well as reports focusing on public health topics that have not traditionally been included in medical school curricula.2, 3 To help disseminate the lessons learned by the RMPHEC grantees and to identify other promising efforts, the AAMC and the CDC convened the “Patients and Populations: Public Health in Medical Education” conference in Cleveland, Ohio, on September 14 and 15, 2010. More than 190 medical and public health educators and public health practitioners from the U.S. and Canada gathered to share innovative curricular models and strategies to integrate public health into the continuum of medical education. The papers in this supplement to the American Journal of Preventive Medicine4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33 are based on many of the presentations and discussions that occurred during the conference. |
Student vaccination requirements of U.S. health professional schools: a survey
Lindley MC , Lorick SA , Spinner JR , Krull AR , Mootrey GT , Ahmed F , Myers R , Bednash GP , Cymet TC , Maeshiro R , Raines CF , Shannon SC , Sondheimer HM , Strikas RA . Ann Intern Med 2011 154 (6) 391-400 BACKGROUND: Unvaccinated health care personnel are at increased risk for transmitting vaccine-preventable diseases to their patients. The Advisory Committee on Immunization Practices (ACIP) recommends that health care personnel, including students, receive measles, mumps, rubella, hepatitis B, varicella, influenza, and pertussis vaccines. Prematriculation vaccination requirements of health professional schools represent an early opportunity to ensure that health care personnel receive recommended vaccines. OBJECTIVE: To examine prematriculation vaccination requirements and related policies at selected health professional schools in the United States and compare requirements with current ACIP recommendations. DESIGN: Cross-sectional study using an Internet-based survey. SETTING: Medical and baccalaureate nursing schools in the United States and its territories. PARTICIPANTS: Deans of accredited medical schools granting MD (n = 130) and DO (n = 26) degrees and of baccalaureate nursing programs (n = 603). MEASUREMENTS: Proportion of MD-granting and DO-granting schools and baccalaureate nursing programs that require that entering students receive vaccines recommended by the ACIP for health care personnel. RESULTS: 563 schools (75%) responded. More than 90% of all school types required measles, mumps, rubella, and hepatitis B vaccines for entering students; varicella vaccination also was commonly required. Tetanus, diphtheria, and acellular pertussis vaccination was required by 66%, 70%, and 75% of nursing, MD-granting, and DO-granting schools, respectively. Nursing and DO-granting schools (31% and 45%, respectively) were less likely than MD-granting schools (78%) to offer students influenza vaccines free of charge. LIMITATIONS: Estimates were conservative, because schools that reported that they did not require proof of immunity for a given vaccine were considered not to require that vaccine. Estimates also were restricted to schools that train physicians and nurses. CONCLUSION: The majority of schools now require most ACIP-recommended vaccines for students. Medical and nursing schools should adopt policies on student vaccination and serologic testing that conform to ACIP recommendations and should encourage annual influenza vaccination by offering influenza vaccination to students at no cost. PRIMARY FUNDING SOURCE: None. |
Medical education for a healthier population: reflections on the Flexner Report from a public health perspective
Maeshiro R , Johnson I , Koo D , Parboosingh J , Carney JK , Gesundheit N , Ho ET , Butler-Jones D , Donovan D , Finkelstein JA , Bennett NM , Shore B , McCurdy SA , Novick LF , Velarde LD , Dent MM , Banchoff A , Cohen L . Acad Med 2010 85 (2) 211-9 Abraham Flexner's 1910 report is credited with promoting critical reforms in medical education. Because Flexner advocated scientific rigor and standardization in medical education, his report has been perceived to place little emphasis on the importance of public health in clinical education and training. However, a review of the report reveals that Flexner presciently identified at least three public-health-oriented principles that contributed to his arguments for medical education reform: (1) The training, quality, and quantity of physicians should meet the health needs of the public, (2) physicians have societal obligations to prevent disease and promote health, and medical training should include the breadth of knowledge necessary to meet these obligations, and (3) collaborations between the academic medicine and public health communities result in benefits to both parties. In this article, commemorating the Flexner Centenary, the authors review the progress of U.S. and Canadian medical schools in addressing these principles in the context of contemporary societal health needs, provide an update on recent efforts to address what has long been perceived as a deficit in medical education (inadequate grounding of medical students in public health), and provide new recommendations on how to create important linkages between medical education and public health. Contemporary health challenges that require a public health approach in addition to one-on-one clinical skills include containing epidemics of preventable chronic diseases, reforming the health care system to provide equitable high-quality care to populations, and responding to potential disasters in an increasingly interconnected world. The quantitative skills and contextual knowledge that will prepare physicians to address these and other population health problems constitute the basics of public health and should be included throughout the continuum of medical education. |
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