Research Interests: Long Term Care, Qualitative Research, Medicine, Thematic Analysis, Chronic disease management, and 15 moreNarration, Humans, Chronic Disease, Female, Male, Young Adult, Patient Centred Care, Longitudinal Studies, Adult, Public health systems and services research, Longitudinal Study, Patient Centered Care, Continuity of Patient Care, Clinical clerkship, and Patient discharge
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A newborn infant who developed a vesicular eruption, clinically indistinguishable from herpetic lesions, eventually developed the classic features of Job's syndrome. The initial ares of involvement included the hands and feet,... more
A newborn infant who developed a vesicular eruption, clinically indistinguishable from herpetic lesions, eventually developed the classic features of Job's syndrome. The initial ares of involvement included the hands and feet, then the scalp, face, and suprapubic skin. The clear, tense vesicles varied only slightly in size and appeared as isolated, grouped, or confluent lesions on inflamed skin. Many eventually became umbilicated. The more typical eczematous component appeared over the course of the next several months. Although the child initially had an elevated white blood cell count and eosinophilia, his IgE level did not become dramatically elevated until after 1 year of age. Job's syndrome should be considered as part of the differential diagnosis of a vesicular eruption in the newborn.
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Research Interests: Primary Care, Decision Making, Medical Education, Accreditation, Medicine, and 11 moreCurriculum, Clinical Practice, INTENSIVE CARE, Graduate medical education, Qualitative Analysis, IT Education, Public health systems and services research, Mandate, Online Continuing Medical Education, Training Program, and ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION
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Histiocytosis X is a disorder of histiocytes of the Langerhans' cell lineage. As the initial feature is often cutaneous, recognition of these skin changes is important. Several cutaneous manifestations have been described, most... more
Histiocytosis X is a disorder of histiocytes of the Langerhans' cell lineage. As the initial feature is often cutaneous, recognition of these skin changes is important. Several cutaneous manifestations have been described, most commonly, seborrheic dermatitis with a hemorrhagic component. We saw two patients with histiocytosis X with cutaneous manifestations resembling cherry angiomas.
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Research Interests: Graduate Education, Medical Education, Global Health, Singapore, International Cooperation, and 13 moreMedicine, Curriculum, Humans, Program Development, North Carolina, Undergraduate medical education, Academic Medicine, Educational Models, Curriculum and Pedagogy, Medical School, Academic, Internet, and Schools Medical
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Chronic cough in children is a frequent complaint seen by the primary health care provider. Although many of these coughs spontaneously resolve, some are caused by a more serious process and require further attention. Selecting those... more
Chronic cough in children is a frequent complaint seen by the primary health care provider. Although many of these coughs spontaneously resolve, some are caused by a more serious process and require further attention. Selecting those patients who will benefit from a more extensive evaluation can be a difficult challenge. An overview is provided that emphasizes a systematic approach to the diagnosis and management of chronic cough.
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Books for the general physician who encounters children with difficult diagnoses and management problems are few, but in great demand. The major pediatric textbooks emphasize individual diseases rather than problems of diagnosis and... more
Books for the general physician who encounters children with difficult diagnoses and management problems are few, but in great demand. The major pediatric textbooks emphasize individual diseases rather than problems of diagnosis and management. This book attempts to fill that void. The book is divided into two sections. We are told that the first section deals with approaches to evaluations of common problems and that the second section deals with specific disease entities that are difficult to diagnose or to distinguish from similar disorders. I was confused by exactly how each chapter was chosen for one section vs the other, and, therefore, this division into two sections did not help organize the book for me. Nevertheless, each chapter easily stands by itself. The book discusses a broad spectrum of disease categories, but as Stockman warns in his introduction, the list can hardly be comprehensive. While reading each chapter, it seemed
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Research Interests: Pediatrics, Primary Care, Family Medicine, Medical Education, Job Satisfaction, and 12 moreAccreditation, Medicine, Humans, San Francisco, Graduate medical education, Pilot Projects, Continuity of Patient Care, Working Hours, personnel staffing and scheduling, internship and residency, Community health services, and Paediatrics and reproductive medicine
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Introduction: The Academic Medicine Education Institute (AM∙EI), jointly established by Duke-NUS Graduate Medical School (Duke-NUS) and Singapore Healthcare Services (SingHealth), is a newly formed health professions education academy... more
Introduction: The Academic Medicine Education Institute (AM∙EI), jointly established by Duke-NUS Graduate Medical School (Duke-NUS) and Singapore Healthcare Services (SingHealth), is a newly formed health professions education academy designed to cultivate best education practices and create a community of health professions educators. To achieve the aims of AM∙EI, the needs of SingHealth educators have to be understood. Therefore, this study was carried out to assess educators’ perceptions towards the current education climate and their academic needs. Materials and Methods: A 28-item questionnaire consisting of free-response, Likert-type and ranking questions was developed. The questionnaire was electronically distributed to 200 medical and nursing educators, and made available to attendees of the 2012 Singhealth Duke-NUS Scientific Congress through hardcopies. Results: A total of 150 completed questionnaires were received (94 from electronic survey and 56 from Congress). Five the...
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1.Pediatric Health Supervision, Kim J. Overby 2.Adolescence, William Adelman and Jonathan Ellen 3.Developmental & Behavioral Pediatrics, Daniel L. Coury 4.The Perinatal Period, Augusto Sola, Marta R. Rogido, and John Colin Partridge 5.An... more
1.Pediatric Health Supervision, Kim J. Overby 2.Adolescence, William Adelman and Jonathan Ellen 3.Developmental & Behavioral Pediatrics, Daniel L. Coury 4.The Perinatal Period, Augusto Sola, Marta R. Rogido, and John Colin Partridge 5.An Approach to Clinical Genetics, Cynthia R. Curry 6.A Clinical Approach to Inborn Errors of Metabolism, John Christodoulou 7. Immunologic Disorders, Anna Huttenlocher and Diane Wara 8.Rheumatic Diseases, Mary Denise Moore 9.Infectious Diseases, Allan S. Lau, Alan Uba, and Deborah Lehman 10.Injuries & Emergencies, Joel A. Fein, Dennis R. Durbin, and Steven M. Selbst 11.Skin, Judith V. Williams, Sheila Fallon Friedlander, and Lawrence F. Eichenfield 12.The Gastrointestinal Tract & Liver, Donald Wayne Laney, Jr. 13.Blood, Caroline A. Hastings and Bertram H. Lubin 14.Cancer in Children, Daniel C. West 15.Kidneys & Electrolytes, Anthony A. Portale, Robert S. Mathias, Donald E. Potter, and David r. Rozansky 16.Circulation, Michael M. Brook, Phillip Moore, a...
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Research Interests: Psychology, Perception, Epidemiology, Medical Education, Singapore, and 15 moreAutonomy, Procedures, Medicine, Human, Humans, Burnout, Organization and Management, Psychological Resilience, Mentors, Mentor, Medical School, Medical Student, Prevention and Control, Statistics and numerical data, and Resilience Psychological
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To identify the factors associated with medical students' clinical reasoning (CR) use and evidence-based medicine (EBM) use in the clinical setting. Our cross-sectional study surveyed 44 final-year medical students at an emerging... more
To identify the factors associated with medical students' clinical reasoning (CR) use and evidence-based medicine (EBM) use in the clinical setting. Our cross-sectional study surveyed 44 final-year medical students at an emerging academic medical center in Singapore. We queried the students' EBM and CR value and experiences in the classroom and clinical settings. We compared this to their perceptions of supervisors' value and experiences using t-tests. We developed measures of teaching culture and practice culture by combining relevant questions into summary scores. Multivariate linear regression models were applied to identify factors associated with the students' CR and EBM clinical use. Eighty-nine percent of students responded (n=39). Students reported valuing CR (p=0.03) and EBM (p=0.001) more than their supervisors, but practiced these skills similarly (p=0.83; p=0.82). Clinical practice culture and classroom CR experience were independently associated with stu...
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Background and Purposes: In response to the new Accreditation Council for Graduate Medical Education (ACGME) mandate for residency programs to use feedback to improve its educational program, we piloted a novel evaluation strategy of a... more
Background and Purposes: In response to the new Accreditation Council for Graduate Medical Education (ACGME) mandate for residency programs to use feedback to improve its educational program, we piloted a novel evaluation strategy of a residency program using structured interviews of resident graduates working in a primary care practice and their physician associates. Methods: A research assistant performed a structured telephone interview. Quantitative data assessing the graduate's self-assessment and the graduate's clinical practice by the associate were analyzed. In addition, we performed a qualitative analysis of the interviews. Results: Thirteen resident graduates in primary care practice and seven physician practice associates participated in the study. Graduate self-assessment revealed high satisfaction with their residency training and competency. The associates judged our graduates as highly competent and mentioned independent decision-making and strong interpersonal skills (such as teamwork and communication) as important. They specifically cited the graduate's skills in intensive care medicine and adolescent medicine as well as communication and teamwork skills as important contributions to their practice. Conclusions: The ACGME Outcomes Project, which increases the emphasis on educational outcomes in the accreditation of residency education programs, requires programs to provide evidence of its effectiveness in preparing residents for practice. Direct assessment of the competency of our physician graduates in practice using structured interviews of graduates and their practice associates provide useful feedback information to a residency program as part of a comprehensive evaluation plan of our program's curriculum and can be used to direct future educational initiatives of our training program
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Following the movement toward globalization by patients, providers, and healthcare institutions, the era of borderless medical education programs has finally arrived. Some well-known United States medical schools recently have established... more
Following the movement toward globalization by patients, providers, and healthcare institutions, the era of borderless medical education programs has finally arrived. Some well-known United States medical schools recently have established medical education programs overseas, while several others are currently being planned. This article describes three adaptations of the standard American medical education model outside the United States. The reports from these institutions demonstrate that such adaptation into diverse cultures has been successful and that they are currently graduating medical doctors meeting highest international standards. While methodology and innovations of these institutions differ, they share common objectives of producing high quality graduates comparable to United States medical graduates based on standardized assessments.
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A newborn infant who developed a vesicular eruption, clinically indistinguishable from herpetic lesions, eventually developed the classic features of Job's syndrome. The initial ares of involvement included the hands and feet,... more
A newborn infant who developed a vesicular eruption, clinically indistinguishable from herpetic lesions, eventually developed the classic features of Job's syndrome. The initial ares of involvement included the hands and feet, then the scalp, face, and suprapubic skin. The clear, tense vesicles varied only slightly in size and appeared as isolated, grouped, or confluent lesions on inflamed skin. Many eventually became umbilicated. The more typical eczematous component appeared over the course of the next several months. Although the child initially had an elevated white blood cell count and eosinophilia, his IgE level did not become dramatically elevated until after 1 year of age. Job's syndrome should be considered as part of the differential diagnosis of a vesicular eruption in the newborn.
Research Interests:
Histiocytosis X is a disorder of histiocytes of the Langerhans' cell lineage. As the initial feature is often cutaneous, recognition of these skin changes is important. Several cutaneous manifestations have been described, most... more
Histiocytosis X is a disorder of histiocytes of the Langerhans' cell lineage. As the initial feature is often cutaneous, recognition of these skin changes is important. Several cutaneous manifestations have been described, most commonly, seborrheic dermatitis with a hemorrhagic component. We saw two patients with histiocytosis X with cutaneous manifestations resembling cherry angiomas.
Research Interests:
Research Interests: Long Term Care, Qualitative Research, Medicine, Thematic Analysis, Chronic disease management, and 15 moreNarration, Humans, Chronic Disease, Female, Male, Young Adult, Patient Centred Care, Longitudinal Studies, Adult, Public health systems and services research, Longitudinal Study, Patient Centered Care, Continuity of Patient Care, Clinical clerkship, and Patient discharge
Research Interests: Primary Care, Decision Making, Medical Education, Accreditation, Medicine, and 11 moreCurriculum, Clinical Practice, INTENSIVE CARE, Graduate medical education, Qualitative Analysis, IT Education, Public health systems and services research, Mandate, Online Continuing Medical Education, Training Program, and ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION
Research Interests:
Books for the general physician who encounters children with difficult diagnoses and management problems are few, but in great demand. The major pediatric textbooks emphasize individual diseases rather than problems of diagnosis and... more
Books for the general physician who encounters children with difficult diagnoses and management problems are few, but in great demand. The major pediatric textbooks emphasize individual diseases rather than problems of diagnosis and management. This book attempts to fill that void. The book is divided into two sections. We are told that the first section deals with approaches to evaluations of common problems and that the second section deals with specific disease entities that are difficult to diagnose or to distinguish from similar disorders. I was confused by exactly how each chapter was chosen for one section vs the other, and, therefore, this division into two sections did not help organize the book for me. Nevertheless, each chapter easily stands by itself. The book discusses a broad spectrum of disease categories, but as Stockman warns in his introduction, the list can hardly be comprehensive. While reading each chapter, it seemed
Research Interests:
Research Interests:
Research Interests: Pediatrics, Primary Care, Family Medicine, Medical Education, Job Satisfaction, and 12 moreAccreditation, Medicine, Humans, San Francisco, Graduate medical education, Pilot Projects, Continuity of Patient Care, Working Hours, personnel staffing and scheduling, internship and residency, Community health services, and Paediatrics and reproductive medicine
Research Interests: Graduate Education, Medical Education, Global Health, Singapore, International Cooperation, and 13 moreMedicine, Curriculum, Humans, Program Development, North Carolina, Undergraduate medical education, Academic Medicine, Educational Models, Curriculum and Pedagogy, Medical School, Academic, Internet, and Schools Medical
To evaluate the Flexible Option (FO), a residency training schedule offered by the University of California, San Francisco, Pediatric Residency Program. In 2002, structured telephone interviews were conducted with residents who... more
To evaluate the Flexible Option (FO), a residency training schedule offered by the University of California, San Francisco, Pediatric Residency Program. In 2002, structured telephone interviews were conducted with residents who participated in the FO between 1992 and 2002. Twenty-four of the 284 pediatrics residents during this time participated in the FO. Descriptive interview data were analyzed. A Web-based questionnaire was sent to 72 regularly scheduled (RS) residents at the end of 2001-02. FO and RS residents' specialty board performances were compared. Twenty-one FO residents participated in the telephone interviews. The majority reported that the FO was critical to their success as residents. Most requested the FO for personal and family reasons; over 40% would otherwise have requested leaves from the residency. The most common perceived disadvantages were delay in graduation and financial concerns. Forty-two RS residents completed the online questionnaire. Seventeen percent considered the FO an important factor in program selection; 43% had considered participating in the FO. Seventy-nine percent felt that the FO had a positive effect on the general morale of the program. RS residents perceived that the FO increased workload (43%) and created scheduling problems (52%). However, 88% of RS residents encouraged the program to continue offering the FO. Specialty board scores were similar across FO and RS residents. Participants perceived that the FO's advantages outweighed the disadvantages. There were no concerning academic disadvantages identified in FO participants. Wide-spread support was found throughout the residency program to sustain the FO. More residency programs should consider creating and offering flexible scheduling options.