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https://www.readbyqxmd.com/read/28079728/surveying-resident-and-faculty-physician-knowledge-attitudes-and-experiences-in-response-to-public-lead-contamination
#1
D Kay Taylor, Brenda Lovegrove Lepisto, Nicolas Lecea, Ranine Ghamrawi, Ghassan Bachuwa, Jenny LaChance, Mona Hanna-Attisha
Environmental health crises can appear anywhere and without warning. After research revealed a significant incidence of elevated pediatric blood lead levels following a water source change, Genesee County declared a public health emergency in Flint, Michigan. Hospital patients and family members began approaching Hurley Medical Center's physicians with questions regarding the health implications of the lead contamination. Many of the physicians voiced concerns about responding appropriately to patient needs and increasing demands for information...
January 10, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28032432/perception-of-prognosis-of-cancer-patients-by-non-oncologists
#2
Hadar Goldvaser, Yonatan Milman, Tal Dujovni, Anat Stern, Muhamad Mahamid, Ekaterina Hanovich, Amir Zivony, Tzippy Shochat, Rinat Yerushalmi, Anat Gafter-Gvili, Baruch Brenner, Daniel Shepshelovich
BACKGROUND: Data are lacking regarding the perception of cancer patients' prognosis by physicians who are not oncologists. METHODS: This was a multicenter survey of seven university-affiliated hospitals, assessing physicians' perception of the median survival of patients with seven advanced malignancies. The study cohort included physicians from all 73 internal medicine, surgery, emergency medicine and critical care departments in the participating hospitals. Family practitioners were contacted through email...
December 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28018542/perceptions-on-the-impact-of-a-just-in-time-room-on-trainees-and-supervising-physicians-in-a-pediatric-emergency-department
#3
Anita A Thomas, Neil G Uspal, Assaf P Oron, Eileen J Klein
BACKGROUND : Just-in-time (JIT) training refers to education occurring immediately prior to clinical encounters. An in situ JIT room in a pediatric emergency department (ED) was created for procedural education. OBJECTIVE : We examined trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the effect its usage has on the need for intervention by supervising physicians during procedures. METHODS : Cross-sectional survey study of a convenience sample of residents rotating through the ED and supervising pediatric emergency medicine physicians...
December 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/27965351/extended-family-medicine-training-measuring-training-flows-at-a-time-of-substantial-pedagogic-change
#4
Steve Slade, Shelley Ross, Kathrine Lawrence, Douglas Archibald, Maria Palacios Mackay, Ivy F Oandasan
OBJECTIVE: To examine trends in family medicine training at a time when substantial pedagogic change is under way, focusing on factors that relate to extended family medicine training. DESIGN: Aggregate-level secondary data analysis based on the Canadian Post-MD Education Registry. SETTING: Canada. PARTICIPANTS: All Canadian citizens and permanent residents who were registered in postgraduate family medicine training programs within Canadian faculties of medicine from 1995 to 2013...
December 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27965348/peer-support-writing-group-in-a-community-family-medicine-teaching-unit-facilitating-professional-development
#5
Lina Al-Imari, Jaisy Yang, Nicholas Pimlott
PROBLEM ADDRESSED: Aspiring physician writers need an environment that promotes self-reflection and can help them improve their skills and confidence in writing. OBJECTIVE OF PROGRAM: To create a peer-support writing group for physicians in the Markham-Stouffville community in Ontario to promote professional development by encouraging self-reflection and fostering the concept of physician as writer. PROGRAM DESCRIPTION: The program, designed based on a literature review and a needs assessment, was conducted in 3 sessions over 6 months...
December 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27943410/number-of-weeks-rotating-in-the-emergency-department-has-a-greater-effect-on-ultrasound-milestone-competency-than-a-dedicated-ultrasound-rotation
#6
Courtney M Smalley, Molly Thiessen, Richard Byyny, Alyrene Dorey, Bryan McNair, John L Kendall
OBJECTIVES: Ultrasound (US) is vital to modern emergency medicine (EM). Across residencies, there is marked variability in US training. The "goal-directed focused US" part of the Milestones Project states that trainees must correctly acquire and interpret images to achieve a level 3 milestone. Standardized methods by which programs teach these skills have not been established. Our goal was to determine whether residents could achieve level 3 with or without a dedicated US rotation. METHODS: Thirty-three first- and second-year residents were assigned to control (no rotation) and intervention (US rotation) groups...
December 10, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27936189/impact-of-attending-physicians-comments-on-residents-workloads-in-the-emergency-department-results-from-two-j-o-pan-randomized-controlled-trials
#7
Akira Kuriyama, Noriyuki Umakoshi, Jun Fujinaga, Toshie Kaihara, Seigo Urushidani, Naoki Kuninaga, Motohiro Ichikawa, Shinichiro Ienaga, Akira Sasaki, Tetsunori Ikegami
OBJECTIVE: To examine whether peppy comments from attending physicians increased the workload of residents working in the emergency department (ED). METHODS: We conducted two parallel-group, assessor-blinded, randomized trials at the ED in a tertiary care hospital in western Japan. Twenty-five residents who examined either ambulatory (J(^o^)PAN-1 Trial) or transferred patients (J(^o^)PAN-2 Trial) in the ED on weekdays. Participants were randomly assigned to groups that either received a peppy message such as "Hope you have a quiet day!" (intervention group) or did not (control group) from the attending physicians...
2016: PloS One
https://www.readbyqxmd.com/read/27925077/challenges-to-implementation-of-advance-directives-of-will-in-hospital-practice
#8
Silvana Bastos Cogo, Valéria Lerch Lunardi, Alberto Manuel Quintana, Nara Marilene Oliveira Girardon-Perlini, Rosemary Silva da Silveira
Objective: to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context. Method: qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles. Results: the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27919374/the-m-health-revolution-exploring-perceived-benefits-of-whatsapp-use-in-clinical-practice
#9
Kurubaran Ganasegeran, Pukunan Renganathan, Abdul Rashid, Sami Abdo Radman Al-Dubai
BACKGROUND: The dawn of m-Health facilitates new horizons of professional communication through WhatsApp, allowing health professionals to interact fast and efficiently for effective patient management. This preliminary study aimed to investigate perceived benefits, if any, of WhatsApp use across general medical and emergency teams during clinical practice in Malaysia. METHODS: A cross-sectional study was conducted in a universal sample of 307 health professionals comprising of nurses, medical assistants, medical residents, medical officers and physicians across medical and casualty departments in a Malaysian public hospital...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27918408/full-practice-authority-for-nurse-practitioners
#10
Deborah Dillon, Faye Gary
Implementation of the Affordable Care Act (2010) enabled more than 30 million people to have new access to primary care services. On the basis of current utilization patterns, demand for primary care providers is expected to grow more rapidly than physician supply. This imbalance is expected to worsen, as the aging population requires more health care resources. In addition, more patients are requiring critical care services and physician numbers are not keeping with this growing need. Restrictions on resident physician practice hours have impacted inpatient care as well...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#11
Saundra A Jackson, Charlotte Derr, Anthony De Lucia, Marvin Harris, Zuheily Closser, Branko Miladinovic, Rahul Mhaskar, Theresa Jorgensen, Lori Green
BACKGROUND: With the growing utilization of ultrasonography in emergency medicine combined with the concern over adequate pain management in the emergency department (ED), ultrasound guidance for peripheral nerve blockade in ED is an area of increasing interest. The medical literature has multiple reports supporting the use of ultrasound guidance in peripheral nerve blocks. However, to perform a peripheral nerve block, one must first be able to reliably identify the specific nerve before the procedure...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27893672/risk-factors-of-severe-hypoglycemia-requiring-medical-assistance-and-neurological-sequelae-in-patients-with-diabetes-a-case-control-study
#12
Ja Young Jeon, Se Ran Kim, Hae Jin Kim, Dae Jung Kim, Kwan-Woo Lee, Jung-Dong Lee, Seung Jin Han
Hypoglycemia commonly occurs in patients who are being treated for diabetes. In some cases, these patients suffer from severe hypoglycemia that requires medical assistance and which can unfortunately result in long-term disabilities. Therefore, we investigated risk factors associated with severe hypoglycemia requiring medical assistance (HMA) and the resulting neurological sequelae in patients with diabetes. This investigation was a case-control study that assessed 129 patients with diabetes and documented hypoglycemia from a single tertiary hospital between February 2013 and May 2015...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27893012/surgeons-and-trauma-care-physicians-perception-of-the-impact-of-the-globalization-of-medical-education-on-quality-of-care-in-lima-peru
#13
Lacey N LaGrone, Leah N Isquith-Dicker, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Alfredo Allagual, Fernando Revoredo, Charles N Mock
Importance: The globalization of medical education-the process by which trainees in any region gain access to international training (electronic or in-person)-is a growing trend. More data are needed to inform next steps in the responsible stewardship of this process, from the perspective of trainees and institutions at all income levels, and for use by national and international policymakers. Objective: To describe the impact of the globalization of medical education on surgical care in Peru from the perspective of Peruvian surgeons who received international training...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27875598/results-of-the-2016-national-resident-matching-program%C3%A2-1986-2016-a-comparison-of-family-medicine-e-roads-and-other-select-specialties
#14
Stanley M Kozakowski, Alexandra Travis, Ashley Bentley, Gerald Fetter
This article is a continuation in a series of national studies conducted by the American Academy of Family Physicians that reports the performance of family medicine and other primary care specialties in the National Residency Matching Program® (NRMP) Main Residency Match, hereafter called the Match. Match data from 1986-2016 were analyzed to compare the numbers of positions offered and filled in family medicine, other primary care specialties, emergency medicine, diagnostic radiology, ophthalmology, anesthesiology, and dermatology (E-ROAD), and other select specialties...
November 2016: Family Medicine
https://www.readbyqxmd.com/read/27871770/ptsd-in-those-who-care-for-the-injured
#15
Kevin Luftman, Jayson Aydelotte, Kevin Rix, Sadia Ali, Katherine Houck, Thomas B Coopwood, Pedro Teixeira, Alex Eastman, Brian Eastridge, Carlos V R Brown, Matthew Davis
BACKGROUND: Post Traumatic Stress Disorder (PTSD) has become a focus for the care of trauma victims, but the incidence of PTSD in those who care for injured patients has not been well studied. Our hypothesis was that a significant proportion of health care providers involved with trauma care are at risk of developing PTSD. METHODS: A system-wide survey was applied using a modified version of the Primary Care PTSD Screen [PC-PTSD], a validated PTSD screening tool currently being used by the VA to screen veterans for PTSD...
November 10, 2016: Injury
https://www.readbyqxmd.com/read/27864243/determinants-of-the-sustained-employment-of-physician-assistants-in-hospitals-a-qualitative-study
#16
Marijke J C Timmermans, Anneke J A H van Vught, Irma T H M Maassen, Lisette Draaijer, Anton G M Hoofwijk, Marcel Spanier, Wijnand van Unen, Michel Wensing, Miranda G H Laurant
OBJECTIVES: To identify determinants of the initial employment of physician assistants (PAs) for inpatient care as well as of the sustainability of their employment. DESIGN: We conducted a qualitative study with semistructured interviews with care providers. Interviews continued until data saturation was achieved. All interviews were transcribed verbatim. A framework approach was used for data analysis. Codes were sorted by the themes, bringing similar concepts together...
November 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27860022/shared-decision-making-with-vulnerable-populations-in-the-emergency-department
#17
Ana Castaneda-Guarderas, Jeffrey Glassberg, Corita R Grudzen, Ka Ming Ngai, Margaret E Samuels-Kalow, Erica Shelton, Stephen P Wall, Lynne D Richardson
The emergency department (ED) occupies a unique position within the healthcare system, serving as a safety net for vulnerable patients, regardless of their race, ethnicity, religion, country of origin, sexual orientation, socioeconomic status, or medical diagnosis. Shared decision making (SDM) presents special challenges when used with vulnerable population groups. The differing circumstances, needs, and perspectives of vulnerable groups invoke issues of provider bias, disrespect, judgmental attitudes, and lack of cultural competence, as well as patient mistrust and the consequences of their social and economic disenfranchisement...
December 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27859987/evolution-of-the-model-of-the-clinical-practice-of-emergency-medicine-1979-to-present
#18
Francis L Counselman, Michael S Beeson, Catherine A Marco, Susan K Adsit, Anne L Harvey, Julia N Keehbauch
The Model of the Clinical Practice of Emergency Medicine (The EM Model) is a three dimensional representation of the clinical practice of Emergency Medicine. It is a product of successful collaboration involving the American Board of Emergency Medicine (ABEM), the American College of Emergency Physicians (ACEP), the Society for Academic Emergency Medicine (SAEM), the Emergency Medicine Residents' Association (EMRA), the Council of Emergency Medicine Residency Directors (CORD), the Residency Review Committee for Emergency Medicine (RRC-EM) and the American Academy of Emergency Medicine (AAEM)...
November 17, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27856140/impact-of-scribes-on-emergency-department-patient-throughput-one-year-after-implementation
#19
Heather A Heaton, David M Nestler, Christine M Lohse, Annie T Sadosty
OBJECTIVES: Assess the impact of scribes on an academic emergency department's (ED) throughput one year after implementation. METHODS: A prospective cohort design compared throughput metrics of patients managed when scribes were and were not a part of the treatment team during pre-defined study hours in a tertiary academic ED with both an adult and pediatric ED. An alternating-day pattern one year following scribe implementation ensured balance between the scribe and non-scribe groups in time of day, day of week, and patient complexity...
November 5, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27849499/trauma-resuscitation-evaluation-times-and-correlating-human-patient-simulation-training-differences-what-is-the-standard
#20
Timothy J Bonjour, Grigory Charny, Robert E Thaxton
BACKGROUND: Rapid effective trauma resuscitations (TRs) decrease patient morbidity and mortality. Few studies have evaluated TR care times. Effective time goals and superior human patient simulator (HPS) training can improve patient survivability. OBJECTIVES: The purpose of this study was to compare live TR to HPS resuscitation times to determine mean incremental resuscitation times and ascertain if simulation was educationally equivalent. The study was conducted at San Antonio Military Medical Center, Department of Defense Level I trauma center...
November 2016: Military Medicine
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