Writing for publication: a workshop to prepare faculty as medical writers.

BACKGROUND AND OBJECTIVES: A 2 1/2-day Writing for Publication Workshop was presented to faculty and fellows for 5 successive years, 1991-1995. This paper describes the workshop curriculum and reports evaluation results. METHODS: A three-part evaluation plan incorporated both quantitative and qualitative methods. First, a nine-item questionnaire was administered to the 1992-1995 participants immediately prior to and after the workshop to identify perceived change in knowledge and skills. Second, a follow-up qualitative interview was administered to the 1991 and 1992 participants to identify their perceptions of the workshop's usefulness. Third, pre- and postworkshop publications of the 1991 and 1992 participants were analyzed to identify types of publications and significant differences in rates of publication. RESULTS: Eighty individuals participated in the five workshops given during the 1991-1995 period. Pre/post self-assessment data indicated significant increases in perceived knowledge and skill in all nine areas of assessment. The follow-up interview data showed that participants felt that the workshop motivated them to begin and sustain writing projects, gave them skills that made their writing more effective, and demystified the submission and publication processes. Analysis of the difference between pre- and postworkshop rates of publication showed a significant increase in the rate of publication. CONCLUSIONS: The evaluation findings indicate that the Writing for Publication Workshop met its educational objectives. Future curricula to prepare faculty as medical writers need to be tested using quasi-experimental designs to determine their impact on publication productivity and quality.

Professional competencies in the changing health care system: physicians' views on the importance and adequacy of formal training in medical school.

PURPOSE: To examine physicians' attitudes toward 16 competencies deemed essential to the effective practice of medicine in the changing health care system. METHOD: In early 1991 a telephone survey was conducted of 300 physicians from random samples selected as representative of the physician population in the continental United States. The physicians were categorized as general practitioners, surgery specialists, and other specialists, and as belonging to the graduation cohorts of 1960-1969, 1970-1979, and 1980-1989. The physicians were asked to rate (1) the importance of formal undergraduate training in each of 16 competencies and (2) the adequacy of their own undergraduate training in the competencies (these ratings are reported only for the 87 physicians in the 1980-1989 cohort). The competencies were derived from the skills, attitudes, and behaviors defined by the Pew Health Professions Commission as necessary for the nation's health care practitioners to meet society's evolving health care needs. RESULTS: Fifty percent or more of the physicians thought that 12 of the 16 competencies were "very important" to include in undergraduate training. Over 75% thought that it was "very important" to include the five competencies involving skills traditionally valued in medical practice: diagnosis and treatment, effective communication with patients, problem solving, lifelong learning, and counseling on medical ethics. More than 50% thought that undergraduate training was "very important" in some competencies that reflect the changing dynamics of medicine and care delivery over the past ten years: health promotion and preventive medicine, involvement of patient and family in care, management of large volumes of information, appropriate use of technology, working on a team with other professionals, and consideration of cost in clinical decision making. In rating their own training, over 50% felt well prepared (ratings of "excellent" or "good") in the five traditional competencies and, in addition, in their abilities to promote health, to manage large volumes of information, to work in teams, to understand and respond to diverse cultures, and to expand access to care. However, a majority felt that their training was only "fair" or "poor" regarding the involvement of patients and their families, evaluation of the appropriateness of costly technology, consideration of cost implications in their decision making, and understanding and supporting the community's role in health care. Forty percent or more felt poorly prepared to work in managed care settings or to accommodate increasing external scrutiny. CONCLUSION: The physicians validated the traditional strengths of medical schools, but revealed curricular weaknesses in the teaching of competencies proposed as important for the emerging health care system, especially in the managed care environment.