Medical Students' Acquisition of Adolescent Interview Skills after Coached Role Play.

STUDY OBJECTIVE: To develop and evaluate an educational activity designed to teach the adolescent Home, Education and employment, Eating, Activities, Drugs, Sexuality, Suicide/depression, and Safety (HEADS) examination. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Participants were third-year medical students in their pediatric clerkships. Students received an article on the HEADS interview and attended an adolescent medicine educational session. The session included individualized goal-setting and coached role play. Students' skills in doing a HEADS interview were evaluated through a standardized patient encounter (SPE) with a checklist and a retrospective pre- and post-test survey. The SPE checklist was used to assess whether the students included questions in 6 key areas of a HEADS interview. RESULTS: One hundred fifty-two students participated. During the SPE, 90% of students queried the adolescent's home life, 91% education, 82% activities, 84% drug/substance abuse, 95% sexual history, and 61% symptoms of depression. Pre- and postintervention data were compared using the Kruskal-Wallis Test and showed a statistically significant difference in the students' ability to list key topic areas of the HEADS exam (P < .001) and to use the skills needed for an adolescent interview using the HEADS exam (P < .001). CONCLUSION: After an introduction to the HEADS examination, most students covered almost all of the topic areas of this screening interview during a SPE. Only three-fifths of the students, however, included questions about symptoms of depression. Coached role play with goal-setting facilitated effective learning of this approach to adolescent interviewing.

Development of a model web-based system to support a statewide quality consortium in radiation oncology.

PURPOSE: A database in which patient data are compiled allows analytic opportunities for continuous improvements in treatment quality and comparative effectiveness research. We describe the development of a novel, web-based system that supports the collection of complex radiation treatment planning information from centers that use diverse techniques, software, and hardware for radiation oncology care in a statewide quality collaborative, the Michigan Radiation Oncology Quality Consortium (MROQC). METHODS AND MATERIALS: The MROQC database seeks to enable assessment of physician- and patient-reported outcomes and quality improvement as a function of treatment planning and delivery techniques for breast and lung cancer patients. We created tools to collect anonymized data based on all plans. RESULTS: The MROQC system representing 24 institutions has been successfully deployed in the state of Michigan. Since 2012, dose-volume histogram and Digital Imaging and Communications in Medicine-radiation therapy plan data and information on simulation, planning, and delivery techniques have been collected. Audits indicated >90% accurate data submission and spurred refinements to data collection methodology. CONCLUSIONS: This model web-based system captures detailed, high-quality radiation therapy dosimetry data along with patient- and physician-reported outcomes and clinical data for a radiation therapy collaborative quality initiative. The collaborative nature of the project has been integral to its success. Our methodology can be applied to setting up analogous consortiums and databases.