What would you like to ask your audience? Enhancing feedback value in PM&R grand rounds through customizable evaluation forms with presenter-generated questions.

BACKGROUND: Feedback and evaluation are important in the professional development of academic physiatrists. Yet, physical medicine and rehabilitation (PM&R) learners giving academic presentations receive limited narrative feedback through generic evaluation forms. OBJECTIVE: To assess whether customizable evaluation forms that integrate a presenter's specific questions would be associated with an increase in quantity and quality of narrative feedback received from the audience. DESIGN: Separate samples pre-post intervention study. SETTING: A large academic PM&R department's grand rounds. PARTICIPANTS: PM&R faculty and trainees attending grand rounds (10-50 attendees with one presenter per session). The study included 20 presentations pre intervention (across 1 year) and 38 presentations post intervention (across about 3 years). INTERVENTION: A customizable evaluation form that integrates a presenter's own questions into a tailored evaluation form comprising both standardized and presenter-built questions. MAIN OUTCOME MEASURE(S): Narrative feedback quantity was defined as the mean percentage and number of evaluation forms per presentation with at least one comment. Narrative feedback quality included three metrics: mean percentage and number of evaluation forms per presentation with comments that (1) contained ≥8 words, (2) referenced something specific, and (3) offered an actionable suggestion. RESULTS: Compared to preintervention, presentations in the postintervention period had a greater mean percentage of evaluation forms containing at least one comment (pre = 33.4%, post =74.7%, p < .001), a comment that contained ≥8 words (pre = 20.2%, post = 44.2%, p < .001), a comment that referenced something specific (pre = 19.6%, post = 55.1%, p < .001), and a comment that offered an actionable suggestion (pre = 10.2%, post = 22.2%, p < .001). CONCLUSIONS: Use of a customizable evaluation form in PM&R grand rounds that integrates a presenter's own questions was associated with a greater mean percentage of evaluation forms containing comments as well as comments meeting quality metrics related to length, specificity, and actionability.

Longitudinal performance of a surgically implanted neuroprosthesis for lower-extremity exercise, standing, and transfers after spinal cord injury.

OBJECTIVE: To investigate the longitudinal performance of a surgically implanted neuroprosthesis for lower-extremity exercise, standing, and transfers after spinal cord injury. DESIGN: Case series. SETTING: Research or outpatient physical therapy departments of 4 academic hospitals. PARTICIPANTS: Subjects (N=15) with thoracic or low cervical level spinal cord injuries who had received the 8-channel neuroprosthesis for exercise and standing. INTERVENTION: After completing rehabilitation with the device, the subjects were discharged to unrestricted home use of the system. A series of assessments were performed before discharge and at a follow-up appointment approximately 1 year later. MAIN OUTCOME MEASURES: Neuroprosthesis usage, maximum standing time, body weight support, knee strength, knee fatigue index, electrode stability, and component survivability. RESULTS: Levels of maximum standing time, body weight support, knee strength, and knee fatigue index were not statistically different from discharge to follow-up (P>.05). Additionally, neuroprosthesis usage was consistent with subjects choosing to use the system on approximately half of the days during each monitoring period. Although the number of hours using the neuroprosthesis remained constant, subjects shifted their usage to more functional standing versus more maintenance exercise, suggesting that the subjects incorporated the neuroprosthesis into their lives. Safety and reliability of the system were demonstrated by electrode stability and a high component survivability rate (>90%). CONCLUSIONS: This group of 15 subjects is the largest cohort of implanted lower-extremity neuroprosthetic exercise and standing system users. The safety and efficiency data from this group, and acceptance of the neuroprosthesis as demonstrated by continued usage, indicate that future efforts toward commercialization of a similar device may be warranted.

Musculoskeletal education in US medical schools: lessons from the past and suggestions for the future.

Despite the prevalence of musculoskeletal disorders in the United States, physicians have received inadequate training during medical school on how to examine, diagnose, and manage these conditions. This article provides an overview of the existing literature on undergraduate medical musculoskeletal education, including learning objectives, researched methodology, and currently utilized assessment tools. A discussion of challenges to and suggested approaches for the implementation of medical school musculoskeletal curricula is presented.