Dale Berg

University of Alabama at Birmingham, Birmingham, Alabama, United States

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Publications (17)25.28 Total impact

  • Source
    Medical Education 11/2013; 47(11):1129. · 3.55 Impact Factor
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    ABSTRACT: Radial arterial line placement is an invasive procedure that may result in complications. Validated checklists are central to teaching and assessing procedural skills and may result in improved health care quality. The results of the first step of the validation of a radial arterial line placement checklist are described. A comprehensive literature review of articles published on radial arterial line placement did not yield a checklist validated by the Delphi method. A modified Delphi technique, involving a panel of 9 interdisciplinary, interinstitutional experts, was used to develop a radial arterial line placement checklist. The internal consistency coefficient using Cronbach α was .99. Developing a 22-item checklist for teaching and assessing radial arterial line placement is the first step in the validation process. For this checklist to become further validated, it should be implemented and studied in the simulation and clinical environments.
    American Journal of Medical Quality 07/2013; · 1.47 Impact Factor
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    ABSTRACT: Foley catheterization (FC) is known to result in complications. Validated checklists are central to teaching/assessing procedural skills and may result in improved health care quality. The results of the first step of the validation of male and female FC checklists are described. A comprehensive literature review of articles published on FC did not yield a checklist validated by the Delphi method. A modified Delphi technique involving a panel of 7 experts was used to develop FC checklists. The internal consistency coefficients using Cronbach's α were .91 and .88, respectively, for males and females. Developing a 24-item male FC checklist and a 23-item female FC checklist for teaching/assessing FC is the first step in the validation process. For these checklists to become further validated, they should be implemented and studied in the simulation and the clinical environments.
    American Journal of Medical Quality 03/2013; · 1.47 Impact Factor
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    ABSTRACT: Nasogastric (NG) tube insertion is known to result in complications. Validated checklists are central to teaching and assessing procedural skills and may result in improved health care quality. The results of the first step of the validation of an NG tube insertion checklist are described. A comprehensive literature review of articles published on NG tube insertion did not yield a checklist validated by the Delphi method. A modified Delphi technique, involving a panel of 9 interdisciplinary, interinstitutional experts, was used to develop an NG tube insertion checklist. The internal consistency coefficient using Cronbach's α was .80. Developing a 19-item checklist for teaching and assessing NG tube insertion is the first step in the validation process. For this checklist to become further validated, it should be implemented and studied in the simulation and clinical environments.
    American Journal of Medical Quality 02/2013; · 1.47 Impact Factor
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    ABSTRACT: Disaster preparedness training is a critical component of medical student education. Despite recent natural and man-made disasters, there is no national consensus on a disaster preparedness curriculum. The authors designed a survey to assess prior disaster preparedness training among incoming interns at an academic teaching hospital. In 2010, the authors surveyed incoming interns (n = 130) regarding the number of hours of training in disaster preparedness received during medical school, including formal didactic sessions and simulation, and their level of self-perceived proficiency in disaster management. Survey respondents represented 42 medical schools located in 20 states. Results demonstrated that 47% of interns received formal training in disaster preparedness in medical school; 64% of these training programs included some type of simulation. There is a need to improve the level of disaster preparedness training in medical school. A national curriculum should be developed with aspects that promote knowledge retention.
    American Journal of Medical Quality 01/2013; · 1.47 Impact Factor
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    ABSTRACT: INTRODUCTION: Basic invasive procedural skills are traditionally taught during clerkships. Using simulation to teach invasive skills provides students the opportunity to practice in a structured environment without risking patient safety. We surveyed incoming interns at Thomas Jefferson University Hospital to assess the prevalence of simulation training for invasive and semi-invasive procedural skills during medical school. METHODS: From 2008 to 2010, we surveyed 357 incoming interns at Thomas Jefferson University Hospital. The questionnaire asked incoming interns if they received formal instruction or procedural training with or without a simulation component for 34 procedures during medical school. Interns indicated their number of attempts and successes for each procedure in clinical care. RESULTS: All 357 incoming interns completed the survey. Experience in 28 procedures is reported in this article. For all but three basic procedures, more than 75% of interns received formal didactic instruction. Only 3 advanced procedures were formally taught to most interns. The prevalence of simulation training for the basic and advanced procedures was 46% and 23%, respectively. For the basic procedures, the average number of attempts and successes was 6.5 (range, 0-13.9) and 6.2 (range, 0-13.4), respectively. For the advanced procedures, the average number of attempts and successes was 1.5 (range, 0-4.8) and 1.3 (range, 0-4.7), respectively. CONCLUSIONS: Although most medical students receive formal instruction in basic procedures, fewer receive formal instruction in advanced procedures. The use of simulation to complement this training occurs less often. Simulation training should be increased in undergraduate medical education and integrated into graduate medical education.
    Simulation in healthcare: journal of the Society for Simulation in Healthcare 12/2012; · 1.64 Impact Factor
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    ABSTRACT: Lumbar puncture (LP) is known to result in complications. Procedure skills should be taught and evaluated more effectively to improve health care quality. Validated checklists are central to teaching and assessing procedural skills. The results of the first step of the validation of an adult LP checklist are described. A comprehensive literature review of articles published on LP did not yield a checklist validated by the Delphi method. A modified Delphi technique, involving a panel of 9 experts, was used to develop a 20-item LP checklist for teaching and assessing LP, the first step in the validation process. The internal consistency coefficient using Cronbach's αwas 0.79. The authors used a modified Delphi method to develop a checklist for teaching and assessing LP. For this checklist to become further validated, it should be implemented and studied in the simulation and clinical environments.
    American Journal of Medical Quality 10/2012; · 1.47 Impact Factor
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    ABSTRACT: Paracentesis is an invasive procedure known to result in complications. Procedure skills should be taught and evaluated more effectively to improve health care quality. Validated checklists are central to teaching and assessing procedural skills. The results of the first step of the validation of a paracentesis checklist are described. A comprehensive literature review of articles published on paracentesis did not yield a validated checklist. A modified Delphi technique, involving a panel of 8 interdisciplinary, interinstitutional experts, was used to develop a paracentesis checklist. The internal consistency coefficient using Cronbach's α was .92. Developing the 24-item paracentesis checklist for teaching and assessing paracentesis is the first step in the validation process. For this checklist to become further validated, it should be implemented and studied in the simulation and clinical environments.
    American Journal of Medical Quality 09/2012; · 1.47 Impact Factor
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    ABSTRACT: Thoracentesis is an invasive procedure known to result in complications. Procedure skills should be taught and evaluated more effectively to improve health care quality. Validated checklists are central to teaching and assessing procedural skills. The results of the first step of the validation of a thoracentesis checklist are described. A comprehensive literature review of articles published on thoracentesis did not yield a validated checklist. A modified Delphi technique, involving a panel of 8 interdisciplinary, interinstitutional experts, was used to develop a thoracentesis checklist. The internal consistency coefficient using Cronbach's α was .94. Developing the 23-item thoracentesis checklist for teaching and assessing thoracentesis is the first step in the validation process. For this checklist to become further validated, it should be implemented and studied in the simulation and clinical environments.
    American Journal of Medical Quality 09/2012; · 1.47 Impact Factor
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    ABSTRACT: To examine the contribution of students' gender and ethnicity to assessments by simulated patients (SPs) of medical students' empathy, and to compare the results with students' self-assessments of their own empathy. In 2008, the authors used three different tools to assess the empathy of 248 third-year medical students. Students completed the Jefferson Scale of Physician Empathy (JSPE), and SPs completed the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and a global rating of empathy (GRE) in 10 objective structured clinical examination (OSCE) encounters. Of the 248 students who completed an end-of-third-year OSCE, 176 (71%) also completed the JSPE. Results showed that women scored higher than men on all three measures of empathy. The authors detected no significant difference between white and Asian American students on their self-report JSPE scores. However, the SPs' assessments on the JSPPPE and on the GRE were significantly lower, indicating less empathy, for Asian American students. A tool for SPs to assess students' empathy during an OSCE could be helpful for unmasking some deficits in empathy in students during the third year of medical school. Because the authors found no significant differences on self-reported empathy, the differences they observed in the SPs' assessments of white and Asian American students were unexpected and need further exploration. These findings call for investigation into the reasons for such differences so that OSCEs and other examinations comply with the guidelines for fairness in educational and psychological testing as recommended by professional testing organizations.
    Academic medicine: journal of the Association of American Medical Colleges 06/2011; 86(8):984-8. · 2.34 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the use of simulated patients in conjunction with anatomic and tissue task-training models to assess skills. Faculty reviewed the objectives of the clerkship to identify skills to be acquired. Three cases were developed related to rectal examination, suturing, and inserting intravenous lines and nasogastric tubes. Student scores were based on their ability to gather data from simulated patients and perform procedures on simulation models. A total of 670 students were assessed between 2006 and 2009. Alpha reliability coefficients were .97 for Communication/Interpersonal Skills, .71 for Procedures, and .58 for Data Gathering. Students receiving low ratings from faculty in the clerkship had significantly (P < .001) lower simulation scores. There were significant (P < .001) relationships between scores and grades in other clerkships. The combination of simulated patients and simulation models yielded reliable scores for procedural and interpersonal skills, and evidence of validity related to clinical ratings.
    American journal of surgery 06/2011; 201(6):835-40. · 2.36 Impact Factor
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    ABSTRACT: Empathy is necessary for communication between patients and physicians to achieve optimal clinical outcomes. To examine associations between Simulated Patients' (SPs) assessment of medical students' empathy and the students' self-reported empathy. A total of 248 third-year medical students completed the Jefferson Scale of Physician Empathy (JSPE). SPs completed the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a global rating of empathy in 10 objective clinical skills examination encounters during a comprehensive end of third-year clinical skills examination. High correlation was found between the scores on the JSPPPE and the global ratings of empathy completed by the SPs (r = 0.87, p < 0.01). A moderate but statistically significant correlation was observed between scores of the JSPE and the JSPPPE (r = 0.19, p < 0.05). Significant differences were observed on the JSPE and global ratings of empathy among top, middle and low scorers on the JSPPPE in the expected direction. While significant associations exist between students' self-reported scores on the JSPE and SPs' evaluations of students' empathy, the associations are not large enough to conclude that the two evaluations are redundant.
    Medical Teacher 01/2011; 33(5):388-91. · 1.82 Impact Factor
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    ABSTRACT: Multiple interventions have been developed to teach and improve internal medicine residents' end-of-life communication skills, but have not been easily adaptable to other institutions. The purpose of this study was to develop and evaluate a program to enhance physicians' end-of-life communication with families of dying patients using a format that could be incorporated into an existing curriculum for first-year internal medicine residents. An end-of-life educational program was developed and evaluated in the context of educating first-year residents at an urban academic medical center during the 2008-2009 academic year. The program consisted of three sessions including an interactive workshop flanked by pre- and post-workshop evaluations in simulated encounter and clinical vignette formats. Simulated encounters were recorded on video and residents' performances were rated by two independent observers using a 23 point checklist. Complete data were available for 24 (73%) of 33 residents who participated in the program. The residents' checklist scores increased significantly from a mean of 48.1 at baseline to 73.9 at follow-up. The increase in the scores on the clinical vignettes was also statistically significant, but of lesser magnitude. A short, focused intervention can have significant impact on residents' communication skills in the setting of an end-of-life objective structured clinical examination (OSCE).
    The American journal of hospice & palliative care 12/2010; 28(5):328-34.
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    ABSTRACT: Proficiency in the clinical skill of effective hand washing is integral to high quality health care. Studies at our hospital revealed that in 2008, of 1215 direct, anonymous, observations of residents and attendings, only 53.3% washed their hands correctly during clinical activities. Medical students in fiscal year 2009 (July 1, 2008-June 30 2009) had a 52% compliance rate from 109 observations. This data prompted our hospital to work with the faculty of the University Clinical Skills and Simulation Center (UCSSC) to develop a module on the indications and technique of effective handwashing. This intervention, using multimedia simulation was introduced to our interns during their orientation program.
    Department of Obstetrics and Gynecology Faculty Papers. 01/2010;
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    ABSTRACT: Little is known about the relationship between performance on clinical assessments during medical school and performance on similar licensing tests. Correlation coefficients were computed and corrected for measurement error using data for 217 students who completed a school's clinical assessment and took the Step 2 Clinical Skills (CS) examination. Observed (and corrected) correlations between the two tests were 0.18 (0.32) for Data Gathering, 0.35 (0.75) for Documentation, and 0.32 (0.56) for Communication/Interpersonal Skills. The highest correlation within each test was between Documentation and Data Gathering. The lowest was between Documentation and Communication/ Interpersonal Skills. The pattern of correlations supports each test's construct validity. The low correlations suggest that the tests are not redundant, and do not support using the scores on the school's assessment to predict performance on Step 2 CS. Future studies of these relationships need to address the time between the two assessments and the effect of intervening remedial programs.
    Academic medicine: journal of the Association of American Medical Colleges 10/2008; 83(10 Suppl):S37-40. · 2.34 Impact Factor
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    ABSTRACT: Questions remain about the congruence between students' written notes and checklists as summaries of encounters. Students examined standardized patients and summarized findings in postencounter notes. The patients completed checklists. A physician read the students' notes and completed parallel checklists to document the history and physical items performed. Rates of under- and overdocumentation were calculated. Students documented findings for 71% of items performed - an underdocumentation rate of 29%. Approximately 94% of their documented findings were consistent with what they had done. Their rate of overdocumentation was 6%, in which they documented findings inconsistent with the checklists. About half the students had no instances of overdocumentation. Students' rate of underdocumentation was comparable to experienced clinicians. Although their overdocumentation rate was low overall, it was high for a few students. Evaluation of the congruence between checklists and postencounter notes provides useful information and informs checklist development.
    Teaching and Learning in Medicine 01/2008; 20(1):31-6. · 0.94 Impact Factor
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    ABSTRACT: The ACGME requires that all residents are competent in performing basic invasive clinical procedures. Although simulation models have been used in other programs to teach these skills to interns with the intent to provide training and skills attainment before learning and performing on real patients, a large scale, mandatory simulation training, in which every incoming intern must satisfactorily complete training in a simulation center, prior to starting their intern year, has yet to be described. We describe such a curricular intervention produced in our Simulation Center.
    Department of Obstetrics and Gynecology Faculty Papers.

Publication Stats

31 Citations
25.28 Total Impact Points

Institutions

  • 2013
    • University of Alabama at Birmingham
      Birmingham, Alabama, United States
    • Boston Children's Hospital
      • Division of Infectious Diseases
      Boston, Massachusetts, United States
  • 2012–2013
    • Thomas Jefferson University
      Philadelphia, Pennsylvania, United States
  • 2010
    • Thomas Jefferson University Hospitals
      Philadelphia, Pennsylvania, United States