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Engage and Empower Me: Patient Engagement Design

Date: 
Tuesday, September 9, 2014
Course topic: 

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About This Course

Engage and Empower Me: Patient Engagement Design is an online course brought to you by the Stanford AIM Lab and Medicine X at Stanford University.

Our goal is to educate you about participatory medicine and empower you to create a more inclusive, collaborative healthcare system for patients. In this course, you will learn the science of habit formation, behavior change, and decision-making. You will gain knowledge about how human-centered design can empower people and help them make healthy choices. Finally, you will discover how social media platforms can be used to create robust patient communities and how self-tracking devices can provide day-to-day data points that motivate people to make positive changes.

Prerequisites

This course is open to patients, healthcare providers, caregivers, entrepreneurs and anyone interested in how we can engage patient perspectives to improve health outcomes for all. Patient Engagement Design is for anyone who shares the goal of creating a healthier, activated population, and an inclusive, empathic healthcare system. We look forward to assisting you as you progress through this course and encourage you to reach out with feedback. There are no prerequisites.

FAQ: 

Do I need to buy a textbook?

No, all reading materials are optional and are provided.

What is the purpose of this course?

This is nine-week course composed of modules that will teach you design theory, consumer and patient psychology, and models for behavior design and habit formation. We aim to build a motivated, inspired, and informed cohort of patients healthcare innovators by providing a broad spectrum of tools and exposure to experts from various fields who will teach and inspire you.

How is the course structured?

Each module will introduce you to an ePatient with a powerful story to share and a unique perspective on the healthcare system. In addition, you will hear from academics, industry leaders, researchers, and healthcare providers.

We have included several opportunities for you to engage in conversations about the topics covered during the course. Please use the discussion boards for reflection, critical analysis, dialogue, brainstorming, and as an outlet for forming social contracts and committing to your goals.

You can check your understanding by completing questions embedded in the course and an end-of-module assessment.

We will you to apply the strategies you learn to reach your personal health goals; to improve your relationship with the healthcare system; to create innovative healthcare solutions on a large or small scale; or to be a more empathetic and inclusive care providers.

Dr. Larry Chu, MD, MS

Larry Chu is an Associate Professor of Anesthesia on the faculty of the Stanford University School of Medicine. Dr. Chu studies how information technologies can be used to improve medical education and collaborates with researchers in simulation and computer science at Stanford to study how cognitive aids can improve health care outcomes. He is the Executive Director of Stanford Medicine X.

Dr. Kyra Bobinet, MD, MPH

When is comes to health engagement, Dr. Bobinet has 5 words of advice: be caring, authentic, and useful. As the CEO-founder of engagedIN, a behavior design firm sprouted out of Stanford, Kyra is devoting her life to helping people crack the code of how, what, and especially, WHY we engage in things. Kyra has founded several healthcare start-ups, spanning behavior health, population health, and mobile health. She has designed behavior change programs, big data algorithms, billion dollar products, mobile health apps, and evidence-based studies in mind-body and metabolic medicine. All of her designs, whether for at-risk teens or seniors, are rooted in the belief that true caring is our greatest salve. Dr. Bobinet currently co-teaches courses at Stanford School of Medicine on patient engagement and empowerment, and health design with Dr. Larry Chu, founder of MedicineX. She also studies in Dr. BJ Fogg’s Persuasive Tech Lab at Stanford. Dr. Bobinet received her Masters in Public Health at Harvard University, specializing in Healthcare Management, Technology-enabled Behavior Change, and Population Health Management. She received her medical degree from the UCSF School of Medicine. When she’s not geeking out on neuroscience literature, you can find her engaged in her kids, minimalist eco design, and surfing.

Writing in the Sciences

Date: 
Tuesday, September 2, 2014 to Sunday, October 26, 2014
Course topic: 

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About This Course

This course teaches scientists to become more effective writers, using practical examples and exercises. Topics include: principles of good writing, tricks for writing faster and with less anxiety, the format of a scientific manuscript, and issues in publication and peer review. Students from non-science disciplines can benefit from the training provided in the first four weeks (on general principles of effective writing).

Course Format

In the first four weeks, we will review principles of effective writing, examples of good and bad writing, and tips for making the writing process easier. In the second four weeks, we will examine issues specific to scientific writing, including: authorship, peer review, the format of an original manuscript, and communicating science for lay audiences. Students will watch video lectures, complete quizzes and editing exercises, write two short papers, and edit each others’ work.

Course Syllabus

Week 1 - Introduction; principles of effective writing (cutting unnecessary clutter)
Week 2 - Principles of effective writing (verbs)
Week 3 - Crafting better sentences and paragraphs
Week 4 - Organization; and streamlining the writing process
Week 5 - The format of an original manuscript
Week 6 - Reviews, commentaries, and opinion pieces; and the publication process
Week 7 - Issues in scientific writing (plagiarism, authorship, ghostwriting, reproducible research)
Week 8 - How to do a peer review; and how to communicate with the lay public

FAQ: 

Prerequisites

The course has no prerequisites other than fluency in English.

Will I get a Statement of Accomplishment?

Yes, students who score at least 60 percent will pass the course and receive a Statement of Accomplishment.
Students who score at least 90 percent will receive a Statement of Accomplishment with distinction.

How much of a time commitment will this course be?

You should expect this course to require 4 to 8 hours of work per week.

Can I get CME credit for this course?

This free version of the course does not offer CME credits, but there is a fee-based CME version available as well. Go to the Stanford online CME course page for more information. You are welcome to take this free version of the course before the CME course, but note that you will still need to create an account on the CME site, pay the registration fee, and complete the CME Pre-test, Post-test, Evaluation Survey, and Activity Completion Attestation statement in order to receive your credits.

Any additional textbooks/software required?

There is no textbook for this course. Students who would like additional reading may enjoy:

- On Writing Well, William Zinsser
- The Elements of Style, Strunk and White
- Sin and Syntax, Constance Hale
- Essentials of Writing Biomedical Research Papers, Mimi Zeiger
- http://www.aacc.org/publications/clin_chem/ccgsw/Pages/default.aspx
- Science and Society: An Anthology for Readers and Writers, eds: Nelson-McDermott, LePan, Buzzard

- We recommend taking this course on a standard computer using Google Chrome as the internet browser. We are not yet optimized for mobile devices.

Course logo image adapted from one of Nic McPhee's photos on flickr. Used under a Creative Commons license.

Mobile Health Without Borders

Date: 
Sunday, July 27, 2014 to Sunday, August 31, 2014
Course topic: 

Note: The course start date for Mobile Health Without Borders has been moved to July 27th.

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The course will function like a conference, but it takes place over three months rather than two days, and encourages the transformation from passive audience observer to active participant and thought leader.

The themes to be addressed are:

  • Global Health Challenges.
  • Mobile Health Opportunities.
  • Entrepreneurship in Health Care.

Today, more people have access to a mobile phone than to clean drinking water. At the same time, health systems around the world struggle to deliver cost-effective care. For example, where the United States confronts unsustainably soaring costs and millions of underserved citizens, Sub-Saharan Africa endeavours to provide medical care in the context of infrastructural challenges, economic shortfalls, and the highest disease burden in the world. Throughout India and China, investments in mobile entrepreneurship are reshaping how health care is delivered to massive populations. Meanwhile South America is experiencing a surge of entrepreneurial activity that promises to reshape how its citizens interact with the health system.

To expose you to the breadth of activity and opportunity, each class will consist of multiple short presentations from renowned experts. Class discussions about these presentations will also take place online. In the era of expansive and ever-expanding access to mobile technology, ideas can be more readily shared and solutions can more readily reach patients in need, wherever they are. We are more connected than ever before, in many ways: through global dissemination of infectious diseases; through shared challenges such as chronic disease burden; and of course through the Internet and telecom networks. Mobile Health Without Borders aims to realize that promise by providing a platform for participants to increase their capacity to have a meaningful impact on global health. To achieve this, students will work closely with classmates from around the world on small group assignments to prepare for the Health Innovation Challenge: an opportunity to work with a global multi-disciplinary team and world-class mentors to design a solution to a health challenge you care about.

Instructors

Homero Rivas (Advisor)

Homero Rivas, MD, MBA, FACS, is an Assistant Professor of Surgery, and the Director of Innovative Surgery at Stanford University School of Medicine. He has been involved in Mobile Health for nearly five years. With Eric Leroux and others, they have designed and created several mobile phone applications for patients. They have also undertaken research projects exploring software development of HTLM5 platforms to improve safety in the operating room and for technical assessment of surgeons and surgeons in training. Eric and Homero have developed numerous pilot programs with mHealth and Tele Medicine for non-insured Hispanics in the Bay Area. Dr. Rivas has been involved in all of these ventures either as an entrepreneur or as an academician. As a digestive surgeon, he has 13 years of experience, and has been part of Stanford’s General Surgery and Bariatric Surgery faculty since March 2010. Before then, he was an Assistant Professor of Surgery at UT Southwestern Medical Center in Dallas, TX for five years. He is certified by the American Board of Surgery. He is a pioneer and leader in numerous state-of-the art innovative techniques of minimal access surgery including: Single incision laparoscopic surgery; natural orifice surgery; robotic surgery, and more. He has been involved in minimal access surgery both nationally in the U.S. and internationally in nearly all continents, as a surgeon-in-training, a practicing surgeon and also as teacher of other surgeons. He holds an MBA from the Cox School of Business at the Southern Methodist University in Dallas, TX.

Eric Leroux (Director)

Eric Leroux was born and raised in Canada before attending Princeton University, where he earned honors in biology, received the NCAA Sportsmanship Award, Hockey Humanitarian Award, performed research on HIV/AIDS in Kenya, and received the Spirit of Princeton Award. He then moved to South Africa where he worked with BroadReach Healthcare to expand access to therapy for people living with HIV/AIDS. While pursuing his MD at the Stanford University School of Medicine, he published numerous articles and abstracts in top medical journals, has been a teaching assistant for four classes, and received the Gold Humanism in Medicine Award for his clinical skills and dedication to patient care. Eric met Homero while completing his surgery rotation, and since then they have founded two companies together and have worked closely on many projects. He then enrolled at the Stanford Graduate School of Business for an accelerated MD/MBA dual degree program, which he will complete in June of this year. He sees immense opportunities for mobile health and entrepreneurship to help address our most pressing global health challenges. In his words: “The success of MHWB can be measured by two questions: When the class ends, 1) Are you more committed to solving health challenges? and 2) Are you more capable?”

 

International Women's Health & Human Rights

Date: 
Thursday, July 10, 2014 to Friday, September 5, 2014

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This course provides an overview of women's health and human rights issues, beginning in infancy and childhood, then moving through adolescence, reproductive years and aging. We will consider economic, social, political and human rights factors, and the challenges women face in maintaining health and managing their lives in the face of societal pressures and obstacles.

The course focuses on "critical issues," namely those that may mean life or death to a woman, depending on whether she can exercise her human rights. These critical issues include poverty; discrimination against women; unequal access to education, food, paid work and health care; forms of violence, in the home and in war and refugee circumstances; maternal health; and sex trafficking of women.

Our MOOC will have a special focus on creating a network of engaged participants to share experiences and to take part in interactive discussions and cooperative exercises. We ask participants to engage with the communities they live in, in order to deepen their understanding of the issues and tie academic ideas to real-life circumstances.

To find out more details about this course and its principles, please visit our Project Page at www.internationalwomenshealth.org

Our Facebook is: https://www.facebook.com/internationalwomenshealth
Twitter: https://twitter.com/intwomenshealth, track using #intlwomenshealth #iwhhr Tumblr:http://intlwomenshealth.tumblr.com/

FAQ: 

What basic principles form the foundation course?

Because we believe that what we do is important but that the way we do it is more important, we attempt to teach and learn according to a set of principles that will guide the content and processes of the course. These are: compassion, mutual learning, respect, transparency, trust, and truth.

What do I need to take this course?

An interest in health and social justice. It will be useful to have an open mind, willingness to hear different points of view, and a commitment to positive social change. 

Access to the Internet. A stable internet connection will also be useful, as much of the other content, including video interviews and lectures will be delivered online.

The course already started! Is it too late to join?

No you don't have to worry.Because it is an online class, you can comfortably jump into this course the first couple weeks while it is running. You get to review the material and watch video lectures and interviews on your own time! However, you'll want to get up to speed so you can interact with the other students in this international online community.

Is there a textbook for the class?

The primary text for the class is a book on international health and human rights, From Outrage to Courage: The Unjust and Unhealthy Situation of Women in Poorer Countries and What They Are Doing About It (Second Edition), by Anne Firth Murray. If you are interested in having a copy of the book, you can obtain one from Amazon.com. We will also make individual chapters available online during the course.

Can I receive a Statement of Accomplishment for this course?

Yes, participants who successfully complete the required elements of the course will receive a personalized Statement of Accomplishment. Please note that online courses do not include university credit.

COURSE STAFF

Anne Firth Murray

Anne Firth Murray, a New Zealander, was educated at the University of California and New York University in economics, political science and public administration, with a focus on international health policy and women’s reproductive health.

For the pasttwenty-five years, Anne has worked in the field of philanthropy, serving as a consultant to many foundations. From 1978-1987, she directed the environment and international population programs at the William and Flora Hewlett Foundation in California. She is the Founding President of The Global Fund for Women, which aims to seed, strengthen, and link groups committed to women’s well-being and human rights. In 2005, Anne was nominated along with a thousand activist women for the Nobel Peace Prize.

Anne is a Consulting Professor in Human Biology at Stanford University, where she teaches on women's health, human rights and love as a force for social justice. She is the author of the books Paradigm Found: Leading and Managing for Positive Change and From Outrage to Courage: The Unjust and Unhealthy Situation of Women in Poorer Countries and What They Are Doing About It, on international women's health.

Kevin Hsu

Kevin runs a design studio, Skyship Educational Design, developing open online courses (MOOCs) and deploying digital tools in the classroom. He is dedicated to crafting new experiences for students and helped launch one of Stanford’s first social science MOOCs for a global audience, featuring Professor Larry Diamond on the topic of “Democratic Development.” He also teaches for the Program on Urban Studies at Stanford University.

Child Nutrition and Cooking

Course topic: 

Next Session Opens August 29th!

Eating patterns that begin in childhood affect health and well-being across the lifespan. The culture of eating has changed significantly in recent decades, especially in parts of the world where processed foods dominate our dietary intake.

This self-paced course examines contemporary child nutrition and the impact of the individual decisions made by each family. The health risks associated with obesity in childhood are also discussed.

Participants will learn what constitutes a healthy diet for children and adults and how to prepare simple, delicious foods aimed at inspiring a lifelong celebration of easy home-cooked meals. This course will help prepare participants to be the leading health providers, teachers, and parents of the present and future.

The text and other material in this course may include the opinion of the specific instructor and are not statements of advice, endorsement, opinion, or information of Stanford University.

We are now offering the opportunity to take Child Nutrition and Cooking for a Course Certificate.

Can I earn a Course Certificate if I completed this course before they were available?
In order to verify one’s identity and maintain academic integrity, learners who completed assignments or quizzes prior to August 1st, 2016 will need to redo and resubmit these assessments in order to earn a Course Certificate. Though your deadlines may have technically passed, please be assured that you may resubmit both types of assessments at any time. We apologize for the inconvenience and appreciate your patience as we strive to ensure the integrity and value of our certificates.
FAQ: 

Self-paced online course
5 hours of videos and quizzes
Statement of Accomplishment: None
Subtitles: English, Spanish

Instructor(s): 
Maya Adam
Child Nutrition

Statistics in Medicine

Date: 
Tuesday, June 24, 2014 to Monday, September 1, 2014

This course aims to provide a firm grounding in the foundations of probability and statistics. Specific topics include:

1. Describing data (types of data, data visualization, descriptive statistics)
2. Statistical inference (probability, probability distributions, sampling theory, hypothesis testing, confidence intervals, pitfalls of p-values)
3. Specific statistical tests (ttest, ANOVA, linear correlation, non-parametric tests, relative risks, Chi-square test, exact tests, linear regression, logistic regression, survival analysis; how to choose the right statistical test)

The course focuses on real examples from the medical literature and popular press. Each week starts with "teasers," such as: Should I be worried about lead in lipstick? Should I play the lottery when the jackpot reaches half-a-billion dollars? Does eating red meat increase my risk of being in a traffic accident? We will work our way back from the news coverage to the original study and then to the underlying data. In the process, students will learn how to read, interpret, and critically evaluate the statistics in medical studies.

The course also prepares students to be able to analyze their own data, guiding them on how to choose the correct statistical test and how to avoid common statistical pitfalls. Optional modules cover advanced math topics and basic data analysis in R.

COURSE SYLLABUS

Week 1 - Descriptive statistics and looking at data
Week 2 - Review of study designs; measures of disease risk and association
Week 3 - Probability, Bayes' Rule, Diagnostic Testing
Week 4 - Probability distributions
Week 5 - Statistical inference (confidence intervals and hypothesis testing)
Week 6 - P-value pitfalls; types I and type II error; statistical power; overview of statistical tests
Week 7 - Tests for comparing groups (unadjusted); introduction to survival analysis
Week 8 - Regression analysis; linear correlation and regression
Week 9 - Logistic regression and Cox regression

PREREQUISITES

There are no prerequisites for this course.

Students will need to be familiar with a few basic math tools: summation sign, factorial, natural log, exponential, and the equation of a line; a brief tutorial is available on the course website for students who need a refresher on these topics.

FAQ: 

Can I get CME credit for this course?

This free version of the course does not offer CME credits, but there is a fee-based CME version available as well. Go to the Stanford online CME course page for more information. You are welcome to take this free version of the course before the CME course, but note that you will still need to create an account on the CME site, pay the registration fee, and complete the CME Pre-test, Post-test, Evaluation Survey, and Activity Completion Attestation statement in order to receive your credits.

SICKO (CME)

Date: 
Monday, June 24, 2013 to Wednesday, June 24, 2015
Course topic: 

Course closed. Completed 6/24/2015

The course will fill the gap between didactic learning and clinical application in developing an interactive course that offers an opportunity to learn and apply surgical decision making skills for practicing surgeons in treating acute and sub-acute surgical conditions and complications.

Learning Objectives

  • Apply safe surgical decision making skills through clinical practice when treating surgical conditions.
  • Develop skills to become discerning and efficient in the use of diagnostic tests in the approach to treating surgical diseases or problems.
  • Develop skills to improve triage and addressing multiple patient problems at once in a given time frame.
  • Develop skills to recognize and consistently treat acute cholecystitis by performing urgent laparoscopic cholecystectomy.
  • Develop skills to recognize and consistently treat acute appendicitis by performing laparoscopic appendectomy.

Intended Audience

This course is designed to meet the educational needs of a national audience of practicing general surgeons.

TTE Basics (CME)

Course topic: 

TEACHING BASIC BEDSIDE TRANSTHORACIC ECHOCARDIOGRAPHY AND ULTRASONOGRAPHY EXAMINATION TO EVALUATE HYPOTENSION AND HYPOXEMIA

Frequently, healthcare professionals are required to handle medical emergencies and manage hemodynamically unstable patients. Recently, new tools and technologies have become available to enhance diagnosis and management of these patients. Small, relatively inexpensive hand-carried cardiac ultrasound (HCU) devices have become available in the inpatient and outpatient settings. Because they are relatively easy to use and portable, HCU's have made powerful echocardiographic diagnostic data available to physicians. Yet, many of today's practicing physicians lack formal training or a thorough understanding of the basic principles of operation of these devices and the diagnostic benefits they offer. This course will provide an evidence-based overview of the use of HCU's at the clinic and the bedside using video based didactics and demonstrations.

This online curriculum is not a replacement for Level 1 or Level 2 training recommendations by the American Society of Echocardiography (ASE) and American College of Cardiology (ACC), which require personally performing and interpreting echo examinations.

However, the curriculum is a didactic and interactive introduction to the topic, designed to motivate practicing physicians to pursue hands-on training to achieve Level 1 or Level 2 ASE HCU training through further study and practice.

In addition to providing an overview and foundational knowledge about the use of HCU’s in the clinical setting, the curriculum is designed to provide an educational roadmap to further training opportunities and courses that will allow practicing physicians to become independently competent in the use of HCU’s to complement their clinical examination and improve their diagnostic skills.

INTENDED AUDIENCE

This course is designed for physicians with the following specialties: cardiology, family practice, primary care, general surgery, internal medicine, critical care, pulmonology, and emergency medicine.

DATES, DURATION AND FEE

  • Original Release Date: August 29, 2013
  • Latest Review Date: August 12, 2015
  • Expiration Date: August 31, 2017
  • Estimated Time to Complete: 1.5 Hours
  • CME Credits Offered: 1.50
  • Registration Fee: FREE
 

TO OBTAIN CME CREDITS

  • Review the information below and complete the entire activity.
  • Complete the CME Post-test, CME Evaluation Survey, and CME Activity Completion Statement at the end of the activity.
  • You must receive a score of 75% or higher on the post-test in order to receive a certificate. You will have two attempts to answer each multiple-choice question (or one attempt for questions with only two options) to pass the post-test.
  • Once you attest to completing the entire online activity and have scored 75% or higher on the post-test, your certificate will be generated automatically and will be available on your Dashboard page.
  • Physicians will be awarded AMA PRA Category 1 Credits™. All other participants will receive a Certificate of Participation.

LEARNING OBJECTIVES

At the conclusion of this activity, participants should be able to:

  • Develop skills to personally use HCU devices and interpret echo examinations such as identifying cardiac and pulmonary anatomy from HCU exam images and performing a basic HCU exam of the heart and lungs.
  • Develop skills to use HCU devices to diagnose and confirm appropriate therapeutic treatment of pneumothorax.
  • Develop skills to use HCU devices to assess hypoxemia, hypovolemia, and hypotension.
  • Develop skills to use HCU devices to assess presence of cardiac tamponade.
  • Develop skills to use HCU devices to assess ventricular function during CPR.

TTE Basics

SonoDoc (CME)

Course topic: 

Course coming soon! If you would like to be notified of course launch please fill out the CME interest form:
https://stanfordmedicine.qualtrics.com/SE/?SID=SV_b91N3tkQBmouiUZ

Sponsored by
Stanford University School of Medicine 

Presented by
The Department of Surgery, Division of Emergency Medicine at Stanford University School of Medicine

Intended Audience
This course is designed to meet the educational needs of a international audience of physicians, physician assistance and nurse practitioners who specialize in family practice, primary care, general surgery, internal medicine, critical care and emergency medicine.

Course Description
The American Medical Association has recognized the utility of ultrasound; it recommends training and education standards that are developed by each physician’s respective specialty. It has been proven that bedside ultrasound allows the treating physician to more quickly determine the cause of urgent conditions and life-threatening illness and help in guiding resuscitative efforts for patients in shock. If invasive procedures must be performed, they can be done under ultrasound guidance (instead of using blind landmark techniques), decreasing the risk of complications. This has been recommended by the Agency for Healthcare Research and Quality as a key intervention. Emergency Medicine was an early adopter of bedside focused ultrasound due to the need for rapid evaluation of critically ill patients and patients in acute pain. Now, other specialty organizations, including critical care, surgery, internal medicine, ob-gyn, and pediatrics are starting to include ultrasound during residency training. However, many currently practicing physicians were trained before ultrasound training was available or realized its utility in their practice. This course will provide strategies on how to use bedside focused ultrasound, image interpretation, and integrate it in the clinical practice.

Learning Objectives

  • Develop skills to screen for and diagnose emergent conditions such as:

- tamponade, 

-abdominal aortic aneurysm, 

-pneumothorax, 

-shock, 

-ruptured ectopic pregnancy, 

-intraperitoneal hemorrhage, 

-acute hydronephrosis, 

-cholecystitis, 

-acute heart strain/failure 

-cellulitis, 

-abscess, 

-DVT, 

-pulmonary edema, 

-pleural effusion, 

-retinal detachment, 

-orbital rupture, 

-increased intracranial pressure 

and associated symptoms such as:

- abdominal pain, 

-hematuria, 

-chest pain, 

-shortness of breath, 

-leg edema, 

-skin redness, 

-vision loss, 

-back pain, 

-pelvic pain, 

-vaginal bleeding,

- altered mental status and 

-headache.

  • Develop skills and integrate them in clinical practice for ultrasound guided high risk procedures such as:

- central lines placement, 

-thoracentesis, 

-paracentesis, 

-peripheral lines, 

-lumbar puncture, 

-arthrocentesis, 

-pericardiocentesis, 

-abscess drainage, 

-foreign body removal

 

Safe Opioid Prescribing and Risk Evaluation and Mitigation Strategies (REMS) (CME)

Date: 
Monday, November 2, 2015
Course topic: 

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Internet Enduring Material Sponsored by:

Stanford University School of Medicine

Stanford School of Medicine logo

Presented by:

The Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine, in collaboration with the American Academy of Pain Medicine

Course Description

This course aims to improve knowledge, competence and performance in prescribing opioids in the treatment of chronic pain. Specifically, it will increase knowledge of the significant potential for abuse of opioid analgesics and knowledge of the emerging opioid formulations and combinations with the goal to decrease the risks of diversion and abuse. This course will focus on the assessment and recognition of psychological co-morbidities that increase the risk for opioid abuse and diversion, developing treatment plans and implementing interventions aimed at decreasing risk for unintentional misuse in addition to abuse of and addiction to opioid analgesics.

Intended Audience

This course is designed for a national and international audience of physicians, nurse practitioners and physician assistants in all clinical specialties.

Dates, Duration & Fee

  • Release Date: November 2, 2015
  • Expiration Date: August 31, 2017
  • Estimated Time to Complete: 4.5 hours
  • CME Credits Offered: 4.50
  • Registration fee: Free

Please review all of the information on this page before clicking the Courseware tab at the top of the page to begin the course.

To Obtain CME Credits

  • Review the information below and complete the entire activity.
  • Complete the CME Post-test, CME Evaluation Survey, and CME Activity Completion Statement at the end of the activity.
  • You must receive a score of 75% or higher on the post-test in order to receive a certificate. You will have two attempts to answer each multiple-choice question to pass the post-test.
  • Once you attest to completing the entire online activity and have scored 75% or higher on the post-test, your certificate will be generated automatically and will be available on your Dashboard page.
  • Physicians will be awarded AMA PRA Category 1 Credits™. All other participants will receive a Certificate of Participation.

*Participation in any content marked optional is not certified for AMA PRA Category 1 Credit™.

Learning Objectives

At the conclusion of this activity, participants should be able to:

  • Determine the general characteristics, toxicities and drug interactions associated with opioids and incorporate this knowledge in practice.
  • Utilize various opioid risk assessment tools to reduce the risk of opioid misuse and to ensure patient safety.
  • Evaluate and interpret functional improvement, urine drug testing, and data from prescription drug monitoring systems.
  • Develop and implement strategies for termination of opioid therapy and perform the required steps for proper documentation and referral.
  • Integrate counseling of patients/caregivers on the safe use of opioids into practice.

Table of Contents

1. Introduction 
2. Risk Assessment and Substance Abuse Disorders
3. Initiation, Modification, and Discontinuation of Opioid Therapy
4. Managing Therapy with Opioids 
5. Course Wrap-up 
6. Optional Content: Opioid Prescribing Tools 
7. Resources and References
8. Help!

Disclosures

The following planner indicated having relevant relationship(s) with industry to disclose:

Lynn Webster, MD
Vice President, Scientific Affairs
PRA Health Sciences
Raleigh, NC
Planner

Dr. Webster has indicated that he is on the advisory boards of AcelRx Pharmaceuticals, AstraZeneca, Charleston Labs, Collegium Pharmaceuticals, Covidien Mallinckrodt, Egalet, Inspirion Pharmaceuticals, Insys Therapeutics, Jazz Pharmaceuticals, Kaleo, Mallinckrodt Pharmaceuticals, Medtronic, Nektar Therapeutics, Orexo Pharmaceuticals, Pfizer Inc., Proove Biosciences, Salix Pharmaceuticals, Signature Therapeutics, Teva Pharmaceuticals, and Trevena; serves as a consultant to Acura Pharmaceuticals, AstraZeneca, BioDelivery Sciences International (BDSI), Covidien Mallinckrodt, CVS Caremark, Grunenthal USA, Insys Therapeutics, Jazz Pharmaceuticals, Mallinckrodt, Medtronic, Nektar Therapeutics, Neura Therapeutik, Nevro Corp., Proove Biosciences, Salix Pharmaceuticals, Shionogi, and Zogenix; has received honoraria from AstraZeneca, Covidien Mallinckrodt, Jazz Pharmaceuticals, Medtronic, Nektar Therapeutics, and Salix Pharmaceuticals; has received travel expenses from Cara Therapeutics, Charleston Labs, Collegium Pharmaceuticals, Grunenthal USA, Insys Therapeutics, Kaleo, Mallinckrodt, Nevro Corp., Orexo Pharmaceuticals, Pfizer Inc., Proove Biosciences, QRx Pharma, TEVA, Trevena and Zogenix; and has been employed by CRI Lifetree and PRA Health Sciences.

The following planners, speakers and authors have indicated that they have no relationships with industry to disclose relative to the content of this activity:

Sean Mackey, MD, PhD
Redlich Professor and Professor of Neurology
Anesthesiology, Perioperative and Pain Medicine
Stanford University Medical Center
Course Director

Sam Lahidji, MD 
Adjunct Clinical Instructor 
Anesthesiology, Perioperative and Pain Medicine 
Stanford University School of Medicine
Chief, Pain Management
Kaiser Permanete, East Bay
Co-Course Director
Author/Presenter

Gabriel Schonwald, MD 
Adjunct Clinical Assistant Professor 
Anesthesiology, Perioperative and Pain Medicine 
Stanford University School of Medicine
Planner 
Author/Presenter

Jordan Newmark, MD
Clinical Assistant Professor
Anesthesiology, Perioperative and Pain Medicine 
Associate Fellowship Director, Pain Medicine
Stanford University School of Medicine
Planner 
Author/Presenter

Ming-Chih J Kao, MD, PhD
Clinical Assistant Professor
Anesthesiology, Perioperative and Pain Medicine
Orthopaedic Surgery
Stanford University School of Medicine
Planner

Technical Design and Development

Ian Mackey
Video Editing, Recording

Hardware/Software Requirements

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Accreditation and Designation of Credits

The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Stanford University School of Medicine designates this enduring material for a maximum of 4.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Commercial Support Acknowledgement

The Stanford University School of Medicine has received and has used undesignated program funding from Pfizer, Inc. to facilitate the development of innovative CME activities designed to enhance physician competence and performance and to implement advanced technology. A portion of this funding supports this activity.

Cultural and Linguistic Competency

California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. It is the intent of the bill, which went into effect July 1, 2006, to encourage physicians and surgeons, CME providers in the State of California and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area. The Stanford University School of Medicine Multicultural Health Portal also contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws. You are encouraged to visit the portal: http://lane .stanford.edu/portals/cultural.html

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Contact Information

If you are having technical problems (video freezes or is unplayable, can't print your certificate, etc.) you can submit a Help Request to the OpenEdX Team. If you have questions related to CME credit, requirements (Pre-test, Post-test, Evaluation, Attestation) or course content, you can contact the CME Online support team at cmeonline@stanford.edu

Resources and References

Model Policy for the Use of Controlled Substances for the Treatment of Pain Federation of State Medical Boards of the United States, Inc.http://www.fsmb.org/Media/Default/PDF/FSMB/Advocacy/pain_policy_july2013.pdf

VA/DoD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Painhttp://www.healthquality.va.gov/Chronic_Opioid_Therapy_COT.asp

American Pain Society/American Academy of Pain Medicine Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain http://www.jpain.org/article/S1526-5900(08)00831-6/fulltext

For a complete list, go to Resources and References page in the Courseware tab above.

©2015 Stanford University School of Medicine

Safe Opioid Prescription

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