4-Box Practical Approach© is a series of patient-based studies that complement the apprenticeship model of medical education. These case-studies and slide presentations help learners gain cognitive, technical, affective, and experiential knowledge necessary for competent medical procedural practice. Guidelines help construct and deconstruct each case using a uniform approach. Individual coaching, feedback,and dialogue using these case-based exercises significantly improves medical decision-making. The 4-Box Practical Approach is thus able to address virtually every technical, ethical, or scientific aspects of bronchoscopy practice.
THE 4-BOX APPROACH TO BRONCHOSCOPY CONSULTATION
- Learners gain cognitive, technical, affective, and experiential skills necessary to perform minimally invasive bronchoscopic procedures in a patient/family focused-care environment.
- Competency is sought in three major elements of a procedure; strategy and planning, execution, and response to procedure-related adverse events or complications.
- A 4-box clinical case-based approach (inspired from Albert Jonsen’s classic work in medical ethics) addresses pre-procedure evaluation, techniques, expected results, and follow-up/response to complications.
- Clinical judgement and depth of knowledge are assessed by asking learners to justify their decisions using background information, pertinent literature, institutional biases, and personal experience.
- Consistent with the ACGME professionalism competency guides, learners address components of Informed Consent, as well as outcomes based on possible, probable or real results.
|Procedural Techniques and Results
||Long term Management Plan
FOUR BOX APPROACH SCENARIOS vol 1 and PRESENTATIONS are used for clinical case discussions, lectures, and as part of competency-oriented training to objectively and subjectively evaluate a learner’s level of knowledge, clinical judgement and decision-making skills.
4-BOX PRACTICAL APPROACH VIDEO ARCHIVE: View and download from our BronchOrg YouTube channel.
– 4 Box Video Archive clinical cases 1-3
– 4 Box Video Archive clinical cases 4-6
– 4 Box Video Archive clinical cases 7-11
– 4 Box Video Archive clinical cases 12-15
The 4-Box Practical Approach© follows recommendations set forth by the American College of Graduate Medical Education whereby trainees learn to:
- Gather essential and accurate information about their patients.
- Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence and clinical judgment.
- Use information technology to support patient care decisions and patient education.
- Develop patient management plans.
- Counsel and educate patients and their families.
- Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families.
- Provide health care services aimed at preventing health problems or maintaining health.
- Work with health care professionals, including those from other disciplines, to provide patient-focused care.
1. Jonsen AR, Siegler M, Winslade WJ. Clinical Ethics. 6th Ed, McGraw Hill, NY 2006.
2. ACGME Web site: http://www.acgme.org/outcome/comp/compfull.asp
3. Apelgren K. ACGME e-Bulletin. August 2006
4. ACGME Competencies at http://www.acgme.org
4-Box Practical Approach© templates and clinical case scenarios may be used for training, lectures, or research. In case of publication or presentations, please cite as follows:
Bronchoscopy International: The Practical Approach©, an Electronic On-Line Multimedia Slide Presentation. http://www.Bronchoscopy.org/Practical Approach. Published 2016 (Please add “Date Accessed”).
To learn more about The 4-Box Practical Approach©, please watch the video below:
Also, please see Bronchoscopy and Central Airways Disorders: A Patient-centered Approach by Colt HG and Murgu S, published by Elsevier/Saunders, 2012.
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