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https://www.readbyqxmd.com/read/29346222/-to-err-is-human-but-disclosure-must-be-taught-a-simulation-based-assessment-study
#1
Ashley C Crimmins, Ambrose H Wong, James W Bonz, Alina Tsyrulnik, Karen Jubanyik, James D Dziura, Kelly L Dodge, Leigh V Evans
INTRODUCTION: Although error disclosure is critical in promoting safety and patient-centered care, physicians are inconsistently trained in its practice, and few objective methods to assess competence exist. We used an immersive simulation scenario to determine whether providers with varying levels of clinical experience adhere to the disclosure safe practice guidelines when exposed to a serious adverse event simulation scenario. METHODS: This was a prospective cohort study with medical students, junior emergency medicine (EM) residents (PGY 1-2), senior EM residents (PGY 3-4), and attending EM physicians participating in a simulated case in which a scripted medication overdose resulted in an adverse event...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29342985/community-based-health-and-exposure-study-around-urban-oil-developments-in-south-los-angeles
#2
Bhavna Shamasunder, Ashley Collier-Oxandale, Jessica Blickley, James Sadd, Marissa Chan, Sandy Navarro, Michael Hannigan, Nicole J Wong
Oilfield-adjacent communities often report symptoms such as headaches and/or asthma. Yet, little data exists on health experiences and exposures in urban environments with oil and gas development. In partnership with Promotoras de Salud (community health workers), we gathered household surveys nearby two oil production sites in Los Angeles. We tested the capacity of low-cost sensors for localized exposure estimates. Bilingual surveys of 205 randomly sampled residences were collected within two 1500 ft. buffer areas (West Adams and University Park) surrounding oil development sites...
January 15, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29317001/video-based-learning-vs-traditional-lecture-for-instructing-emergency-medicine-residents-in-disaster-medicine-principles-of-mass-triage-decontamination-and-personal-protective-equipment
#3
Henry A Curtis, Karen Trang, Kevin W Chason, Paul D Biddinger
Introduction Great demands have been placed on disaster medicine educators. There is a need to develop innovative methods to educate Emergency Physicians in the ever-expanding body of disaster medicine knowledge. The authors sought to demonstrate that video-based learning (VBL) could be a promising alternative to traditional learning methods for teaching disaster medicine core competencies. Hypothesis/Problem The objective was to compare VBL to traditional lecture (TL) for instructing Emergency Medicine residents in the American College of Emergency Physicians (ACEP; Irving, Texas USA) disaster medicine core competencies of patient triage and decontamination...
January 10, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29315613/the-learning-curve-in-diagnosing-acute-appendicitis-with-emergency-sonography-among-novice-emergency-medicine-residents
#4
Jeehyun Kim, Kipum Kim, Jungwan Kim, Jungwoo Yoo, Wonjoon Jeong, Sunguk Cho, Kihyuk Joo, Yongchul Cho, Jinwoong Lee, Seung Ryu, Yeonho Yoo
PURPOSE: Ultrasonography (US) has good accuracy for diagnosing appendicitis when it is performed by emergency physicians. This study aimed to determine the amount of experience that is required to achieve competency in this field. METHODS: Three novice emergency medicine residents completed a 1-day training course regarding the US diagnosis of appendicitis. Then, they performed appendix US in the emergency department on patients complaining of right lower quadrant pain...
January 5, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29301226/impact-of-pharmacist-conducted-comprehensive-medication-reviews-for-older-adult-patients-to-reduce-medication-related-problems
#5
Whitney J Kiel, Shaun W Phillips
Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization...
December 31, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29299519/expeditious-emergency-room-referral-pathway-improves-patient-access-to-otolaryngology-care
#6
Jeffrey Johnson, Zi Yang Jiang, Daniel Martinez, David Smith, Elizabeth Curtis, David Robinson, Ibrahim Alava
Objectives: Historically at a multi-hospital residency program, there was an unexpected number of non-urgent consults from the county hospital emergency room (ER) that caused residents to make more trips between hospitals and come closer to violating duty hours. Moreover, there was also a poor follow-up rate for these patients. An alternate pathway to redirect such consults to the Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) clinic, staffed by an attending physician, was devised...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29298710/emergency-medicine-for-25%C3%A2-years-in-iceland-history-of-the-specialty-in-a-nutshell
#7
Jón Baldursson, Hjalti Már Björnsson, Ari Palomäki
After the early implementation of Emergency Medicine (EM) 25 years ago, Iceland became the first Nordic country to nationally realize the benefits of this specialty. However, the road has been rocky as in many other countries. The early years of EM in Iceland were characterized by a significant shortage of resources, particularly a lack of medical staff dedicated to EM and properly trained for the services required. The main task for the first couple of decades was to build the infrastructure of an operational emergency department based primarily on the model of EM...
January 3, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29290889/perceptions-of-emergency-medicine-residents-on-the-quality-of-residency-training-in-the-united-states-and-saudi-arabia
#8
Ahmad Aalam, Mark Zocchi, Khalid Alyami, Abdullah Shalabi, Abdullah Bakhsh, Asaad Alsufyani, Abdulrahman Sabbagh, Mohammed Alshahrani, Jesse M Pines
BACKGROUND: We compare educational environments (i.e. physical, emotional and intellectual experiences) of emergency medicine (EM) residents training in the United States of America (USA) and Saudi Arabia (SA). METHODS: A cross-sectional survey study was conducted using an adapted version of the validated Postgraduate Hospital Educational Environment Measure (PHEEM) survey instrument from April 2015 through June 2016 to compare educational environments in all emergency medicine residency programs in SA and three selected programs in the USA with a history of training Saudi physicians...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29286282/an-assessment-of-emotional-intelligence-in-emergency-medicine-resident-physicians
#9
Dimitrios Papanagnou, Kathryn Linder, Anuj Shah, Kory Scott London, Shruti Chandra, Robin Naples
Objectives: To define the emotional intelligence (EI) profile of emergency medicine (EM) residents, and identify resident EI strengths and weaknesses. Methods: First-, second-, and third-year residents (post-graduate years [PGY] 1, 2, and 3, respectively) of Thomas Jefferson University Hospital's EM Program completed the Emotional Quotient Inventory (EQ-i 2.0), a validated instrument offered by Multi-Health Systems. Reported scores included total mean EI, 5 composite scores, and 15 subscales of EI...
December 27, 2017: International Journal of Medical Education
https://www.readbyqxmd.com/read/29277130/an-interdisciplinary-academic-detailing-approach-to-decrease-inappropriate-medication-prescribing-by-physician-residents-for-older-veterans-treated-in-the-emergency-department
#10
Jason M Moss, William E Bryan, Loren M Wilkerson, Heather A King, George L Jackson, Ryan K Owenby, Courtney H Van Houtven, Melissa B Stevens, James Powers, Camille P Vaughan, William W Hung, Ula Hwang, Alayne D Markland, Richard Sloane, William Knaack, Susan Nicole Hastings
OBJECTIVE: To evaluate the impact of an academic detailing intervention delivered as part of a quality improvement project by a physician-pharmacist pair on (1) self-reported confidence in prescribing for older adults and (2) rates of potentially inappropriate medications (PIMs) prescribed to older adults by physician residents in a Veteran Affairs emergency department (ED). METHODS: This quality improvement project at a single site utilized a questionnaire that assessed knowledge of Beers Criteria, self-perceived barriers to appropriate prescribing in older adults, and self-rated confidence in ability to prescribe in older adults which was administered to physician residents before and after academic detailing delivered during their emergency medicine rotation...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29273028/implementation-of-a-novel-population-panel-management-curriculum-among-interprofessional-health-care-trainees
#11
Catherine P Kaminetzky, Lauren A Beste, Anne P Poppe, Daniel B Doan, Howard K Mun, Nancy Fugate Woods, Joyce E Wipf
BACKGROUND: Gaps in chronic disease management have led to calls for novel methods of interprofessional, team-based care. Population panel management (PPM), the process of continuous quality improvement across groups of patients, is rarely included in health professions training for physicians, nurses, or pharmacists. The feasibility and acceptance of such training across different healthcare professions is unknown. We developed and implemented a novel, interprofessional PPM curriculum targeted to diverse health professions trainees...
December 22, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29261245/evaluation-of-the-quality-blue-primary-care-program-on-health-outcomes
#12
Qian Shi, Thomas J Yan, Peter Lee, Paul Murphree, Xiaojing Yuan, Hui Shao, William H Bestermann, Selina Loupe, Dawn Cantrell, David Carmouche, John Strapp, Lizheng Shi
OBJECTIVES: This study aimed to investigate the role of the Quality Blue Primary Care (QBPC) program on healthcare utilization and overall cost among the beneficiaries of Blue Cross and Blue Shield of Louisiana (BCBSLA). STUDY DESIGN: Retrospective observational cohort study using claims data from adults residing in QBPC-implemented regions continuously enrolled through BCBSLA from June 2012 to December 2014 (N = 89,034). METHODS: Controlling for age, gender, and risk score by propensity score weighting, inpatient, outpatient, and corresponding medical expenditures were each compared between the QBPC group and the control group using a difference-in-differences regression model...
December 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29247274/procedural-sedation-and-analgesia-practices-by-emergency-physicians-in-the-netherlands-a-nationwide-survey
#13
Maybritt I Kuypers, Gaël J P Smits, Suzanne C Valkenet, Wendy A M H Thijssen, Frans B Plötz
BACKGROUND: Several efforts have been made to assure and to improve the quality of procedural sedation and analgesia (PSA) performed by emergency physicians (EPs) in The Netherlands. This study investigated the current PSA practice and competences of EPs in both adult and paediatric patients. In particular, if residency and current training, awareness of guidelines is sufficient for registered EPs to adequately perform PSA and if the availability of both adult and paediatric PSA in the ED is adequate...
December 15, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29230475/improving-decisions-about-transport-to-the-emergency-department-for-assisted-living-residents-who-fall
#14
Jefferson G Williams, Michael W Bachman, Michael D Lyons, Benjamin B Currie, Lawrence H Brown, A Wooten Jones, Jose G Cabanas, Alan K Kronhaus, J Brent Myers
Background: Residents of assisted living facilities who fall may not be seriously ill or injured, but policies often require immediate transport to an emergency department regardless of the patient's condition. Objective: To determine whether unnecessary transport can be avoided. Design: Prospective cohort study. Setting: One large county with a single system of emergency medical services. Participants: Convenience sample of residents in 22 assisted living facilities served by 1 group of primary care physicians...
December 12, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29228837/feeling-inadequate-residents-stress-and-learning-at-primary-care-clinics-in-the-united-states
#15
Joanna Veazey Brooks, Sara J Singer, Meredith Rosenthal, Alyna T Chien, Antoinette S Peters
BACKGROUND: Educators hope that residents' experiences in primary care continuity clinics will influence more trainees to enter primary care careers. Unfortunately, evidence shows that outpatient primary care training in the United States is stressful and fails to promote primary care careers. We conducted qualitative interviews with residents to understand the source of stress and to explain this failure. METHODS: In-person individual interviews were conducted with 37 primary care residents training at outpatient clinics in the US...
December 11, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29226232/connecting-undergraduate-and-postgraduate-medical-education-through-an-elective-epa-based-transitional-year-in-acute-care-an-early-project-report
#16
Gersten Jonker, Reinier G Hoff, Stefan Max, Cor J Kalkman, Olle Ten Cate
Objective: A well-designed final year may ease the transition from medical school to postgraduate training, if it has enough depth to enable the acquisition of early specialty expertise, while keeping enough breadth to support the graduation as all-round physician. Aim of this article is to describe the design of a multidisciplinary dedicated transitional year (DTY) around the theme of recognition and initial treatment of vitally threatened patients. Methods: Undergraduate and postgraduate training directors from the departments of Anaesthesiology, Cardiology, Emergency Medicine, Intensive Care Medicine and Respiratory Medicine at UMC Utrecht and partnering hospitals have collaboratively developed and implemented a curriculum for a final year focusing on three entrustable professional activities (EPAs) in the domain of acute care...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/29216331/combined-short-and-long-axis-ultrasound-guided-central-venous-catheterization-is-superior-to-conventional-techniques-a-cross-over-randomized-controlled-manikin-trial
#17
Jun Takeshita, Kei Nishiyama, Satoru Beppu, Nozomu Sasahashi, Nobuaki Shime
OBJECTIVES: Visualizing the needle tip using the short-axis (SA) ultrasound-guided central venous catheterization approach can be challenging. It has been suggested to start the process with the SA approach and then switch to the long-axis (LA); however, to our knowledge, this combination has not been evaluated. We compared the combined short- and long-axis (SLA) approach with the SA approach in a manikin study. METHODS: We performed a prospective randomized controlled cross-over study in an urban emergency department and intensive care unit...
2017: PloS One
https://www.readbyqxmd.com/read/29214627/a-12-month-descriptive-analysis-of-emergency-intubations-at-brooke-army-medical-center-a-national-emergency-airway-registry-study
#18
Michael D April, Steven G Schauer, Calvin A Brown Rd, Patrick C Ng, Jessie Fernandez, Andrea E Fantegrossi, Joseph K Maddry, Shane Summers, Daniel J Sessions, Robert M Barnwell, Mark Antonacci
Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. MATERIAL AND METHODS: Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition...
October 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/29210754/managing-multiplicity-conceptualizing-physician-cognition-in-multi-patient-environments
#19
Teresa Chan, Mathew Mercuri, Kenneth Van Dewark, Jonathan Sherbino, Alan Schwartz, Geoff Norman, Matthew Lineberry
PURPOSE: Emergency physicians (EPs) regularly manage multiple patients simultaneously, often making time-sensitive decisions around priorities for multiple patients. Few studies have explored physician cognition in multi-patient scenarios. The authors sought to develop a conceptual framework to describe how EPs think in busy, multi-patient environments. METHOD: From July 2014 to May 2015, a qualitative study was conducted at McMaster University, using a think aloud protocol to examine how 10 attending EPs and 10 junior residents made decisions in multi-patient environments...
November 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29209996/understanding-ownership-of-patient-care-a%C3%A2-dual-site-qualitative-study-of-faculty-and-residents-from-medicine-and-psychiatry
#20
Deborah S Cowley, Jesse D Markman, Jennifer A Best, Erica L Greenberg, Michael J Grodesky, Suzanne B Murray, Kelli A Corning, Mitchell R Levy, William E Greenberg
INTRODUCTION: With changes in duty hours and supervision requirements, educators have raised concerns about erosion of patient care ownership by resident physicians. However, the definition of ownership is unclear. This qualitative study investigated definitions of ownership in medicine and psychiatry faculty and residents. METHODS: The authors distributed an anonymous online survey regarding definitions of ownership to faculty and residents at the psychiatry and internal medicine residency programs at the University of Washington and the Harvard Longwood psychiatry residency and conducted a qualitative analysis of free-text responses to identify emergent themes...
December 5, 2017: Perspectives on Medical Education
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