Monica L Lypson

Concordia University‚ÄďAnn Arbor, Ann Arbor, Michigan, United States

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Publications (58)136.32 Total impact

  • Paula T Ross, Monica L Lypson
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    ABSTRACT: Background: Physician bias toward patients directly impacts patient care and health outcomes. However, too little research has been done investigating avenues to bring about self-awareness in this area to eliminate commonly held stereotypes that fuel physician bias. Purposes: The purpose of this study was to explore the ways in which 2nd-year medical students' reflected on an artistic-narrative presentation given by a woman with sickle cell disease. Methods: A total of 320 2nd-year medical student essays were reviewed for content relevant to the artistic-narrative presentation. A total of 75 essays were identified and served as the data for this study. These 75 essays were analyzed using qualitative interpretive thematic content analysis to identify students' perceptions and reflections on culture in the healthcare environment and the patient-provider relationship. Results: The analysis of the reflective essays revealed that this exercise helped students acknowledge physician bias in pain treatment, foster empathetic views toward patients as individuals, and recognize various ways in which biased beliefs can provide incite in healthcare disparities. Conclusions: These findings suggest that the combination of methods-art, narrative, and written reflection-helped students acknowledge their own bias as well as the ways in which taken-for-granted assumptions and biases can influence patient care.
    Teaching and Learning in Medicine 10/2014; 26(4):344-349. · 0.94 Impact Factor
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    ABSTRACT: Abstract Objectives: Determine postgraduate first-year (PGY-1) trainees ability to perform patient care handoffs and associated medical school training. Methods: About 173 incoming PGY-1 trainees completed an OSCE handoff station and a survey eliciting their training and confidence in conducting handoffs. Independent t-tests compared OSCE performance of trainees who reported receiving handoff training to those who had not. Analysis of variance examined differences in performance based on prior handoff instruction and across levels of self-assessed abilities, with significance set at p < 0.05. Results: About 35% of trainees reported receiving instruction and 51% reported receiving feedback about their handoff performance in medical school. Mean handoff performance score was 69.5%. Trainees who received instruction or feedback during medical school had higher total and component handoff performance scores (p < 0.05); they were also more confident in their handoff abilities (p < 0.001). Trainees with higher self-assessed skills and preparedness performed better on the OSCE (p < 0.05). Conclusions: This study provides evidence that incoming trainees are not well prepared to perform handoffs. However, those who received instruction during medical school perform better and are more confident on standardized performance assessments. Given communication failures lead to uncertainty in patient care and increases in medical errors, medical schools should incorporate handoff training as required instruction.
    Medical Teacher 08/2014; · 1.82 Impact Factor
  • Rachel L Perlman, Paula T Ross, Monica L Lypson
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    ABSTRACT: Physicians and their spouses experience challenges to their relationships, some of which are shared with the general population and others of which are unique to the field of medicine. Trainees and junior faculty members remain curious about how they will balance their careers alongside marriage and family obligations. This study explores the challenges and strengths of dual- and single-physician relationships.
    Academic medicine: journal of the Association of American Medical Colleges 08/2014; · 2.34 Impact Factor
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    ABSTRACT: Nearly half of graduating medical students in the United States report that medical school provides inadequate instruction in topics related to health policy. Although most medical schools report some form of policy education, there lacks a standard for teaching core concepts and evaluating student satisfaction.
    Academic medicine: journal of the Association of American Medical Colleges 07/2014; · 2.34 Impact Factor
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    ABSTRACT: Despite increasing radiology coverage, nonradiology residents continue to preliminarily interpret basic radiologic studies independently, yet their ability to do so accurately is not routinely assessed.
    Academic radiology. 07/2014; 21(7):909-15.
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    ABSTRACT: Portfolios are emerging as a tool for documenting learning progression and assessing competency. ePortfolios are appealing as a portable and fluid means of documenting both learning and relevant experiences in a large number of students. Competence and learning can be especially difficult to document in important aspects of education and training, such as patient-centeredness, the cultural context of disease, and social determinants of health that do not lend themselves to fact-based assessment methods. Successful implementation of a method such as an ePortfolio requires explicit faculty development, as many faculty members have limited expertise with modern educational assessment technology. As part of the authors' introduction of a Sociocultural ePortfolio Assessment Tool in the undergraduate medical curriculum, three faculty development workshops were held to expand faculty skills in using this technology. In addition to gaining comfort using a new Web-based technology, faculty members also needed to develop skills with providing mentored feedback and stimulating student reflection. Workshops were modeled after other successful programs reported in the literature and allowed faculty to develop a structured format for evaluating student content. Faculty members were given multiple opportunities to practice their newly developed skills providing mentored reflections using an ePortfolio. The workshop evaluations were positive, suggesting that faculty participation in the workshops were a necessary component for them to develop sufficient assessment skills for providing mentored reflection. Faculty members who participated in this program-whether or not they had content expertise in sociocultural medicine-valued the hands-on faculty development program.
    Academic medicine: journal of the Association of American Medical Colleges 12/2013; · 2.34 Impact Factor
  • Paul Dougherty, Paula T Ross, Monica L Lypson
    Journal of graduate medical education. 12/2013; 5(4):701-2.
  • Medical Education 11/2013; 47(11):1126-1127. · 3.55 Impact Factor
  • Monica L Lypson, Ingrid Philibert
    Academic medicine: journal of the Association of American Medical Colleges 10/2013; 88(10):1404. · 2.34 Impact Factor
  • Journal of graduate medical education. 09/2013; 5(3):515-516.
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    ABSTRACT: Soaring costs of health care, patients living longer with chronic illnesses, and continued attrition of interest in primary care contribute to the urgency of developing an improved model of health care delivery. Out of this need, the concept of the team-based, patient-centered medical home (PCMH) has developed. Amidst implementation in academic settings, clinical teachers face complex challenges not previously encountered: teaching while simultaneously learning about the PCMH model, redesigning clinical delivery systems while simultaneously delivering care within them, and working more closely in expanded interprofessional teams.To address these challenges, the authors reviewed three existing faculty development models and recommended four important adaptations for preparing clinical teachers for their roles as system change agents and facilitators of learning in these new settings. First, many faculty find themselves in the awkward position of teaching concepts they have yet to master themselves. Professional development programs must recognize that, at least initially, health professions learners and faculty will be learning system redesign content and skills together while practicing in the evolving workplace. Second, all care delivery team members influence learning in the workplace. Thus, the definition of faculty must expand to include nurses, pharmacists, social workers, medical assistants, patients, and others. These team members will need to accept their roles as educators. Third, learning to deliver health care in teams will require support of both interprofessional collaboration and intraprofessional identity development. Fourth, learning to manage change and uncertainty should be part of the core content of any faculty development program within the PCMH.
    Academic medicine: journal of the Association of American Medical Colleges 07/2013; · 2.34 Impact Factor
  • Journal of graduate medical education. 06/2013; 5(2):333-334.
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    ABSTRACT: Introduction: The purpose was to evaluate the Bookmark standard-setting method for use on a performance-based assessment in medical education. Methods: We compared cutscores for Aseptic performance assessment using the modified Angoff, Hofstee and modified Bookmark methods. Results: The Angoff produced a cutscore of 62%, SD = 18 and a percent passing (pp) = 64%. The Hofstee cutscore was 71%, SD = 7 and pp = 46%. Bookmark mean cutscores were 65.9% SD = 10.7 and pp = 42% for advanced beginners; 83.6%, SD = 9.2 and pp = 17% for competent and the proficient category resulted in a cutscore of 96.4% SD = 3.9 and pp = 1%. Faculty judges found the Bookmark method to be an easy and acceptable method. Conclusions: The Bookmark method was acceptable to faculty, has reasonable quality metrics when compared to other methods and can be a practical tool for establishing standards in performance-based examinations. The Bookmark method could be useful for establishing multiple levels of competency using the Dreyfus criteria.
    Medical Teacher 04/2013; · 1.82 Impact Factor
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    ABSTRACT: OBJECTIVE: To investigate the influence of participation in a health behavior counseling (HBC) case by examining standardized patients' real-life attitudes and behaviors toward nutrition and physical activity habits. METHODS: Focus group sessions were held with 10 standardized patients who regularly participated in the HBC case. Emergent themes were identified using grounded theory data analysis. RESULTS: Standardized patients reported how participation with role playing in the HBC case prompted personal lifestyle changes. Changes occurred through increased awareness and motivation to make adjustments to health habits, such as exercise and improved food choices. CONCLUSIONS AND IMPLICATIONS: The HBC model can be an effective method for helping patients to recognize the need to take action and implement positive lifestyle changes.
    Journal of nutrition education and behavior. 03/2013;
  • Preeti N Malani, Monica L Lypson
    Journal of graduate medical education. 12/2012; 4(4):541-542.
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    Monica Lypson, Ingrid Philibert
    Journal of graduate medical education. 06/2012; 4(2):138-9.
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    Steven J Kasten, Mark E P Prince, Monica L Lypson
    Journal of graduate medical education. 06/2012; 4(2):257-60.
  • Mitesh S Patel, Matthew M Davis, Monica L Lypson
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    ABSTRACT: National efforts to improve the value of health care must include graduate medical education (GME) if they are to succeed. Proposals to teach residents to provide value-based care have come from the Medicare Payment Advisory Commission (MedPAC), the Accreditation Council for Graduate Medical Education (ACGME) and the American College of Physicians (ACP). Such proposals skip a key step: residency programs currently lack a clear strategy to prepare residents to assess and deliver value-based care. In this article, we present the VALUE Framework for programs to utilize to teach residents to assess and deliver value-based care for their patients. We then present more than 20 opportunities for residency programs to incorporate training in value-based care.
    Journal of General Internal Medicine 05/2012; 27(9):1210-4. · 3.28 Impact Factor
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    ABSTRACT: To characterize national physician organizations' efforts to reduce health disparities and identify organizational characteristics associated with such efforts. This cross-sectional study was conducted between September 2009 and June 2010. The authors used two-sample t tests and chi-square tests to compare the proportion of organizations with disparity-reducing activities between different organizational types (e.g., primary care versus subspecialty organizations, small [<1,000 members] versus large [>5,000 members]). Inclusion criteria required physician organizations to be (1) focused on physicians, (2) national in scope, and (3) membership based. The number of activities per organization ranged from 0 to 22. Approximately half (53%) of organizations had 0 or 1 disparity-reducing activities. Organizational characteristics associated with having at least 1 disparity-reducing effort included membership size (88% of large groups versus 58% of small groups had at least 1 activity; P = .004) and the presence of a health disparities committee (95% versus 59%; P < .001). Primary care (versus subspecialty) organizations and racial/ethnic minority physician organizations were more likely to have disparity-reducing efforts, although findings were not statistically significant. Common themes addressed by activities were health care access, health care disparities, workforce diversity, and language barriers. Common strategies included education of physicians/trainees and patients/general public, position statements, and advocacy. Despite the national priority to eliminate health disparities, more than half of national physician organizations are doing little to address this problem. Primary care and minority physician organizations, and those with disparities committees, may provide leadership to extend the scope of disparity-reduction efforts.
    Academic medicine: journal of the Association of American Medical Colleges 04/2012; 87(6):694-700. · 2.34 Impact Factor
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    ABSTRACT: This study sought to determine the academic and professional outcomes of medical school graduates who failed the United States Licensing Examination Step 1 on the first attempt. This retrospective cohort study was based on pooled data from 2,003 graduates of six Midwestern medical schools in the classes of 1997-2002. Demographic, academic, and career characteristics of graduates who failed Step 1 on the first attempt were compared to graduates who initially passed. Fifty medical school graduates (2.5 %) initially failed Step 1. Compared to graduates who initially passed Step 1, a higher proportion of graduates who initially failed Step 1 became primary care physicians (26/49 [53 %] vs. 766/1,870 [40.9 %]), were more likely at graduation to report intent to practice in underserved areas (28/50 [56 %] vs. 419/1,939 [ 21.6 %]), and more likely to take 5 or more years to graduate (11/50 [22.0 %] vs. 79/1,953 [4.0 %]). The relative risk of first attempt Step 1 failure for medical school graduates was 13.4 for African Americans, 7.4 for Latinos, 3.6 for matriculants >22 years of age, 3.2 for women, and 2.3 for first generation college graduates. The relative risk of not being specialty board certified for those graduates who initially failed Step 1 was 2.2. Our observations regarding characteristics of graduates in our study cohort who initially failed Step 1 can inform efforts by medical schools to identify and assist students who are at particular risk of failing Step 1.
    Advances in Health Sciences Education 04/2012; · 2.06 Impact Factor

Publication Stats

208 Citations
136.32 Total Impact Points

Institutions

  • 2010–2013
    • Concordia University‚ÄďAnn Arbor
      Ann Arbor, Michigan, United States
  • 2011–2012
    • University of Pennsylvania
      • Department of Medicine
      Philadelphia, PA, United States
  • 2002–2011
    • University of Michigan
      • • Department of Health Behavior and Health Education
      • • Department of Urology
      • • Department of Internal Medicine
      Ann Arbor, Michigan, United States