Sondra R Zabar, M.D.

The professionalism curriculum as a cultural change agent in surgical residency education
Hochberg MS; Berman RS; Kalet AL; Zabar SR; Gillespie C; Pachter HL
2011 Jan;203(1):14-20, American journal of surgery
BACKGROUND: Teaching professionalism effectively to fully engaged residents is a significant challenge. A key question is whether the integration of professionalism into residency education leads to a change in resident culture. METHODS: The goal of this study was to assess whether professionalism has taken root in the surgical resident culture 3 years after implementing our professionalism curriculum. Evidence was derived from 3 studies: (1) annual self-assessments of the residents' perceived professionalism abilities to perform 20 defined tasks representing core Accrediting Council on Graduate Medical Education professionalism domains, (2) objective metrics of their demonstrated professionalism skills as rated by standardized patients annually using the objective structure clinical examination tool, and (3) a national survey of the Surgical Professionalism and Interpersonal Communications Education Study Group. RESULTS: Study 1: aggregate perceived professionalism among surgical residents shows a statistically significant positive trend over time (P = .016). Improvements were seen in all 6 domains: accountability, ethics, altruism, excellence, patient sensitivity, and respect. Study 2: the cohort of residents followed up over 3 years showed a marked improvement in their professionalism skills as rated by standardized patients using the objective structure clinical examination tool. Study 3: 41 members of the national Surgical Professionalism and Interpersonal Communications Education Study Group rated their residents' skills in admitting mistakes, delivering bad news, communication, interdisciplinary respect, cultural competence, and handling stress. Twenty-nine of the 41 responses rated their residents as 'slightly better' or 'much better' compared with 5 years ago (P = .001). Thirty-four of the 41 programs characterized their department's leadership view toward professionalism as 'much better' compared with 5 years ago. CONCLUSIONS: All 3 assessment methods suggest that residents feel increasingly prepared to effectively deal with the professionalism challenges they face. Although professionalism seminars may have seemed like an oddity several years ago, residents today recognize their importance and value their professionalism skills. As importantly, department chairpersons report that formal professionalism education for residents is viewed more favorably compared with 5 years ago
— id: 141463, year: 2011, vol: 203, page: 14, stat: Journal Article,

More thoughts about residents' professionalism education in malpractice
Hochberg, Mark S; Kalet, Adina L; Zabar, Sondra R
2011 Oct;86(10):1192-1193, Academic medicine
— id: 137896, year: 2011, vol: 86, page: 1192, stat: Journal Article,

Perspective: Malpractice in an academic medical center: a frequently overlooked aspect of professionalism education
Hochberg, Mark S; Seib, Carolyn D; Berman, Russell S; Kalet, Adina L; Zabar, Sondra R; Pachter, H Leon
2011 Mar;86(3):365-368, Academic medicine
Understanding how medical malpractice occurs and is resolved is important to improving patient safety and preserving the viability of a physician's career in academic medicine. Every physician is likely to be sued by a patient, and how the physician responds can change his or her professional life. However, the principles of medical malpractice are rarely taught or addressed during residency training. In fact, many faculty at academic medical centers know little about malpractice.In this article, the authors propose that information about the inciting causes of malpractice claims and their resolution should be incorporated into residency professionalism curricula both to improve patient safety and to decrease physician anxiety about a crucial aspect of medicine that is not well understood. The authors provide information on national trends in malpractice litigation and residents' understanding of malpractice, then share the results of their in-depth review of surgical malpractice claims filed during 2001-2008 against their academic medical center. The authors incorporated those data into an evidence-driven curriculum for residents, which they propose as a model for helping residents better understand the events that lead to malpractice litigation, as well as its process and prevention
— id: 129319, year: 2011, vol: 86, page: 365, stat: Journal Article,

Informed consent in the older adult: OSCEs for assessing fellows' ACGME and geriatric gastroenterology competencies
Shah, Brijen; Miler, Roy; Poles, Michael; Zabar, Sondra; Gillespie, Colleen; Weinshel, Elizabeth; Chokhavatia, Sita
2011 Sep;106(9):1575-1579, American journal of gastroenterology
OBJECTIVES: The American Gastroenterological Association fellowship curriculum identifies geriatric components for gastroenterology (GI) training; however, few tools are available for this purpose. Using an objective structured clinical examination (OSCE), we aimed to assess ACGME competencies of communication, professionalism, and geriatric-specific patient care among GI fellows. METHODS: We developed an informed-consent case involving a geriatric patient who needs surveillance colonoscopy. We used a validated faculty skills checklist to rate fellows across three competency domains. Fifteen fellows from four GI training programs participated. RESULTS: Although the fellows excelled at communication and professionalism, only 51% excelled at geriatric-specific patient-care skills. Fellows were least likely to demonstrate collaboration with the patient, to assess patient understanding, and to explain the limits of the test. Communication and geriatric-specific skills were correlated. CONCLUSIONS: OSCEs are a feasible method for assessing geriatric-related ACGME competencies for fellows. The results highlight the need for curriculum development
— id: 149732, year: 2011, vol: 106, page: 1575, stat: Journal Article,

A Novel Longitudinal Geriatric Medical Student Experience: Using Teaching Objective Structured Clinical Examinations
Sutin D; Rolita L; Yeboah N; Taffel L; Zabar S
2011 Sep;59(9):1739-44 L, Journal of the American Geriatrics Society
It has previously been shown that medical students perform poorly when assessing older adults with recurrent falls. To address this and teach students about other geriatric syndromes, a standardized patient, played by one of nine actresses, aging during the course of an afternoon, was developed. The patient is first aged 75 with falls, then 80 with memory problems, then 82 with an acute confusional state. The third-year students interact with the patient on a one-to-one basis. After seeing and examining her, the students write up the case and then meet with the supervising physician after each section to discuss the case. This intervention was well accepted, scoring 5.95 on a 7-point Likert-type scale. At the end of the clinical year, the students participated in an eight-case clinical skills examination that included a 79-year-old man with falls. Using the actor's checklists, the performances of the 42 medical students who had participated in the standardized patient experience were compared with those of the 128 who had not. Over the eight cases, there was no difference in the three domains of communication, information gathering, and physical examination, but in the geriatric case, the students who had participated in the experience performed significantly better in all three domains. The intervention students were also three times as likely to examine the subject's gait (60% vs 20%). A 3-hour interactive session substantially improved specific geriatric competencies. One can only wonder what more dedicated time could accomplish
— id: 137825, year: 2011, vol: 59, page: 1739, stat: Journal Article,

Observing Handoffs and Telephone Management in GI Fellowship Training
Williams, Renee; Miler, Roy; Shah, Brijen; Chokhavatia, Sita; Poles, Michael; Zabar, Sondra; Gillespie, Colleen; Weinshel, Elizabeth
2011 Aug;106(8):1410-1414, American journal of gastroenterology
OBJECTIVES: Gastroenterology (GI) training programs are mandated to teach fellows interpersonal communication and professionalism as basic competencies. We sought to assess important skill sets used by our fellows but not formally observed or measured: handoffs, telephone management, and note writing. We designed an Observed Standardized Clinical Examination (OSCE) form and provided the faculty with checklists to rate fellows' performance on specific criteria. METHODS: We created two new scenarios: a handoff between a tired overnight senior fellow on call and a more junior fellow, and a telephone management case of an ulcerative colitis flare. Fellows wrote a progress notes documenting the encounters. To add educational value, we gave the participants references about handoff communication. Four OSCE stations-handoff communication, telephone management, informed consent, and delivering bad news-were completed by fellows and observed by faculty. RESULTS: Eight faculty members and eight fellows from four GI training programs participated. All the fellows agreed that handoffs can be important learning opportunities and can be improved if they are structured, and that handoff skills can improve with practice. CONCLUSIONS: OSCEs can serve as practicums for assessing complex skill sets such as handoff communication and telephone management
— id: 135568, year: 2011, vol: 106, page: 1410, stat: Journal Article,

Teaching the competencies: using observed structured clinical examinations for faculty development
Alevi, David; Baiocco, Peter J; Chokhavatia, Sita; Kotler, Donald P; Poles, Michael; Zabar, Sondra; Gillespie, Colleen; Ark, Tavinder; Weinshel, Elizabeth
2010 May;105(5):973-977, American journal of gastroenterology
OBJECTIVES: Gastroenterology (GI) training programs must develop the teaching skills of their faculty and provide feedback to their fellows. Many faculty feel uncomfortable offering feedback or identifying specific areas for improvement to the fellows. We developed an Observed Structured Clinical Exam (OSCE) to assess fellows' skills and provided faculty with specific criteria to rate the fellows' performance. We propose that OSCEs can serve as tools for faculty development in delivering effective feedback. METHODS: Faculty completed a Web-based training module and received written guidelines on giving feedback. Four OSCE stations were completed by each fellow with faculty using standardized checklists to assess the fellows' skills. Afterwards, faculty rated each program component and assessed their comfort level with feedback. RESULTS: Eight faculty members and 10 fellows from 5 GI training programs in NYC participated. 100% of the faculty agreed that feedback is an important learning tool, should include the learner's self-assessment, and that feedback skills could improve with practice. Compared to faculty skills prior to the program, 87.5% of the faculty agreed that they focused more on specific behaviors and 75% agreed that giving negative feedback was now easier. CONCLUSIONS: OSCEs can serve as practicums for faculty development in giving constructive feedback
— id: 109575, year: 2010, vol: 105, page: 973, stat: Journal Article,

BASELINE ASSESSMENT OF INCOMING MEDICAL STUDENTS COMMUNICATION SKILLS: THE NYU CURRICULUM FOR THE 21ST CENTURY BASELINE OSCE
Gillespie, C; Hanley, K; Adams, J; Zabar, S; Kalet, A
2010 JUN ;25(9):232-232, Journal of general internal medicine
— id: 111908, year: 2010, vol: 25, page: 232, stat: Journal Article,

PATIENT ACTIVATION: HOW ARE PATIENT ACTIVATING SKILLS RELATED TO OTHER CORE CLINICAL SKILLS?
Gillespie, C; Hanley, K; Kalet, A; Zabar, S; Porter, B
2010 JUN ;25(9):340-341, Journal of general internal medicine
— id: 111914, year: 2010, vol: 25, page: 340, stat: Journal Article,

PRIMARY CARE COMPETENCE IN PHYSICAL EXAMINATION OF THE KNEE: DOES MEDICINE RESIDENT PROFICIENCY WITH THE PHYSICAL EXAM RELATE TO COMMUNICATION PERFORMANCE AND PATIENT UNDERSTANDING
Greene, R; Gillespie, C; Zabar, S; Hanley, K; Adams, J; Shah, S; Porter, B
2010 JUN ;25(9):365-365, Journal of general internal medicine
— id: 111915, year: 2010, vol: 25, page: 365, stat: Journal Article,

STUDENTS WHO DEVELOP SELF-ASSESSMENT SKILLS IN A STRUCTURED VIDEOTAPE REVIEW IMPROVE THEIR INTERVIEWING SKILLS WITH STANDARDIZED PATIENTS
Hanley, K; Zabar, S; Disney, L; Kalet, A; Gillespie, C
2010 JUN ;25(9):393-394, Journal of general internal medicine
— id: 111917, year: 2010, vol: 25, page: 393, stat: Journal Article,

Can professionalism be taught? Encouraging evidence
Hochberg, Mark S; Kalet, Adina; Zabar, Sondra; Kachur, Elizabeth; Gillespie, Colleen; Berman, Russell S
2010 Jan;199(1):86-93, American journal of surgery
BACKGROUND: Teaching and assessing the Accreditation Council for Graduate Medical Education (ACGME) competencies of Professionalism and Communication have proven to be a challenge for surgical residency training programs. This study used innovative pedagogic approaches and tools in teaching these two competencies. The purpose of this study was to determine whether the learners actually are assimilating and using the concepts and values communicated through this curriculum. METHODS: A six-station Objective Structured Clinical Examination (OSCE) was designed using standardized patients to create varying Professionalism and Communication scenarios. The surgical resident learners were evaluated using these OSCEs as a baseline. The faculty then facilitated a specially designed curriculum consisting of six interactive sessions focusing on information gathering, rapport building, patient education, delivering bad news, responding to emotion, and interdisciplinary respect. At the conclusion of this curriculum, the surgical resident learners took the same six-station OSCE to determine if their professionalism and communication skills had improved. RESULTS: The surgical resident learners were rated by the standardized patients according to a strict task checklist of criteria at both the precurricular and postcurricular OSCEs. Improvement in the competencies of Professionalism and Communication did achieve statistical significance (P = .029 and P = .011, respectively). CONCLUSIONS: This study suggests that the Communication and Professionalism ACGME competencies can be taught to surgical resident learners through a carefully crafted curriculum. Furthermore, these newly learned competencies can affect surgical resident interactions with their patients positively
— id: 106382, year: 2010, vol: 199, page: 86, stat: Journal Article,

New measures to establish the evidence base for medical education: identifying educationally sensitive patient outcomes
Kalet, Adina L; Gillespie, Colleen C; Schwartz, Mark D; Holmboe, Eric S; Ark, Tavinder K; Jay, Melanie; Paik, Steve; Truncali, Andrea; Hyland Bruno, Julia; Zabar, Sondra R; Gourevitch, Marc N
2010 May;85(5):844-851, Academic medicine
Researchers lack the rich evidence base and benchmark patient outcomes needed to evaluate the effectiveness of medical education practice and guide policy. The authors offer a framework for medical education research that focuses on physician-influenced patient outcomes that are potentially sensitive to medical education. Adapting the concept of ambulatory care sensitive conditions, which provided traction to health services research by defining benchmark patient outcomes to measure health system performance, the authors introduce the concept and propose the adoption of educationally sensitive patient outcomes and suggest two measures: patient activation and clinical microsystem activation. They assert that the ultimate goal of medical education is to ensure that measurement of future physicians' competence and skills is based not only on biomedical knowledge and critical clinical skills but also on the ability to translate these competencies into effective patient- and systems-level outcomes. The authors consider methodological approaches and challenges to measuring such outcomes and argue for large, multiinstitutional, prospective cohort studies and the development of a national Database for Research in Education in Academic Medicine to provide the needed infrastructure. They advocate taking the next steps to establish an educational evidence base to guide the academic medical centers of the 21st century in aligning medical education practice with health care delivery that meets the needs of individuals and populations
— id: 110111, year: 2010, vol: 85, page: 844, stat: Journal Article,

WHAT THEY BRING WITH THEM TO MEDICAL SCHO
Mercuri, J; Gillespie, C; Hanley, K; Zabar, S; Kalet, A
2010 JUN ;25(9):431-431, Journal of general internal medicine
— id: 111920, year: 2010, vol: 25, page: 431, stat: Journal Article,

ASSESSING RESIDENTS COMPETENCE IN TWO CONTEXTS: STANDARDIZED PATIENT EXAMS AND UNANNOUNCED STANDARDIZED PATIENT VISITS
Zabar, S; Lipkin, M; Hanley, K; Burgess, A; Bruno, JH; Adams, J; Kalet, A; Gillespie, C
2010 JUN ;25(9):227-227, Journal of general internal medicine
— id: 111907, year: 2010, vol: 25, page: 227, stat: Journal Article,

In Reply to Regarding "Can Unannounced Standardized Patients Assess..."
Zabar, S; Manko, J; Regan, L
2010 MAR ;17(3):346-346, Academic emergency medicine
— id: 108322, year: 2010, vol: 17, page: 346, stat: Journal Article,

UNANNOUNCED STANDARDIZED PATIENTS: A NOVEL METHOD OF ASSESSING THE CLINICAL CARE TEAM
Zabar, S; Murphy, J; Hanley, K; Stevens, D; Burgess, A; Bruno, JH; Kalet, A; Gillespie, C
2010 JUN ;25(9):472-473, Journal of general internal medicine
— id: 111922, year: 2010, vol: 25, page: 472, stat: Journal Article,

Can interactive skills-based seminars with standardized patients enhance clinicians' prevention skills? Measuring the impact of a CME program
Zabar, Sondra; Hanley, Kathleen; Stevens, David L; Ciotoli, Carlo; Hsieh, Amy; Griesser, Cecily; Anderson, Marian; Kalet, Adina
2010 Aug;80(2):248-252, Patient education & counseling
OBJECTIVE: Communication skills are crucial for high-risk behavior screening and counseling. Practicing physicians have limited opportunities to improve these skills. This paper assesses the impact of a continuing medical education (CME) program for Student Health Center clinicians that targeted communication skills, screening practices and patient satisfaction. METHODS: Program evaluation included pre- and post-objective structured clinical examinations (OSCE's), chart review, and provider and patient satisfaction surveys. Data were analyzed using paired t-tests and ranked sum tests. RESULTS: OSCE scores (n=15) revealed significant improvements in communication skills overall (p=0.004) and within specific domains (data gathering: p=0.003; rapport building: p=0.01; patient education: p=0.02), but no change in case-specific knowledge (p=0.1). Participants (n=14) reported high satisfaction with program methods (mean=4.6/5) and content (mean=4.7/5), 70% planning to alter their clinical practice. Chart audits (pre=96, post=103) showed increased screening for smoking (RR 1.65, p=0.03), depressed mood (RR 1.40, p=0.04), anhedonia (RR 1.47, p=0.01), sexual activity (RR 1.73, p=0.002) and drinking (RR 1.77, p=0.04). Sampling of satisfaction among participants' patients (pre n=689, post n=383) detected no increase in already high baseline satisfaction. CONCLUSION: This curriculum improved clinicians' relevant skills and screening behavior. PRACTICE IMPLICATIONS: Skills-oriented CME can improve clinicians' communication skills and screening and counseling practices
— id: 111340, year: 2010, vol: 80, page: 248, stat: Journal Article,

Teaching the Competencies: Using Objective Structured Clinical Encounters for Gastroenterology Fellows
Chander, Bani; Kule, Robert; Baiocco, Peter; Chokhavatia, Sita; Kotler, Don; Poles, Michael; Zabar, Sondra; Gillespie, Colleen; Ark, Tavinder; Weinshel, Elizabeth
2009 May;7(5):509-514, Clinical Gastroenterology & Hepatology
BACKGROUND AIMS: Objective structured clinical encounters (OSCEs) are used widely to educate and assess the competence of medical students and residents; they generally are absent from fellowship training. The Accreditation Council for Graduate Education has cited OSCEs as a best practice for assessing the 6 core competencies. This article reports on the use of an OSCE to assess the competence of second-year gastroenterology fellows in the difficult-to-assess core competencies: interpersonal and communication skills and professionalism. METHODS: We developed a 4-station, faculty-observed OSCE with 4 standardized patients. Information gathering, relationship development, patient education, and counseling skills were assessed. Professionalism skills assessed included obtaining informed consent, delivering bad news, managing difficult situations, and showing interdisciplinary respect. In each station, faculty and standardized patients completed an 18- to 24-item checklist evaluating fellows' performance and provided feedback to the fellows. Nine fellows and 5 faculty from 4 gastroenterology training programs in NYC participated. RESULTS: Fellows and faculty generally highly rated the realism of the OSCE and favorably rated the OSCE for its difficulty and their overall experience. Across all cases, fellows were rated as receiving 'well dones' for 56.4% of the communication items (SD, 18.3%) and for 79.1% of the professionalism items (SD, 16.4%). CONCLUSIONS: Integrating OSCEs into gastroenterology fellowship training may help enhance communication skills and prepare fellows for dealing with difficult clinical situations and provides mechanisms for constructive feedback. OSCEs developed collaboratively can assist in program self-evaluation and reduce costs by sharing resources, in addition to fulfilling Accreditation Council for Graduate Education mandates
— id: 97798, year: 2009, vol: 7, page: 509, stat: Journal Article,

Residents' perceptions of their own professionalism and the professionalism of their learning environment
Gillespie, Colleen; Paik, Steve; Ark, Tavinder; Zabar, Sondra; Kalet, Adina
2009 Dec;1(2):208-215, Journal of graduate medical education
BACKGROUND: The competency of professionalism encompasses a range of behaviors in multiple domains. Residency programs are struggling to integrate and effectively assess professionalism. We report results from a survey assessing residents' perceptions of their professional competence and the professionalism of their learning environment. METHODS: A survey was developed to assess specific behaviors reflecting professionalism based on the conceptualizations of key accrediting bodies. Residents rated their ability to perform the behaviors and reported the frequency with which they observed their fellow residents failing to perform the behaviors. Eighty-five senior residents in emergency medicine, internal medicine, pediatrics, psychiatry, and surgery specialties completed the survey (response rate = 77%). Differences among domains (and among items within domains) were assessed. Correlations between perceived professionalism and the professionalism of the learning environment were described. RESULTS: Cronbach alpha for professionalism competence was .93 and for professionalism in the learning environment it was .86. Residents reported feeling most competent in being accountable (mean score = 51.4%; F = 10.3, p<.001) and in demonstrating respect. Some residents reported having trouble being sensitive to patients (n = 5 to 23). Disrespectful behaviors were the most frequently witnessed professionalism lapse in the learning environment (mean = 41.1%; F = 8.1, p<.001). While serious lapses in professionalism were not witnessed with great frequency in the learning environment, instances of over-representing qualifications were reported. Problems in accountability in the learning environment were negatively associated with residents' perceived competence. CONCLUSIONS: Residents reported being able to perform professionally most of the time, especially in terms of accountability and respect. However, disrespect was a feature of the learning environment for many residents and several serious lapses were witnessed by a small number of residents. Accountability in the learning environment may be an important indicator of or influence on residents' professionalism
— id: 149733, year: 2009, vol: 1, page: 208, stat: Journal Article,

IMPACT OF ADDING VIDEOTAPE REVIEW OF STANDARDIZED PATIENT ENCOUNTERS ON STUDENTS' ATTITUDES AND SKILLS
Hanley, K; Zabar, S; Disney, L; Gillespie, C
2009 APR ;24(10):230-230, Journal of general internal medicine
— id: 99172, year: 2009, vol: 24, page: 230, stat: Journal Article,

IS THERE AN ASSOCIATION BETWEEN QUALITY OF OBESITY COUNSELING AND PATIENTS' MOTIVATION AND INTENTION TO CHANGE THEIR BEHAVIORS?
Jay, M; Schlair, S; Gillespie, C; Zabar, S; Ark, T; Sherman, S; Axtmayer, A; Von Erck, D; Stevens, DL; Kalet, AL
2009 APR ;24(10):111-111, Journal of general internal medicine
— id: 99166, year: 2009, vol: 24, page: 111, stat: Journal Article,

A randomized trial of a brief multimedia intervention to improve comprehension of food labels
Jay, Melanie; Adams, Jennifer; Herring, Sharon J; Gillespie, Colleen; Ark, Tavinder; Feldman, Henry; Jones, Vicky; Zabar, Sondra; Stevens, David; Kalet, Adina
2009 Jan;48(1):25-31, Preventive medicine
OBJECTIVE: Food label use is associated with better food choices, an essential part of the management of many chronic diseases. Previous studies suggest lack of comprehension of food labels. We studied a multimedia intervention to improve food label comprehension in a sample of low income patients in New York City. METHODS: This randomized study took place at Gouverneur Healthcare Services from 2005 until 2007. The intervention group (n=29) received a Nutrition Facts Label pocket card and viewed a video explaining card use. The control group (n=27) received written materials. Participants completed a 12-item pre- and post-intervention nutrition food label quiz. Quiz scores were analyzed using repeated measures analysis of variance. RESULTS: The intervention group had greater improvement on the quiz than the control group (p<0.001). There was a three way interaction by time with health literacy and treatment group where the greatest improvement occurred in patients with adequate health literacy in the intervention group (p<0.05). There was no improvement in patients with limited health literacy. CONCLUSION: A multimedia intervention is an effective way to improve short-term food label comprehension in patients with adequate health literacy. Further research is necessary to improve understanding of food labels in patients with limited health literacy
— id: 97782, year: 2009, vol: 48, page: 25, stat: Journal Article,

Physicians' attitudes about obesity and their associations with competency and specialty: a cross-sectional study
Jay, Melanie; Kalet, Adina; Ark, Tavinder; McMacken, Michelle; Messito, Mary Jo; Richter, Regina; Schlair, Sheira; Sherman, Scott; Zabar, Sondra; Gillespie, Colleen
2009 ;9:106-106, BMC health services research
BACKGROUND: Physicians frequently report negative attitudes about obesity which is thought to affect patient care. However, little is known about how attitudes toward treating obese patients are formed. We conducted a cross-sectional survey of physicians in order to better characterize their attitudes and explore the relationships among attitudes, perceived competency in obesity care, including report of weight loss in patients, and other key physician, training, and practice characteristics. METHODS: We surveyed all 399 physicians from internal medicine, pediatrics, and psychiatry specialties at one institution regarding obesity care attitudes, competency, including physician report of percent of their patients who lose weight. We performed a factor analysis on the attitude items and used hierarchical regression analysis to explore the degree to which competency, reported weight loss, physician, training and practice characteristics explained the variance in each attitude factor. RESULTS: The overall response rate was 63%. More than 40% of physicians had a negative reaction towards obese patients, 56% felt qualified to treat obesity, and 46% felt successful in this realm. The factor analysis revealed 4 factors-Physician Discomfort/Bias, Physician Success/Self Efficacy, Positive Outcome Expectancy, and Negative Outcome Expectancy. Competency and reported percent of patients who lose weight were most strongly associated with the Physician Success/Self Efficacy attitude factor. Greater skill in patient assessment was associated with less Physician Discomfort/Bias. Training characteristics were associated with outcome expectancies with newer physicians reporting more positive treatment expectancies. Pediatric faculty was more positive and psychiatry faculty less negative in their treatment expectancies than internal medicine faculty. CONCLUSION: Physician attitudes towards obesity are associated with competency, specialty, and years since postgraduate training. Further study is necessary to determine the direction of influence and to explore the impact of these attitudes on patient care
— id: 100613, year: 2009, vol: 9, page: 106, stat: Journal Article,

Impact of a Web-Based Alcohol Screening and Brief Intervention Module
Lee, J.; Gillespie, C.; Gourevitch, M. N.; Hanley, K.; Jay, M.; Paik, S.; Richter, R.; Triola, M.; Zabar, S.; Kalet, A.
2009 OCT ;30(2):204-204, Substance abuse
— id: 114207, year: 2009, vol: 30, page: 204, stat: Journal Article,

Medical students retain pain assessment and management skills long after an experiential curriculum: A controlled study
Stevens, David L; King, Danielle; Laponis, Ryan; Hanley, Kathleen; Zabar, Sondra; Kalet, Adina L; Gillespie, Colleen
2009 Oct;145(3):319-324, Pain
We implemented a pain assessment and management (PAM) curriculum for second year medical students and evaluated long-term skills retention compared to the prior year's class which did not receive the curriculum. The curriculum included pain pathophysiology, assessment and treatment instruction plus feedback on PAM practice with standardized patients. Both cohorts underwent a required end-of-third-year clinical skills examination. Intervention and control group performance on three pain cases (acute, chronic and terminal) was compared. The PAM curriculum was implemented 1.5years before the intervention cohort participated in the clinical skills exam. More intervention students (134/159, 84.3% response rate) obtained basic (87.2% vs. 76.0%, p=.028) and comprehensive (75.2% vs. 60.9%, p=.051) descriptions of acute pain than control students (n=129/174, 74.1% response rate). Intervention students demonstrated superior skills for terminal pain, including: more often asking about impact on functioning (40.7% vs. 25.8%, p=.027), advising change of medication (97.3% vs. 38.7%, p<.001), and providing additional medication counseling (55.0% vs. 27.0%, p<.001). Virtually all students obtained basic descriptions of chronic (intervention vs. control, 98.1% vs. 96.1%, p=.367) and terminal (92.9% vs. 91.7%, p=.736) pain. Surprisingly, more control than intervention students obtained a comprehensive description of chronic pain (94.6% vs. 77.8%, p<.001) and asked about current pain medication in the terminal case (75.6% vs. 55.0%, p=.004). Exposure to the curriculum resulted in durable increases in students' ability to perform PAM skills in patients with acute and terminal pain
— id: 101565, year: 2009, vol: 145, page: 319, stat: Journal Article,

UNANNOUNCED STANDARDIZED PATIENTS (USP) CAN ASSESS PROFESSIONALISM AND COMMUNICATION SKILLS IN THE EMERGENCY ROOM
Zabar, S; Ark, TK; Gillespie, C; Kachur, EK; Hsieh, A; Kalet, AL; Manko, JA; Regan, LA
2009 APR ;24(10):203-203, Journal of general internal medicine
— id: 99169, year: 2009, vol: 24, page: 203, stat: Journal Article,

Can Unannounced Standardized Patients Assess Professionalism and Communication Skills in the Emergency Department?
Zabar, Sondra; Ark, Tavinder; Gillespie, Colleen; Hsieh, Amy; Kalet, Adina; Kachur, Elizabeth; Manko, Jeffrey; Regan, Linda
2009 Sep;16(9):915-918, Academic emergency medicine
Abstract Objectives: The authors piloted unannounced standardized patients (USPs) in an emergency medicine (EM) residency to test feasibility, acceptability, and performance assessment of professionalism and communication skills. Methods: Fifteen postgraduate year (PGY)-2 EM residents were scheduled to be visited by two USPs while working in the emergency department (ED). Multidisciplinary support was utilized to ensure successful USP introduction. Scores (% well done) were calculated for communication and professionalism skills using a 26-item, behaviorally anchored checklist. Residents' attitudes toward USPs and USP detection were also surveyed. Results: Of 27 USP encounters attempted, 17 (62%) were successfully completed. The detection rate was 44%. Eighty-three percent of residents who encountered a USP felt that the encounter did not hinder daily practice and did not make them uncomfortable (86%) or suspicious of patients (71%). Overall, residents received a mean score of 60% for communication items rated 'well done' (SD +/- 28%, range = 23%-100%) and 53% of professionalism items 'well done' (SD +/- 20%, range = 23%-85%). Residents' communication skills were weakest for patient education and counseling (mean = 43%, SD +/- 31%), compared with information gathering (68%, SD +/- 36% and relationship development (62%, SD +/- 32%). Scores of residents who detected USPs did not differ from those who had not. Conclusions: Implementing USPs in the ED is feasible and acceptable to staff. The unpredictability of the ED, specifically resident schedules, accounted for most incomplete encounters. USPs may represent a new way to assess real-time resident physician performance without the need for faculty resources or the bias introduced by direct observation. ACADEMIC EMERGENCY MEDICINE 2009; 16:1-4 (c) 2009 by the Society for Academic Emergency Medicine
— id: 101564, year: 2009, vol: 16, page: 915, stat: Journal Article,

No place like home: teaching home visits
Zabar, Sondra; Hanley, Kathleen; Adams, Jennifer; Ark, Tavinder K
2009 Nov;43(11):1102-1103, Medical education
— id: 105167, year: 2009, vol: 43, page: 1102, stat: Journal Article,

Do internists, pediatricians, and psychiatrists feel competent in obesity care?: using a needs assessment to drive curriculum design
Jay, Melanie; Gillespie, Colleen; Ark, Tavinder; Richter, Regina; McMacken, Michelle; Zabar, Sondra; Paik, Steven; Messito, Mary Jo; Lee, Joshua; Kalet, Adina
2008 Jul;23(7):1066-1070, Journal of general internal medicine
BACKGROUND: Physicians must effectively evaluate and treat obesity. To design a needs-driven curriculum intended to improve patient outcomes, physicians were surveyed about their self-perceived knowledge and skills. OBJECTIVE: The objective of this study was to determine the expressed needs of residents and faculty regarding obesity care training across three specialties. DESIGN: The study used a survey given to faculty and residents in General Internal Medicine, Pediatrics, and Psychiatry. METHODS: Survey questions were generated from comprehensive nutrition curriculum and clinical recommendations, administered online, and then organized around a validated behavioral health framework-the 5As (assess, advise, agree, assist, arrange). Analyses were conducted to evaluate differences in perceived knowledge and skills between specialties and across training levels. RESULTS: From an overall response rate of 65% (65 residents and 250 faculty members), nearly 20% reported inadequate competency in every item with 48% of respondents reporting an inability to adequately counsel patients about common treatment options. Internists reported the lowest competency in arranging referrals and follow-up. Psychiatrists reported the lowest competency in assessment skills. CONCLUSIONS: This survey demonstrated a critical need for training in specific areas of obesity care. The proposed curriculum targets these areas taking into consideration observed differences across specialties
— id: 82919, year: 2008, vol: 23, page: 1066, stat: Journal Article,

Twenty years of fostering the development of caring, balanced practitioners for the underserved: Major results of an in-depth survey of graduates of a humanistic primary care residency program
Laponis, R; Gillespie, C; Zabar, S; Kalet, AL; Adams, JG; Shah, NR; Anderson, M; Lipkin, M
2008 MAR ;23(2):429-429, Journal of general internal medicine
— id: 78177, year: 2008, vol: 23, page: 429, stat: Journal Article,

Working with patients with alcohol problems: a controlled trial of the impact of a rich media web module on medical student performance
Lee, Joshua D; Triola, Marc; Gillespie, Colleen; Gourevitch, Marc N; Hanley, Kathleen; Truncali, Andrea; Zabar, Sondra; Kalet, Adina
2008 Jul;23(7):1006-1009, Journal of general internal medicine
INTRODUCTION/AIMS: We designed an interactive web module to improve medical student competence in screening and interventions for hazardous drinking. We assessed its impact on performance with a standardized patient (SP) vs. traditional lecture. SETTING: First year medical school curriculum. PROGRAM DESCRIPTION: The web module included pre/posttests, Flash(c), and text didactics. It centered on videos of two alcohol cases, each contrasting a novice with an experienced physician interviewer. The learner free-text critiqued each clip then reviewed expert analysis. PROGRAM EVALUATION: First year medical students conveniently assigned to voluntarily complete a web module (N = 82) or lecture (N = 81) were rated by a SP in a later alcohol case. Participation trended higher (82% vs. 72%, p < .07) among web students, with an additional 4 lecture-assigned students crossing to the web module. The web group had higher mean scores on scales of individual components of brief intervention (assessment and decisional balance) and a brief intervention composite score (1-13 pt.; 9 vs. 7.8, p < .02) and self-reported as better prepared for the SP case. CONCLUSIONS: A web module for alcohol use interview skills reached a greater proportion of voluntary learners and was associated with equivalent overall performance scores and higher brief intervention skills scores on a standardized patient encounter
— id: 82918, year: 2008, vol: 23, page: 1006, stat: Journal Article,

Two decades of Title VII support of a primary care residency: process and outcomes
Lipkin, Mack; Zabar, Sondra R; Kalet, Adina L; Laponis, Ryan; Kachur, Elizabeth; Anderson, Marian; Gillespie, Colleen C
2008 Nov;83(11):1064-1070, Academic medicine
PURPOSE: To assess 23 years of Health Resources and Services Administration (HRSA) Title VII Training in Primary Care Medicine and Dentistry funding to the New York University School of Medicine/Bellevue Primary Care Internal Medicine Residency Program. The program, begun in 1983 within a traditional, inner-city, subspecialty-oriented internal medicine program, evolved into a crucible of systematic innovation, catalyzed and made feasible by initiatives funded by the HRSA. The curriculum stressed three pillars of generalism: psychosocial medicine, clinical epidemiology, and health policy. It developed tight, objectives-driven, effective, nonmedical specialty blocks and five weekly primary care activities that created a paradigm-driven, community-based, role-modeling matrix. Innovation was built in. Every block and activity was evaluated immediately and in an annual, program-wide retreat. Evaluation evolved from behavioral checklists of taped interviews to performance-based, systematic, annual objective structured clinical examinations. METHOD: The authors reviewed eight grant proposals, project reports, and curriculum and program evaluations. They also quantitatively and qualitatively surveyed the 122 reachable graduates from the first 20 graduating classes of the program. RESULTS: Analysis of program documents revealed recurring emphases on the use of proven educational models, strategic innovation, and assessment and evaluation to design and refine the program. There were 104 respondents (85%) to the survey. A total of 87% of the graduates practice as primary care physicians, 83% teach, and 90% work with the underserved; 54% do research, 36% actively advocate on health issues for their patients, programs, and other constituencies, and 30% publish. Graduates cited work in the community and faculty excitement and energy as essential elements of the program's impact; overall, graduates reported high personal and career satisfaction and low burnout. CONCLUSIONS: With HRSA support, a focused, innovative program evolved which has already met each of the six recommendations for future innovation of the Alliance for Academic Internal Medicine Education Redesign Task Force. This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs
— id: 93382, year: 2008, vol: 83, page: 1064, stat: Journal Article,

Competency in System Based Practice: Making the system transparent - A web module with "learner appeal"
Zabar, S; Gillespie, C; Morris, K; Bernstein, CA; Ark, T; Triola, M; Holloway, W; Kalet, A
2008 MAR ;23(2):217-217, Journal of general internal medicine
— id: 78173, year: 2008, vol: 23, page: 217, stat: Journal Article,

No place like home: Benefits of a home visit curriculum
Zabar, S; Hanley, K; David, S; Ark, T; Mara, K; Fumansky, M; Adams, J; Adina, K
2008 MAR ;23(2):351-351, Journal of general internal medicine
— id: 78176, year: 2008, vol: 23, page: 351, stat: Journal Article,

Using bedside rounds to teach communication skills in the internal medicine clerkship
Janicik, Regina; Kalet, Adina L; Schwartz, Mark D; Zabar, Sondra; Lipkin, Mack
2007 ;12(2):1-6, Medical Education Online
Background: Physicians' communication skills, which are linked to important patient outcomes, are rarely explicitly taught during the clinical years of medical school. This paper describes the development, implementation, and evaluation of a communication skills curriculum during the third-year Internal Medicine Clerkship. Methods: In four two-hour structured bedside rounds with trained Internal Medicine faculty facilitators, students learned core communication skills in the context of common challenging clinical situations. In an end-of-clerkship survey students evaluated the curriculum's educational effectiveness. Results: Over the course of a year, 160 third-year students and 15 faculty participated. Of the 75/160 (47%) of students who completed the post-clerkship survey, almost all reported improvement in their communication skills and their ability to deal with specific communication challenges. Conclusions: The curriculum appears to be a successful way to reinforce core communication skills and practice common challenging situations students encounter during the Internal Medicine Clerkship. (journal abstract)
— id: 79111, year: 2007, vol: 12, page: 1, stat: Journal Article,

Using bedside rounds to teach communication skills in the internal medicine clerkship
Janicik, Regina; Kalet, Adina L; Schwartz, Mark D; Zabar, Sondra; Lipkin, Mack
2007 ;12(1):?-?, Medical Education Online
Background: Physicians\' communication skills, which are linked to important patient outcomes, are rarely explicitly taught during the clinical years of medical school. This paper describes the development, implementation, and evaluation of a communication skills curriculum during the third-year Internal Medicine Clerkship. Methods: In four two-hour structured bedside rounds with trained Internal Medicine faculty facilitators, students learned core communication skills in the context of common challenging clinical situations. In an end-of-clerkship survey students evaluated the curriculum\'s educational effectiveness. Results: Over the course of a year, 160 third-year students and 15 faculty participated. Of the 75/160 (47%) of students who completed the post-clerkship survey, almost all reported improvement in their communication skills and their ability to deal with specific communication challenges. Conclusions: The curriculum appears to be a successful way to reinforce core communication skills and practice common challenging situations students encounter during the Internal Medicine Clerkship.
— id: 105275, year: 2007, vol: 12, page: ?, stat: Journal Article,

Tackling the obesity epidemic in low literacy populations: A RCT of an intervention to teach patients to understand nutrition food labels
Jay, M; Adams, JG; Herring, SJ; Feldman, HJ; Lee, G; Qin, A; Kalet, AL; Tseng, C; Stevens, DL; Zabar, S
2007 APR ;22(1):110-110, Journal of general internal medicine
— id: 87185, year: 2007, vol: 22, page: 110, stat: Journal Article,

Medical students retain pain assesment and management (PAM) skills long after an experiential curriculum: A controlled study
Stevens, DL; King, D; Laponis, R; Hanley, K; Waldman, S; Gillespie, C; Zabar, S; Kalet, AL
2007 APR ;22(1):88-88, Journal of general internal medicine
— id: 87184, year: 2007, vol: 22, page: 88, stat: Journal Article,

General Health Questions- A Virtual OSCE
Triola, Marc M; Feldman, Henry; Kalet, Adina; Zabar, Sondra; Kachur, Elizabeth; Anderson, Marian; Lipkin, Mack
MedEdPORTAL [sl : AAMC],
CHIP Case: 27 Year-old Korean female suffering from normal anxiety and 'worried well.' - We are looking for collaborators to both create and study the impact of Virtual Patients. At this stage of our development, the VP cases are available (after registering with us) to any faculty from an accredited institution. If that faculty wishes to make it available to students in their institution they may do so. The scripts would be available to any faculty/school with whom we are or would be collaborating
— id: 5650, year: 2007, vol: , page: ?, stat: Chapter,

Migraine Follow-up - A Virtual OSCE
Triola, Marc M; Feldman, Henry; Kalet, Adina; Zabar, Sondra; Kachur, Elizabeth; Anderson, Marian; Lipkin, Mack
MedEdPORTAL [sl : AAMC],
CHIP Case: 22 year old Chinese Female and 23-year-old White (Non-Hispanic) female dealing with bereavment. -We are looking for collaborators to both create and study the impact of Virtual Patients. At this stage of our development, the VP cases are available (after registering with us) to any faculty from an accredited institution. If that faculty wishes to make it available to students in their institution they may do so. The scripts would be available to any faculty/school with whom we are or would be collaborating
— id: 5648, year: 2007, vol: , page: ?, stat: Chapter,

Psychosocial Aspects of Terrorism and Disaster Medicine
Triola, Marc M; Feldman, Henry; Kalet, Adina; Zabar, Sondra; Kachur, Elizabeth; Anderson, Marian; Lipkin, Mack
MedEdPORTAL [sl : AAMC],
Web-based online course (Virtual Patient). Users will be required to complete a registration form on the NYU website before gaining access. Registration is free but is restricted to full-time teaching faculty or administrators affiliated with a recognized educational institution. This online course will provide useful information and tools to address patients' psychosocial responses to terrorist threats or attacks, to help focus responses of health care teams in acute situations, and to fulfill leadership roles in communities. The modules emphasize the most common psychosocial stress responses to bio-terrorism and disasters: 1. Acute Stress Disorder 2. Post-Traumatic Stress Disorder (PTSD)
— id: 5647, year: 2007, vol: , page: ?, stat: Chapter,

Surgical PA - A Virtual OSCE
Triola, Marc M; Feldman, Henry; Kalet, Adina; Zabar, Sondra; Kachur, Elizabeth; Anderson, Marian; Lipkin, Mack
MedEdPORTAL [sl : AAMC],
CHIP Case: 31 year-old White male with Acute Stress Disorder. -We are looking for collaborators to both create and study the impact of Virtual Patients. At this stage of our development, the VP cases are available (after registering with us) to any faculty from an accredited institution. If that faculty wishes to make it available to students in their institution they may do so. The scripts would be available to any faculty/school with whom we are or would be collaborating
— id: 5649, year: 2007, vol: , page: ?, stat: Chapter,

A randomized trial of teaching clinical skills using virtual and live standardized patients
Triola, M; Feldman, H; Kalet, A L; Zabar, S; Kachur, E K; Gillespie, C; Anderson, M; Griesser, C; Lipkin, M
2006 May;21(5):424-429, Journal of general internal medicine
BACKGROUND: We developed computer-based virtual patient (VP) cases to complement an interactive continuing medical education (CME) course that emphasizes skills practice using standardized patients (SP). Virtual patient simulations have the significant advantages of requiring fewer personnel and resources, being accessible at any time, and being highly standardized. Little is known about the educational effectiveness of these new resources. We conducted a randomized trial to assess the educational effectiveness of VPs and SPs in teaching clinical skills. OBJECTIVE: To determine the effectiveness of VP cases when compared with live SP cases in improving clinical skills and knowledge. DESIGN: Randomized trial. PARTICIPANTS: Fifty-five health care providers (registered nurses 45%, physicians 15%, other provider types 40%) who attended a CME program. INTERVENTIONS: Participants were randomized to receive either 4 live cases (n=32) or 2 live and 2 virtual cases (n=23). Other aspects of the course were identical for both groups. RESULTS: Participants in both groups were equivalent with respect to pre-post workshop improvement in comfort level (P=.66) and preparedness to respond (P=.61), to screen (P=.79), and to care (P=.055) for patients using the skills taught. There was no difference in subjective ratings of effectiveness of the VPs and SPs by participants who experienced both (P=.79). Improvement in diagnostic abilities were equivalent in groups who experienced cases either live or virtually. CONCLUSIONS: Improvements in performance and diagnostic ability were equivalent between the groups and participants rated VP and SP cases equally. Including well-designed VPs has a potentially powerful and efficient place in clinical skills training for practicing health care workers
— id: 67849, year: 2006, vol: 21, page: 424, stat: Journal Article,

Psychosocial Aspects of Terrorism and Disaster Medicine
Triola, Mark; Feldman, Henry; Zabar, Sondra; Anderson, Marian; Kalet, Adina; Kachur, Elizabeth; Lipkin, Mack
2006;:- [Web Site], Nov 9, 2006, MedEdPORTAL
Web-based online course (Virtual Patient). Users will be required to complete a registration form on the NYU website before gaining access. Registration is free but is restricted to full-time teaching faculty or administrators affiliated with a recognized educational institution. This online course will provide useful information and tools to address patients' psychosocial responses to terrorist threats or attacks, to help focus responses of health care teams in acute situations, and to fulfill leadership roles in communities. The modules emphasize the most common psychosocial stress responses to bio-terrorism and disasters: Acute Stress Disorder; Post-Traumatic Stress Disorder (PTSD); Depression / Bereavement; Sub-Diagnostic Distress
— id: 150921, year: 2006, vol: , page: , stat: Web Site,

"Oh! She doesn't speak english!" Assessing resident competence in managing linguistic and cultural barriers
Zabar, Sondra; Hanley, Kathleen; Kachur, Elizabeth; Stevens, David; Schwartz, Mark D; Pearlman, Ellen; Adams, Jennifer; Felix, Karla; Lipkin, Mack Jr; Kalet, Adina
2006 May;21(5):510-513, Journal of general internal medicine
BACKGROUND: Residents must master complex skills to care for culturally and linguistically diverse patients. METHODS: As part of an annual 10-station, standardized patient (SP) examination, medical residents interacted with a 50-year-old reserved, Bengali-speaking woman (SP) with a positive fecal occult blood accompanied by her bilingual brother (standardized interpreter (SI)). While the resident addressed the need for a colonoscopy, the SI did not translate word for word unless directed to, questioned medical terms, and was reluctant to tell the SP frightening information. The SP/SI, faculty observers, and the resident assessed the performance. RESULTS: Seventy-six residents participated. Mean faculty ratings (9-point scale) were as follows: overall 6.0, communication 6.0, knowledge 6.3. Mean SP/SI ratings (3.1, range 1.9 to 3.9) correlated with faculty ratings (overall r=.719, communication r=.639, knowledge r=.457, all P<.01). Internal reliability as measured by Cronbach's alpha coefficients for the 20 item instrument was 0.91. Poor performance on this station was associated with poor performance on other stations. Eighty-nine percent of residents stated that the educational value was moderate to high. CONCLUSION: We reliably assessed residents communication skills conducting a common clinical task across a significant language barrier. This medical education innovation provides the first steps to measuring interpreter facilitated skills in residency training
— id: 66202, year: 2006, vol: 21, page: 510, stat: Journal Article,

Assessing residents' competency in care management: report of a consensus conference
Frohna, John G; Kalet, Adina; Kachur, Elizabeth; Zabar, Sondra; Cox, Malcolm; Halpern, Ralph; Hewson, Mariana G; Yedidia, Michael J; Williams, Brent C
2004 Winter;16(1):77-84, Teaching & learning in medicine
BACKGROUND: Residency programs must prepare physicians to practice in the current health care environment. This mandate is reflected in 3 of the 6 competency domains now required by the Accreditation Council for Graduate Medical Education: systems-based practice, interpersonal skills and communication, and practice-based learning and improvement. SUMMARY: An invitational conference was convened, with experts in clinical practice, managed care administration, and education to identify and recommend optimal and promising assessment methods for 4 target areas: physician-patient communication, ethics, teamwork and collaboration, and practice management. Working in small groups, participants considered a range of resident assessment methods and identified current or future methods for each area, based on reliability, validity, use of behaviorally oriented outcomes, feasibility, and cost. Preferred methods of assessment varied by domain and include written examinations, computer-based patient management problems, standardized patients, objective structured clinical examinations, portfolios, 360-degree evaluations, and patient satisfaction surveys. CONCLUSIONS: The use of several practical, scientifically sound, and specific methods for assessing residents' competency in care management are recommended. Assessment instruments will need to be flexible enough to adapt to the rapid changes in the health care delivery system and terminology
— id: 68813, year: 2004, vol: 16, page: 77, stat: Journal Article,

Measuring the competence of residents as teachers
Zabar, Sondra; Hanley, Kathleen; Stevens, David L; Kalet, Adina; Schwartz, Mark D; Pearlman, Ellen; Brenner, Judy; Kachur, Elizabeth K; Lipkin, Mack
2004 Jun;19(5 Pt 2):530-533, Journal of general internal medicine
Medical residents, frontline clinical educators, must be competent teachers. Typically, resident teaching competence is not assessed through any other means than gleaning learner's comments. We developed, evaluated, and integrated into our annual objective structured clinical examination a resident teaching skills assessment using 'standardized' students. Faculty observers rated residents using a customized 19-item rating instrument developed to assess teaching competencies that were identified and defined as part of our project. This was feasible, acceptable, and valuable to all 65 residents, 8 students, and 16 faculty who participated. Teaching scenarios have potential as reliable, valid, and practical measures of resident teaching skills
— id: 46163, year: 2004, vol: 19, page: 530, stat: Journal Article,

A brief but multi-faceted approach improves clinicians' domestic violence confidence, competence and clinical performance
Haney, Kathleen; Kachur, Elizabeth; Zabar, Sondra
2003 May;37(5):488-489, Medical education
— id: 36197, year: 2003, vol: 37, page: 488, stat: Journal Article,

Faculty development online: an observation and feedback module
Janicik, Regina; Kalet, Adina; Zabar, Sondra
2002 May;77(5):460-461, Academic medicine
— id: 36048, year: 2002, vol: 77, page: 460, stat: Journal Article,

Cough, bronchitis, and pneumonia
Zabar, Sondra; Ofri, Danielle
Bellevue guide to outpatient medicine London : BMJ, 2001,
— id: 3157, year: 2001, vol: , page: 102, stat: Chapter,

Putting it all together: An effective and efficient videotape seminar for senior residents
Zabar, S; Kalet, A
1999 Apr 29-May 1;14(SUPPL. 2):161-161, Journal of general internal medicine
— id: 15908, year: 1999, vol: 14, page: 161, stat: Journal Article,

Physician-patient gender congruence and the physical examination
Link RN; Zabar SR
1991 Sep-Oct;6(5):466-468, Journal of general internal medicine
To assess the hypothesis that breast, genitourinary (GU), and rectal examinations are performed more frequently when the physician and patient are of the same gender, the authors reviewed the records of 529 patients in a housestaff medical clinic. They found no significant difference between gender-congruent and gender-incongruent patient encounters in the rates of these examinations. However, higher rates of performance by primary care housestaff compared with those of internal medicine housestaff were noted in all categories. The authors conclude that performances of breast, GU, and rectal examinations were not related to gender congruence but may have been associated with the houseofficers' training program
— id: 13926, year: 1991, vol: 6, page: 466, stat: Journal Article,