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Today's physician education system produces trained doctors with strong scientific underpinnings in biological and physical sciences as well as supervised practical experience in delivering care. Significant financial public support underlies the graduate-level training of the nation's physicians. Two federal programs-Medicare and Medicaid-distribute billions each year to support teaching hospitals and other training sites that provide graduate medical education. Graduate Medical Education That Meets the Nation's Health Needs is an independent review of the goals, governance, and financing of the graduate medical education system. This report focuses on the extent to which the current system supports or creates barriers to producing a physician workforce ready to provide high-quality, patient-centered, and affordable health care and identifies opportunities to maximize the leverage of federal funding toward these goals. Graduate Medical Education examines the residency pipeline, geographic distribution of generalist and specialist clinicians, types of training sites, and roles of teaching and academic health centers. The recommendations of Graduate Medical Education will contribute to the production of a better prepared physician workforce, innovative graduate medical education programs, transparency and accountability in programs, and stronger planning and oversight of the use of public funds to support training. Teaching hospitals, funders, policy makers, institutions, and health care organizations will use this report as a resource to assess and improve the graduate medical education system in the United States.

In 2006 the National Institutes of Health (NIH) established the Clinical and Translational Science Awards (CTSA) Program, recognizing the need for a new impetus to encourage clinical and translational research. At the time it was very difficult to translate basic and clinical research into clinical and community practice; making it difficult for individual patients and communities to receive its benefits. Since its creation the CTSA Program has expanded, with 61 sites spread across the nation's academic health centers and other institutions, hoping to provide catalysts and test beds for policies and practices that can benefit clinical and translation research organizations throughout the country. The NIH contracted with the Institute of Medicine (IOM) in 2012 to conduct a study to assess and provide recommendations on appropriateness of the CTSA Program's mission and strategic goals and whether changes were needed. The study was also address the implementation of the program by the National Center for Advancing Translational Sciences (NCATS) while exploring the CTSA's contributions in the acceleration of the development of new therapeutics. A 13-member committee was established to head this task; the committee had collective expertise in community outreach and engagement, public health and health policy, bioethics, education and training, pharmaceutical research and development, program evaluation, clinical and biomedical research, and child health research. The CTSA Program at NIH: Opportunities for Advancing Clinical and Translational Research is the result of investigations into previous program evaluations and assessments, open-session meetings and conference class, and the review of scientific literature. Overall, the committee believes that the CTSA Program is significant to the advancement of clinical and translational research through its contributions. The Program would benefit from a variety of revisions, however, to make it more efficient and effective.

Drawing on New Testament studies and recent scholarship on the expansion of the Christian church, Gary B. Ferngren presents a comprehensive historical account of medicine and medical philanthropy in the first five centuries of the Christian era. Ferngren first describes how early Christians understood disease. He examines the relationship of early Christian medicine to the natural and supernatural modes of healing found in the Bible. Despite biblical accounts of demonic possession and miraculous healing, Ferngren argues that early Christians generally accepted naturalistic assumptions about disease and cared for the sick with medical knowledge gleaned from the Greeks and Romans. Ferngren also explores the origins of medical philanthropy in the early Christian church. Rather than viewing illness as punishment for sins, early Christians believed that the sick deserved both medical assistance and compassion. Even as they were being persecuted, Christians cared for the sick within and outside of their community. Their long experience in medical charity led to the creation of the first hospitals, a singular Christian contribution to health care.

Biological systems have always inspired mankind in the creation of new systems and technologies.In recent years the interface between the biological and non-biological worlds appears increasingly blurred due to significant advances both in our understanding of biological phenomena, as well as the development of sophisticated means to manipulate.

Data sharing can accelerate new discoveries by avoiding duplicative trials, stimulating new ideas for research, and enabling the maximal scientific knowledge and benefits to be gained from the efforts of clinical trial participants and investigators. At the same time, sharing clinical trial data presents risks, burdens, and challenges. These include the need to protect the privacy and honor the consent of clinical trial participants; safeguard the legitimate economic interests of sponsors; and guard against invalid secondary analyses, which could undermine trust in clinical trials or otherwise harm public health. Sharing Clinical Trial Data presents activities and strategies for the responsible sharing of clinical trial data. With the goal of increasing scientific knowledge to lead to better therapies for patients, this book identifies guiding principles and makes recommendations to maximize the benefits and minimize risks. This report offers guidance on the types of clinical trial data available at different points in the process, the points in the process at which each type of data should be shared, methods for sharing data, what groups should have access to data, and future knowledge and infrastructure needs. Responsible sharing of clinical trial data will allow other investigators to replicate published findings and carry out additional analyses, strengthen the evidence base for regulatory and clinical decisions, and increase the scientific knowledge gained from investments by the funders of clinical trials. The recommendations of Sharing Clinical Trial Data will be useful both now and well into the future as improved sharing of data leads to a stronger evidence base for treatment. This book will be of interest to stakeholders across the spectrum of research-from funders, to researchers, to journals, to physicians, and ultimately, to patients.

Interprofessional teamwork and collaborative practice are emerging as key elements of efficient and productive work in promoting health and treating patients. The vision for these collaborations is one where different health and/or social professionals share a team identity and work closely together to solve problems and improve delivery of care. Although the value of interprofessional education (IPE) has been embraced around the world - particularly for its impact on learning - many in leadership positions have questioned how IPE affects patent, population, and health system outcomes. This question cannot be fully answered without well-designed studies, and these studies cannot be conducted without an understanding of the methods and measurements needed to conduct such an analysis. This Institute of Medicine report examines ways to measure the impacts of IPE on collaborative practice and health and system outcomes. According to this report, it is possible to link the learning process with downstream person or population directed outcomes through thoughtful, well-designed studies of the association between IPE and collaborative behavior. Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes describes the research needed to strengthen the evidence base for IPE outcomes. Additionally, this report presents a conceptual model for evaluating IPE that could be adapted to particular settings in which it is applied. Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes addresses the current lack of broadly applicable measures of collaborative behavior and makes recommendations for resource commitments from interprofessional stakeholders, funders, and policy makers to advance the study of IPE.

While the prevalence of plastics and elastomers in medical devices is now quite well known, there is less information available covering the use of medical devices and the applications of polymers beyond medical devices, such as in hydrogels, biopolymers and silicones beyond enhancement applications, and few books in which these are combined into a single reference. This book is a comprehensive reference source, bringing together a number of key medical polymer topics in one place for a broad audience of engineers and scientists, especially those currently developing new medical devices or seeking more information about current and future applications. In addition to a broad range of applications, the book also covers clinical outcomes and complications arising from the use of the polymers in the body, giving engineers a vital insight into the real world implications of the devices they're creating. Regulatory issues are also covered in detail. The book also presents the latest developments on the use of polymers in medicine and development of nano-scale devices.

Resumen: Evidence-based medicine (EBM) has become a required element of clinical practice, but it is critical for the healthcare community to understand the ongoing controversy surrounding EBM. Seeking to address questions raised by critics, The Philosophy of Evidence-based Medicine challenges the over dependency of EBM on randomized controlled trials. This book also explores EBM methodology and its relationship with other approaches used in medicine.

Simulated Patient Methodology is a timely book, aimed at health professional educators and Simulated Patient (SP) practitioners. It connects theory and evidence with practice to ensure maximum benefit for those involved in SP programmes, in order to inform practice and promote innovation. The book provides a unique, contemporary, global overview of SP practice, for all health sciences educators. Simulated Patient Methodology: • Provides a cross-disciplinary overview of the field • Considers practical issues such as recruiting and training simulated patients, and the financial planning of SP programmes • Features case studies, illustrating theory in practice, drawn from across health professions and countries, to ensure relevance to localised contexts Written by world leaders in the field, this invaluable resource summarises the theoretical and practical basis of all human-based simulation methodologies.

Often the switch to telecare-technology used to help caretakers provide treatment to their patients off-site-is portrayed as either a nightmare scenario or a much needed panacea for all our healthcare woes. This widely researched study probes what happens when technologies are used to provide healthcare at a distance. Drawing on ethnographic studies of both patients and nurses involved in telecare, Jeannette Pols demonstrates that instead of resulting in less intensive care for patients, there is instead a staggering rise in the frequency of contact between nursing staff and their patients.Care at a Distancetakes the theoretical framework of telecare and provides hard data about these innovative care practices, while producing an accurate portrayal of the pros and cons of telecare.