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https://www.readbyqxmd.com/read/30216508/what-we-measure-%C3%A2-and-what-we-should-measure-in-medical-education
#1
REVIEW
John R Boulet, Steven J Durning
CONTEXT: As the practice of medicine evolves, the knowledge, skills and attitudes required to provide patient care will continue to change. These competency-based changes will necessitate the restructuring of assessment systems. High-quality assessment programmes are needed to fulfil health professions education's contract with society. OBJECTIVES: We discuss several issues that are important to consider when developing assessments in health professions education...
September 14, 2018: Medical Education
https://www.readbyqxmd.com/read/30216277/learners-experiences-during-rapid-cycle-deliberate-practice-simulations-a-qualitative-analysis
#2
Rebecca J Chancey, Esther M Sampayo, Daniel S Lemke, Cara B Doughty
INTRODUCTION: Rapid Cycle Deliberate Practice (RCDP) is a team-based simulation method, emphasizing repetitive practice over reflective debriefing, with progressively more challenging rounds, frequent starts and stops, and direct coaching. Although some studies have shown improved performance, no study has evaluated learners' perceptions. We aimed to explore learners' experiences during RCDP. METHODS: This was a qualitative study of participants' perceptions regarding RCDP during their pediatric emergency medicine rotation...
September 13, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/30215778/use-of-immersive-learning-and-simulation-techniques-to-teach-and-research-opioid-prescribing-practices
#3
Marissa S Heirich, Lanja S Sinjary, Maisa S Ziadni, Sandra Sacks, Alexandra S Buchanan, Sean C Mackey, Jordan L Newmark
Introduction: Unsafe opioid prescribing practices to treat acute and chronic pain continue to contribute to the opioid overdose crisis in the United States, a growing public health emergency that harms patients and their communities. Poor opioid prescribing practices stem in part from a lack of education and skills training surrounding pain and opioid management. Methods: As part of the Clinical Pain Medicine Fellowship at Stanford University, physicians were given the opportunity to participate in a pilot program to practice opioid management in a live, simulated interaction...
September 12, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/30214718/the-effect-of-antibiotic-stewardship-interventions-with-stakeholder-involvement-in-hospital-settings-a-multicentre-cluster-randomized-controlled-intervention-study
#4
Jannicke Slettli Wathne, Lars Kåre Selland Kleppe, Stig Harthug, Hege Salvesen Blix, Roy M Nilsen, Esmita Charani, Ingrid Smith
Background: There is limited evidence from multicenter, randomized controlled studies to inform planning and implementation of antibiotic stewardship interventions in hospitals. Methods: A cluster randomized, controlled, intervention study was performed in selected specialities (infectious diseases, pulmonary medicine and gastroenterology) at three emergency care hospitals in Western Norway. Interventions applied were audit with feedback and academic detailing. Implementation strategies included co-design of interventions with stakeholders in local intervention teams and prescribers setting local targets for change in antibiotic prescribing behaviour...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/30212960/accuracy-of-objective-parameters-in-acute-epiglottitis-diagnosis-a-case-control-study
#5
Kyung Hee Kim, Yong Hwan Kim, Jun Ho Lee, Dong Woo Lee, Yun Gyu Song, Seung Yong Cha, Seong Youn Hwang
Lateral neck radiography is often used as a screening tool in emergency departments for suspected acute epiglottitis. The qualitative radiographic signs have been mainly used. The aim of this study was to evaluate the accuracy of objective radiographic parameters to aid diagnosis of acute epiglottitis.Patients who were diagnosed with acute epiglottitis from January 2006 to December 2016 were included in this case-control study. Control subjects with normal lateral neck radiograph findings were included at a 1:4 ratio during the same period...
September 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30212564/association-between-emergency-physician-self-reported-empathy-and-patient-satisfaction
#6
Hao Wang, Jeffrey A Kline, Bradford E Jackson, Jessica Laureano-Phillips, Richard D Robinson, Chad D Cowden, James P d'Etienne, Steven E Arze, Nestor R Zenarosa
BACKGROUND: Higher physician self-reported empathy has been associated with higher overall patient satisfaction. However, more evidence-based research is needed to determine such association in an emergent care setting. OBJECTIVE: To evaluate the association between physician self-reported empathy and after-care instant patient-to-provider satisfaction among Emergency Department (ED) healthcare providers with varying years of medical practice experience. RESEARCH DESIGN: A prospective observational study conducted in a tertiary care hospital ED...
2018: PloS One
https://www.readbyqxmd.com/read/30210855/point-of-care-airway-ultrasonography-prior-to-an-emergency-cricothyroidotomy-case-report
#7
Mohamad Iqhbal, Julina M Noor, Nur A Karim, Izzat Ismail, Halim Sanib, Mohd A Mokhtar, Safreeda S F Salim
The use of ultrasonography in acute and critical care medicine is becoming increasingly common. However, use of an airway ultrasound as an adjunct to determine the type of intervention needed and assess complications is not common practice. We report a 56-year-old male who presented to the Emergency Department of the Sungai Buloh Hospital, Selangor, Malaysia, in 2015 with hoarseness, stridor and impending respiratory failure. A point-of-care ultrasound performed to assess the neck and vocal cords indicated a heterogeneous echogenic mass in the larynx, thus ruling out a cricothyroidotomy...
May 2018: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/30209693/additive-manufacturing-with-3d-printing-progress-from-bench-to-bedside
#8
Ziyaur Rahman, Sogra F Barakh Ali, Tanil Ozkan, Naseem A Charoo, Indra K Reddy, Mansoor A Khan
Three-dimensional (3D) printing was discovered in the 1980s, and many industries have embraced it, but the pharmaceutical industry is slow or reluctant to adopt it. Spiritam® is the first and only 3D-printed drug product approved by FDA in 2015. Since then, the FDA has not approved any 3D-printed drug product due to technical and regulatory issues. The 3D printing process cannot compete with well-established and understood conventional processes for making solid dosage forms. However, pharmaceutical companies can utilize it where mass production is not required; rather, consistency, precision, and accuracy in quality are paramount...
September 12, 2018: AAPS Journal
https://www.readbyqxmd.com/read/30198129/lifestyle-and-periodontitis-the-emergence-of-personalized-periodontics
#9
REVIEW
P Mark Bartold
Personalized medicine is a medical model that involves the tailoring of healthcare - with medical decisions, practices, and/or products being customized to an individual patient. In this model, diagnostic testing is often employed for selecting appropriate and optimal therapies based on the context of a patient's genetic content or other epidemiologic, sociologic, molecular, physiologic, or cellular analyses. With the advent of major advances in periodontal medicine, including genomic discoveries and greater understanding of the multifactorial nature of periodontitis, it seems that the time is ripe to use personalized medicine as a model for personalized periodontics...
October 2018: Periodontology 2000
https://www.readbyqxmd.com/read/30193576/safety-work-and-risk-management-as-burdens-of-treatment-in-primary-care-insights-from-a-focused-ethnographic-study-of-patients-with-multimorbidity
#10
Gavin Daker-White, Rebecca Hays, Thomas Blakeman, Sarah Croke, Benjamin Brown, Aneez Esmail, Peter Bower
BACKGROUND: In primary health care, patient safety failures can arise in service access, doctor-patient relationships, communication between care providers, relational and management continuity, or technical procedures. Through the lens of multimorbidty, and using qualitative ethnographic methods, our study aimed to illuminate safety issues in primary care. METHODS: Data were triangulated from electronic health records (EHRs); observation of primary care consultations; annual interviews with patients, (informal) care providers and GPs...
September 8, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30192763/exploring-the-knowledge-explanatory-models-of-illness-and-patterns-of-healthcare-seeking-behaviour-of-fang-culture-bound-syndromes-in-equatorial-guinea
#11
Raquel Jimenez Fernandez, Inmaculada Corral Liria, Rocio Rodriguez Vázquez, Susana Cabrera Fernandez, Marta Elena Losa Iglesias, Ricardo Becerro de Bengoa Vallejo
In 1994, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) included "culture-bound syndromes" in its classification of psychiatric disorders and associated them with disease processes that manifest in behavioural or thought disorders that develop within a given cultural context. This study examines the definitions, explanatory models, signs and symptoms, and healthcare-seeking behaviours common to Fang culture-bound syndromes (i.e., kong, eluma, witchcraft, mibili, mikug, and nsamadalu)...
2018: PloS One
https://www.readbyqxmd.com/read/30191191/emergency-medicine-physicians-perspectives-on-subspecialty-training-a-national-survey
#12
Mehmet Ali Aslaner, Serkan Emre Eroğlu, Ali Batur, Volkan Arslan
Background: Subspecialty training (sST) is an accepted educational model for the branches that have completed the maturation period. At the end of a rapid growth and reaching its limits, we wanted to determine the emergency medicine (EM) physicians' thoughts about subspecialty training in EM in Turkey. Method: This is a national cross-sectional survey study conducted in November 2017. Participants were physicians who were receiving or who had completed emergency medicine education...
September 2018: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30191188/assessment-of-efast-training-for-final-year-medical-students-in-emergency-medicine-clerkship
#13
Arif Alper Cevik, Abdel Noureldin, Margret El Zubeir, Fikri M Abu-Zidan
Background: Extended Focused Assessment Sonography for Trauma (EFAST) is an important bedside tool for the management of multiple trauma patients. We aimed to evaluate the assessment of our EFAST education in the Emergency Medicine Clerkship (EMC) for final year medical students and the correlations of EFAST marks with other practical skill stations and the final multiple choice question (MCQ) exam marks. Methods: Fifty-four final year medical students were trained on performing EFAST on human models during their 4-week clerkship...
September 2018: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30191187/acute-coronary-syndromes-diagnosis-version-2-0-tomorrow-s-approach-to-diagnosing-acute-coronary-syndromes
#14
REVIEW
Richard Body
Chest pain accounts for approximately 6% of Emergency Department (ED) attendances and is the most common reason for emergency hospital admission. For many years, our approach to diagnosis has required patients to stay in hospital for at least 6-12 h to undergo serial biomarker testing. As less than one fifth of the patients undergoing investigation actually has an acute coronary syndrome (ACS), there is tremendous potential to reduce unnecessary hospital admissions. Recent advances in diagnostic technology have improved the efficiency of care pathways...
September 2018: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30189067/airway-management-for-trauma-patients
#15
Benjamin D Walrath, Stephen Harper, Ed Barnard, Joshua M Tobin, Brendon Drew, Cord Cunningham, Chetan Kharod, James Spradling, Craig Stone, Matthew Martin
Trauma airway management is a critical skill for medical providers supporting combat casualties since it is an integral component of damage control resuscitation and surgery. This clinical practice guideline presents methods for optimizing the airway management of patients with traumatic injury in the operational medical treatment facility environment. The guidelines represent the knowledge and experience of 10 co-authors from 3 allied countries representing Emergency Medicine, Surgery and Anesthesia.
September 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/30188361/diagnostic-and-predictive-immunohistochemistry-for-non-small-cell-lung-carcinomas
#16
Yin P Hung, Lynette M Sholl
Non-small cell lung carcinoma (NSCLC) accounts for significant morbidity and mortality worldwide, with most patients diagnosed at advanced stages and managed increasingly with targeted therapies and immunotherapy. In this review, we discuss diagnostic and predictive immunohistochemical markers in NSCLC, one of the most common tumors encountered in surgical pathology. We highlight 2 emerging diagnostic markers: nuclear protein in testis (NUT) for NUT carcinoma; SMARCA4 for SMARCA4-deficient thoracic tumors. Given their highly aggressive behavior, proper recognition facilitates optimal management...
September 4, 2018: Advances in Anatomic Pathology
https://www.readbyqxmd.com/read/30188203/advanced-clinical-practitioners-in-emergency-care-past-present-and-future
#17
Robert Crouch, Ruth Brown
Developing a consistent and skilled workforce is critical to the sustainability of any clinical service. Nurses and paramedics have formed part of the emergency care workforce for many years and the extended role of these staff groups has supported patient care as the demand has risen and outstripped the capacity of the medical staff. In many hospitals and health-care systems, these extended roles have developed in response to local demand and case mix, resulting in inconsistent role descriptions and lack of transportable qualifications...
September 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/30188198/training-in-emergency-medicine
#18
Alexandra Hughes, Dan Boden, Maya Naravi
One of the key challenges faced in emergency medicine is to provide effective training so that clinicians feel valued and supported in the roles they undertake. While there are numerous areas of exemplar practice nationally this article details two areas of particular focus for the Royal College of Emergency Medicine: supporting trainees' return to formal training programmes and developing specialty and associate specialist doctors in emergency medicine.
September 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/30188197/emergency-medicine-myths-and-misconceptions-evaluating-the-evidence
#19
Daniel J Kim
Medical reversal is common, with rates of reversal of practices that were considered standard of care as high as 40%. Unfortunately, many standards of care are never tested, but instead are often promoted based on pathophysiological explanations or simply being long-established practices. Much of medical practice is based on dogma: a set of principles laid down by authority as incontrovertibly true. This article evaluates four commonly taught dogmatic practices in emergency medicine to determine if they are supported by the medical literature or are instead myths and misconceptions: (1) topical anaesthetics inhibit corneal healing, (2) treatment of myocardial infarction is MONA (morphine, oxygen, nitrates, aspirin), (3) children do not get sprains because their ligaments are stronger than bone, and (4) vagal manoeuvres for supraventricular tachycardia never work in adults...
September 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/30186720/emergency-management-of-anaphylaxis-a-high-fidelity-interprofessional-simulation-scenario-to-foster-teamwork-among-senior-nursing-medicine-and-pharmacy-undergraduate-students
#20
Sandra MacDonald, April Manuel, Adam Dubrowski, Natalie Bandrauk, Rebecca Law, Vernon Curran, Young Wah Lee
Nursing, medicine, and pharmacy students have limited opportunities during their undergraduate programs to learn and practice together as an interprofessional team. This has prompted faculty at Memorial University of Newfoundland to explore the use of high fidelity simulated interprofessional education (HF-IPE) to help nursing, medicine, and pharmacy students learn about their roles, develop communication and collaboration skills, and foster teamwork. Research has shown that high fidelity simulated education can promote critical thinking, engage learners, improve confidence, and enhance psychomotor skills; however, there is limited data on the impact of HF-IPE on fostering teamwork...
July 3, 2018: Curēus
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