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Richard E. Hawkins

Richard E. Hawkins
American Board of Medical Specialties

M.D.

About

85
Publications
22,240
Reads
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4,035
Citations
Introduction
Additional affiliations
December 2012 - February 2016
American Medical Association (AMA)
Position
  • Vice President, Medical Education Outcomes
February 2009 - December 2012
American Board of Medical Specialites
Position
  • Senior Vice President for Professional and Scientific Affairs
July 1997 - June 2002
Uniformed Services University of the Health Sciences
Position
  • Assistant Dean, Simulation Education

Publications

Publications (85)
Article
The American Medical Association’s (AMA’s) Accelerating Change in Medical Education (ACE) initiative, launched in 2013 to foster advancements in undergraduate medical education, has led to the development and scaling of innovations influencing the full continuum of medical training. Initial grants of $1 million were awarded to 11 U.S. medical schoo...
Article
An important tenet of competency-based medical education is that the educational continuum should be seamless. The transition from undergraduate medical education (UME) to graduate medical education (GME) is far from seamless, however. Current practices around this transition drive students to focus on appearing to be competitively prepared for res...
Article
The health systems science (HSS) framework articulates systems-relevant topics that medical trainees must learn to be prepared for physician practice. As new HSS-related curricula are developed, measures demonstrating appropriate levels of reliability and validity are needed. The authors describe a collaborative effort between a consortium of medic...
Article
In 2000, the American Board of Medical Specialties (ABMS) adopted Maintenance of Certification (MOC) to ensure that diplomates maintained professional standards throughout their practice careers. MOC included standards for learning, assessment, professionalism, and practice improvement. Diplomates began to raise concerns about MOC that focused on v...
Article
Assessments of physician learners during the transition from undergraduate to graduate medical education generate information that may inform their learning and improvement needs, determine readiness to move along the medical education continuum, and predict success in their residency programs. To achieve a constructive transition for the learner,...
Article
Longitudinal assessment (LA) involves the regular, spaced delivery of a limited number of questions on practice relevant content on a computer or mobile internet platform. Depending on the platform, participants may indicate relevance of the content to their practice and confidence in their answer prior to receiving immediate feedback (including cr...
Article
Medical educators are not yet taking full advantage of the publicly available clinical practice data published by federal, state, and local governments, which can be attributed to individual physicians and evaluated in the context of where they attended medical school and residency training. Understanding how graduates fare in actual practice, both...
Article
With the aim of improving the health of individuals and populations, medical schools are transforming curricula to ensure physician competence encompasses health systems science (HSS), which includes population health, health policy, high-value care, interprofessional teamwork, leadership, quality improvement, and patient safety. Large-scale, meani...
Article
Medical students need hands-on experience documenting clinical encounters as well as entering orders to prepare for residency and become competent physicians. In the era of paper medical records, students consistently acquired experience writing notes and entering orders as part of their clinical experience. Over the past decade, however, patient r...
Article
Physicians want to maintain current knowledge of evidence-based medicine, new therapies, and changing technology while providing high-quality care to patients. Although many physicians participate in continuous learning, debate continues regarding how best to improve clinical performance and patient outcomes.
Article
Purpose: As health systems evolve, the education community is seeking to reimagine student roles that combine learning with meaningful contributions to patient care. The authors sought to identify potential stakeholders regarding the value of student work, and roles and tasks students could perform to add value to the health system, including key...
Article
Full-text available
Change is ubiquitous in health care, making continuous adaptation necessary for clinicians to provide the best possible care to their patients. The authors propose that developing the capabilities of a Master Adaptive Learner will provide future physicians with strategies for learning in the health care environment and for managing change more effe...
Article
The increasing number of senior physicians and calls for increased accountability of the medical profession by the public have led regulators and policymakers to consider implementing age-based competency screening. Some hospitals and health systems have initiated age-based screening, but there is no agreed upon assessment process. Licensing and ce...
Article
This article describes the presentations and discussions at a conference co-convened by the Council on Medical Education of the American Medical Association (AMA) and by the American Board of Medical Specialties (ABMS). The conference focused on the ABMS Maintenance of Certification (MOC) Part III Examination. This article, reflecting the conferenc...
Article
Full-text available
Educators, policy makers, and health systems leaders are calling for significant reform of undergraduate medical education (UME) and graduate medical education (GME) programs to meet the evolving needs of the health care system. Nationally, several schools have initiated innovative curricula in both classroom and workplace learning experiences to p...
Article
Full-text available
In order to construct and evaluate the validity argument for the Objective Structured Assessment of Technical Skills (OSATS), based on Kane's framework, we conducted a systematic review. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus, and selected reference lists through February 2013. Working in duplicate, we selected...
Article
Competency-based medical education (CBME) has emerged as a core strategy to educate and assess the next generation of physicians. Advantages of CBME include: a focus on outcomes and learner achievement; requirements for multifaceted assessment that embraces formative and summative approaches; support of a flexible, time-independent trajectory throu...
Article
The American Board of Medical Specialties Maintenance of Certification Program (ABMS MOC) is designed to provide a comprehensive approach to physician lifelong learning, self-assessment, and quality improvement (QI) through its 4-part framework and coverage of the 6 competencies previously adopted by the ABMS and the Accreditation Council for Gradu...
Article
In this issue, Lipner and colleagues describe research supporting the value of the examinations used in the maintenance of certification (MOC) programs of the American Board of Internal Medicine and the American Board of Surgery. The authors of this commentary review the contribution of this research and previous investigations that underscore the...
Article
The mini-Clinical Evaluation Exercise (mCEX) is increasingly being used to assess the clinical skills of medical trainees. Existing mCEX research has typically focused on isolated aspects of the instrument's reliability and validity. A more thorough validity analysis is necessary to inform use of the mCEX, particularly in light of increased interes...
Article
During the last decade, interest in assessing professionalism in medical education has increased exponentially and has led to the development of many new assessment tools. Efforts to validate the scores produced by tools designed to assess professionalism have lagged well behind the development of these tools. This paper provides a structured frame...
Article
Introduction: Deficiencies in physician competence play an important role in medical errors and poor-quality health care. National trends toward implementation of continuous assessment of physicians hold potential for significant impact on patient care because minor deficiencies can be identified before patient safety is threatened. However, the a...
Article
Physician competence and performance problems contribute to medical errors and substandard health care quality. Assessment of the clinical competence of practicing physicians, however, is challenging. Although physician competence assessment undoubtedly does take place at the local level (e.g., hospital, medical group), it is difficult to objective...
Article
Medical professionalism is increasingly recognized as a core competence of medical trainees and practitioners. Although the general and specific domains of professionalism are thoroughly characterized, procedures for assessing them are not well-developed. This article outlines an approach to designing and implementing an assessment program for medi...
Article
Previous studies have found gender bias in the global evaluations of trainees. The purpose of this study was to investigate the association of faculty and residents' gender on the evaluation of residents' specific clinical skills, using direct observation. In 2001-2002, 40 clinician-educators from 16 internal medicine residency programs viewed a se...
Article
The American Society of Clinical Oncology (ASCO) developed its own test -- the Medical Oncology In-Training Examination (MedOnc ITE) -- as a tool to assess trainees' knowledge of the clinical oncology subspecialty, establish consistency in educational standards across training programs, identify areas of strength and weakness in individual programs...
Article
Step 2 Clinical Skills (CS) was recently introduced into the United States Medical Licensing Examination (USMLE) to ensure that successful candidates for licensure possess the clinical skills to provide safe and effective patient care. To explore if medical schools had changed the objectives, content, or emphasis in their pre-clinical curriculum in...
Article
Full-text available
While checklists are often used to score standardized patient based clinical assessments, little research has focused on issues related to their development or the level of agreement with respect to the importance of specific items. Five physicians independently reviewed checklists from 11 simulation scenarios that were part of the former Education...
Article
Self-assessment has been held out as an important mechanism for lifelong learning and self-improvement for health care professionals. However, there is growing concern that individual learners often interpret the results inaccurately. This idea has led to skepticism that self-assessment in its current form can ever be truly useful for lifelong prof...
Article
The Post-Licensure Assessment System of the Federation of State Medical Boards and the National Board of Medical Examiners has been evolving for nearly 10 years in its effort to develop a system of evaluation for practicing physicians. The development of such a system requires collaboration among a variety of assessment and educational institutions...
Article
Multivariate generalizability analysis was used to investigate the performance of a commonly used clinical evaluation tool. Practicing physicians were trained to use the mini-Clinical Skills Examination (CEX) rating form to rate performances from the United States Medical Licensing Examination Step 2 Clinical Skills examination. Differences in rate...
Article
Background: Despite the nearly universal practice of using standardized patients in introduction to clinical medicine (ICM) courses, no studies have compared the performance of students trained with standardized patients to that of those trained with hospitalized patients with regard to short- and long-term educational outcomes. Purpose: To examine...
Article
Full-text available
Step 2 Clinical Skills (CS) was introduced into the United States Medical Licensing Examination (USMLE). The purpose of USMLE Step 2 CS is to ensure successful candidates for licensure in the United States possess the clinical skills that are essential for safe and effective patient care. Ensuring high quality in such a large-scale, performance-bas...
Article
Full-text available
Over the last several years there has been much attention focused on the detection and remediation of problems that pose potential threats to patient safety and that interfere with the provision of effective care. It has been noted that changes in medical education and assessment are integral to eventual improvement in this area. Within the assessm...
Article
Standardised assessments of practising doctors are receiving growing support, but theoretical and logistical issues pose serious obstacles. To obtain reference performance levels from experienced doctors on computer-based case simulation (CCS) and standardised patient-based (SP) methods, and to evaluate the utility of these methods in diagnostic as...
Article
Full-text available
Faculty observation of residents and students performing clinical skills is essential for reliable and valid evaluation of trainees. To evaluate the efficacy of a new multifaceted method of faculty development called direct observation of competence training. Controlled trial of faculty from 16 internal medicine residency programs using a cluster r...
Article
Full-text available
This study examined the extent to which differences in clinical experience, gained in postgraduate training programs, affect performance on Step 3 of the United States Medical Licensing Examination (USMLE). Subjects in the study were 36,805 U.S. and Canadian medical school graduates who took USMLE Step 3 for the first time between November 1999 and...
Article
The purpose of the present study was to examine the extent to which an automated scoring procedure that emulates expert ratings with latent semantic analysis could be used to score the written patient note component of the proposed clinical skills examination (CSE). Human ratings for four CSE cases collected in 2002 were compared to automated holis...
Article
To investigate the construct validity of the miniclinical evaluation exercise (miniCEX). Forty faculty participants from 16 internal medicine residency programs enrolled in a randomized, controlled trial of faculty development. Using a standard nine-point miniCEX rating form, participants watched and rated performances of standardized residents on...
Article
Evaluation of resident clinical competence is a complex task. A multimodal approach is necessary to capture all of the dimensions of competence. Recent guidelines from the Accreditation Council for Graduate Medical Education delineate six general competencies that physicians should posses. Application of these guidelines presents challenges to resi...
Article
The introduction of a clinical skills examination (CSE) to Step 2 of the U.S. Medical Licensing Examination (USMLE) has focused attention on the design and delivery of large-scale standardized tests of clinical skills and raised the question of the appropriateness of evaluation of these competencies across the span of a physician's career. This ini...
Article
Clinical education is critically important because competency in practice ultimately will determine the future of advanced practice nursing. Skills taught in Health Assessment, the first in a series of clinical courses, exposed students to tools that form the basis on which other competencies are built. The availability of standardized patients, pe...
Article
To compare the performances of three evaluation methods in detecting deficiencies of professionalism among third-year medical students during their ambulatory care and inpatient ward rotations of a core internal medicine clerkship. From 1994 to 1997, 18 students at The Uniformed Services University of the Health Sciences failed to satisfactorily co...
Article
We sought to survey residents' perceptions regarding the In-Training Examination in Internal Medicine and to assess the ability of faculty members to evaluate the knowledge base of internal medicine residents. Residents were asked about the perceived utility of the In-Training Examination and related self-directed educational activities. Residents...
Article
To examine the effect on residents' compliance with preventive health guidelines of an intensive quality-improvement program using medical record audits and individualized feedback. The before-and-after study was set in a general internal medicine clinic at a military teaching hospital. In 1995, the authors retrospectively reviewed 280 medical reco...
Article
A total of 628 female and 526 male U.S. military personnel completed a health survey questionnaire at the completion of four shipboard deployments lasting 10 to 180 days (mean, 57 days). During deployment, women visited clinic (sick call) at significantly higher rates than men: 189 versus 117 visits per week per 1,000 personnel. Except for generall...
Article
This paper reviews methods commonly used to assess the clinical competence of residents in internal medicine, including the In-Training Examination, medical record audits, rating scales, clinical evaluation exercises, and the use of standardized patients. Studies were identified through a MEDLINE search (1966 to present) and from the bibliographies...
Article
Background: Standardized patients are used frequently for the evaluation and teaching of clinical skills in medical school. They are less commonly used in residency programs, particularly for the demonstration, teaching and evaluation of trainees' skills in the male and female genitourinary (GU) examinations. Few data exist regarding the potential...
Article
During Operations Desert Shield and Desert Storm, U.S. troops were at high risk of diarrheal disease due to Shigella spp., particularly Shigella sonnei. In order to better understand the serologic response to Shigella infection, 830 male U.S. combat troops were evaluated before and after the deployment to Saudi Arabia and Kuwait for immunoglobulin...
Article
To describe clinical and treatment aspects of syphilis infection among patients seropositive for the human immunodeficiency virus (HIV). Results of serologic tests for syphilis, CD4+ T-lymphocyte counts, and clinical response to therapy were retrospectively monitored in 100 HIV-infected adults with syphilis from a tertiary-care military HIV program...
Article
To determine whether military personnel deployed outside the United States are at increased risk of Helicobacter pylori infection, 1,000 male U.S. Navy and Marine Corps personnel (mean age 22 years) were evaluated. Study subjects included 200 recruits, 500 shipboard personnel deployed for six months to South America, West Africa, and the Mediterran...
Article
Fusobacterium nucleatum and Capnocytophaga species are common oral pathogens and infrequent causes of systemic infection in patients with compromised immunity or disrupted mucosal integrity. The isolation of both organisms from a clinical specimen suggests an oral source of infection. A 23-year-old black woman was admitted at 24 weeks' gestation in...
Article
Information regarding risk factors for STD transmission is needed to assist in designing and evaluating prevention and control programs for US military populations. To obtain STD risk factor data among deployed U.S. military personnel. A questionnaire survey was administered to military personnel deployed aboard ship for six months to South America...
Article
The polymerase chain reaction (PCR) was used to identify spores of Bacillus anthracis. By using an assay capable of amplifying a 1247-bp fragment from the gene that encodes the edema factor of B. anthracis, as few as 103 copies of a plasmid containing the edema factor gene and as few as 2 × 104 spores were detected. Subjecting the product of this P...
Article
A prevalence study of 2072 male US shipboard military personnel scheduled for deployment to South America/West Africa and the Mediterranean was conducted to determine whether serologic evidence of prior hepatitis A, B, or C infection is associated with exposure in foreign countries. There were 210 subjects (10.1%) who had antibodies to hepatitis A...
Article
A cross-sectional study was undertaken to determine the prevalence of Mycoplasma fermentans infection in patients with human immunodeficiency virus (HIV) infection using polymerase chain reaction methodology. Targeted M. fermentans DNA sequences could be amplified from the DNA extracted from the blood of 6 (11%) of 55 HIV-seropositive patients but...
Article
We have reported a case of E sakazakii primary bacteremia in an elderly patient in whom evaluation failed to reveal a source of infection. This patient had an uneventful recovery after intravenous administration of a third-generation cephalosporin for 7 days followed by 1 week of oral ciprofloxacin. This excellent response supports the previous sug...
Article
Haemophilus influenzae is a rare cause of septic arthritis in adults. We describe a case of septic arthritis with nontypable Haemophilus influenzae presenting as the first invasive infection leading to a diagnosis of common variable hypogammaglobulinemia. Although nontypable strains have been shown to cause serious infections in adults, they are a...
Article
Chryseomonas luteola and Flavimonas oryzihabitans are phenotypically similar gram-negative bacilli and are also referred to as CDC groups Ve-1 and Ve-2, respectively. These bacteria are rarely reported as pathogens in humans. Infections described in the literature include primarily bacteremia in critically ill patients and peritonitis in patients u...

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