Monica L Lypson

Concordia University–Ann Arbor, Ann Arbor, Michigan, United States

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Publications (86)178.95 Total impact

  • Paula T. Ross · Divy Ravindranath · Michael Clay · Monica L. Lypson

    No preview · Article · Dec 2015
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    ABSTRACT: Background: Despite the frequency of patient-care handovers and vulnerability to errors, medical schools infrequently teach handover skills. Our study evaluated the impact of a medical school handover curriculum on students' performance, as rated by faculty members, peers and self-assessment. Methods: Nineteen fourth-year medical students participated in a handover curriculum that included a workshop and three directly observed patient handovers, with feedback from faculty members. Multivariate repeated-measures analysis evaluated faculty member, peer, and self-rated performance over time. Students' self-assessed confidence in performing handovers prior to, at the end of, and 8-12 months after the curriculum was also analysed. Results: Faculty member, peer and self-assessments showed that students' performance significantly improved after the curriculum, on handover content, clinical judgment and overall performance (p < 0.05). Students rated the curriculum as effective and characterised themselves as more prepared to perform handovers, with these findings persisting for 8-12 months (p ≤ 0.001). Medical schools infrequently teach handover skills DISCUSSION: A handover curriculum appears to improve medical students' handover performance, as evaluated by independent ratings from faculty members, peers and the students themselves, in addition to improving the students' confidence.
    No preview · Article · Dec 2015 · The Clinical Teacher
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    ABSTRACT: Problem: Competency-based education, including assessment of specialty-specific milestones, has become the dominant medical education paradigm; however, how to determine baseline competency of entering interns is unclear-as is to whom this responsibility falls. Medical schools should take responsibility for providing residency programs with accurate, competency-based assessments of their graduates. Approach: A University of Michigan ad hoc committee developed (spring 2013) a post-Match, milestone-based medical student performance evaluation for seven students matched into emergency medicine (EM) residencies. The committee determined EM milestone levels for each student based on assessments from the EM clerkship, end-of-third-year multistation standardized patient exam, EM boot camp elective, and other medical school data. Outcomes: In this feasibility study, the committee assessed nearly all 23 EM milestones for all seven graduates, shared these performance evaluations with the program director (PD) where each student matched, and subsequently surveyed the PDs regarding this pilot. Of the five responding PDs, none reported using the traditional medical student performance evaluation to customize training, four (80%) indicated that the proposed assessment provided novel information, and 100% answered that the assessment would be useful for all incoming trainees. Next steps: An EM milestone-based, post-Match assessment that uses existing assessment data is feasible and may be effective for communicating competency-based information about medical school graduates to receiving residency programs. Next steps include further aligning assessments with competencies, determining the benefit of such an assessment for other specialties, and articulating the national need for an effective educational handover tool between undergraduate and graduate medical education institutions.
    No preview · Article · Oct 2015 · Academic medicine: journal of the Association of American Medical Colleges
  • Monica L Lypson · Kathryn Goldrath · Chiu Yueh Yao · Paula T Ross

    No preview · Article · Oct 2015 · Journal of Women's Health
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    Monica Lypson · Rachel Perlman · Paula Ross

    Preview · Article · Oct 2015
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    Jennifer N Stojan · Michael A Clay · Monica L Lypson

    Preview · Article · Oct 2015 · BMJ quality & safety
  • Scott D Gitlin · Monica L Lypson
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    ABSTRACT: Preparing for a laboratory or research-based career in academic medicine involves learning and acquiring a broad set of knowledge, skills, and experiences that facilitate the transition from trainee to faculty member. It also involves identifying and cultivating solid mentor/mentee relationships in the laboratory environment. It is well known that different skill sets and mentoring approaches are necessary for those pursuing laboratory-based research as compared with those needed for clinical practice and patient-oriented research. Here, we discuss several key approaches to help mentees identify fruitful mentor/mentee relationships.
    No preview · Article · Sep 2015 · Journal of Cancer Education

  • No preview · Article · Jul 2015
  • Rachel L Perlman · Paula T Ross · Monica L Lypson

    No preview · Article · Jun 2015 · Mayo Clinic Proceedings
  • Rachel L. Perlman · Paula T. Ross · Monica L. Lypson

    No preview · Article · May 2015 · Academic Medicine
  • Rachel L Perlman · Paula T Ross · Monica L Lypson

    No preview · Article · May 2015 · Academic medicine: journal of the Association of American Medical Colleges
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    ABSTRACT: Background: Derived from multiple disciplines and established in industries outside of medicine, Implementation Science (IS) seeks to move evidence-based approaches into widespread use to enable improved outcomes to be realized as quickly as possible by as many as possible. Methods: This review highlights selected IS theories and models, chosen based on the experience of the authors, that could be used to plan and deliver medical education activities to help learners better implement and sustain new knowledge and skills in their work settings. Results: IS models, theories and approaches can help medical educators promote and determine their success in achieving desired learner outcomes. We discuss the importance of incorporating IS into the training of individuals, teams, and organizations, and employing IS across the medical education continuum. Challenges and specific strategies for the application of IS in educational settings are also discussed. Conclusions: Utilizing IS in medical education can help us better achieve changes in competence, performance, and patient outcomes. IS should be incorporated into curricula across disciplines and across the continuum of medical education to facilitate implementation of learning. Educators should start by selecting, applying, and evaluating the teaching and patient care impact one or two IS strategies in their work.
    Full-text · Article · Apr 2015 · Medical Education Online
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    ABSTRACT: As residency programs move toward measuring milestones for competency based education assessment, medical schools will need to collaborate with residencies to determine competencies for graduating students. The objective of this study is to define the educational milestones for fourth year medical students during an internal medicine sub-internship. Cross-sectional internet based survey (with attention to validity evidence) was developed in early 2013 and administered to Internal medicine attendings and Internal medicine sub-interns working on an inpatient team at three academic medical centers. With the purpose to determine the milestones for sub-interns items asked respondents what responsibilities a sub-intern could be entrusted to perform without direct supervision. Faculty responded that behaviors sub-interns could perform with indirect supervision were mostly at the "reporter" level including completing a history and physical examination and collecting data such as test results. Other skills such as venipuncture and some communication skills such as calling consults, providing patient counseling, responding to pages, and creating discharge instructions were examples of tasks in which the majority of faculty felt that students were progressing toward unsupervised practice. Behaviors where the majority of faculty would always supervise a medical student performance included performance on the "interpreter" level including interpreting electrocardiograms, significant physical examination findings, and laboratory results. Medical students less commonly noted needed supervision on the majority of the items when compared to faculty. Tasks in the reporter domain such as taking a history, collecting medical records, and reporting results can be characterized as medical student milestones. Copyright © 2015 Elsevier Inc. All rights reserved.
    Full-text · Article · Mar 2015 · The American Journal of Medicine
  • Monica Lypson · Stacie Buckler · Kelly Poszywak

    No preview · Article · Jan 2015
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    Laurie Whitman · Kelly Poszywak · Paula Ross · Monica Lypson

    Full-text · Conference Paper · Jan 2015
  • Monica Lypson · Richard Cohan · F. Seagull

    No preview · Article · Jan 2015
  • 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.
    No preview · Article · Oct 2014 · Teaching and Learning in Medicine
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    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.
    Full-text · Article · Aug 2014 · Medical Teacher
  • Rachel L Perlman · Paula T Ross · Monica L Lypson
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    ABSTRACT: Purpose: 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. Method: In 2009, using appreciative inquiry as a theoretical framework, the authors conducted in-depth qualitative interviews with 25 individuals: 12 women and 13 men; 10 from dual-physician and 15 from single-physician relationships. A phenomenological analytic approach was used to arrive at the final themes. Results: Four themes emerged during the interviews: "We rely on mutual support in our relationships," "We recognize the important roles of each family member," "We have shared values," and "We acknowledge the benefit of being a physician to our relationships." Conclusions: These findings illustrate that physicians identify strategies to navigate the difficult aspects of their lives. Learn ing from others' best practices can assist in managing personal relationships and work-life balance. These data can also be useful when counseling physicians on successful relationship strategies. As systems are developed that improve wellness and focus on role models for work-life balance, it will be important for this topic to be integrated into formal curricula across the continuum of medical education.
    No preview · Article · Aug 2014 · Academic medicine: journal of the Association of American Medical Colleges
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    ABSTRACT: Problem: 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. Approach: Responses to the Association of American Medical College's Medical School Graduation Questionnaire were obtained for the years 2007-2008 and 2011-2012 and mapped to domains of training in health policy curricula for four domains: systems and principles; value and equity; quality and safety; and politics and law. Chi-square tests were used to test differences among unadjusted temporal trends. Multiple logistic regression models were fit to the outcome variables and adjusted for student characteristics, student preferences, and medical school characteristics. Outcomes: Compared with 2007-2008, students' perceptions of training in 2011-2012 increased on a relative basis by 11.7% for components within systems and principles, 2.8% for quality and safety, and 6.8% for value and equity. Components within politics and law had a composite decline of 4.8%. Multiple logistic regression models found higher odds of reporting satisfaction with training over time for all components within the domains of systems and principles, quality and safety, and value and equity (P < .01), with the exception of medical economics. Next steps: Medical student perceptions of training in health policy improved over time. Causal factors for these trends require further study. Despite improvement, nearly 40% of graduating medical students still report inadequate instruction in health policy.
    No preview · Article · Jul 2014 · Academic medicine: journal of the Association of American Medical Colleges

Publication Stats

444 Citations
178.95 Total Impact Points

Institutions

  • 2010-2015
    • Concordia University–Ann Arbor
      Ann Arbor, Michigan, United States
  • 2002-2015
    • University of Michigan
      • • Department of Internal Medicine
      • • Department of Health Behavior and Health Education
      • • Division of General Medicine
      Ann Arbor, Michigan, United States