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https://www.readbyqxmd.com/read/29166352/more-learners-finite-resources-and-the-changing-landscape-of-procedural-training-at-the-bedside
#1
Michael A Gisondi, Linda Regan, Jeremy Branzetti, Laura R Hopson
There is growing competition for non-operative, procedural training in teaching hospitals, due to an increased number of individuals seeking to learn procedures from a finite number of appropriate teaching cases. Procedural training is required by students, post-graduate learners, and practicing providers who must maintain their skills. These learner groups are growing in size as the number of medical schools increase and advance practice providers expand their skills to include complex procedures. These various learner needs occur against a background of advancing therapeutic techniques that improve patient care, but also act to reduce the overall numbers of procedures available to learners...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29166350/competency-crosswalk-a-multispecialty-review-of-the-accreditation-council-for-graduate-medical-education-milestones-across-four-competency-domains
#2
Laura Edgar, Sydney Roberts, Nicholas Yaghmour, Andrea Leep Hunderfund, Stanley J Hamstra, Lisa Conforti, Eric S Holmboe
PURPOSE: To identify common and overlapping themes among the interpersonal and communication skills (ICS), practice-based learning and improvement (PBLI), professionalism (PROF), and systems-based practice (SBP) milestones of the transitional year and 26 specialties. METHOD: In May 2017, milestones were accessed from the Accreditation Council for Graduate Medical Education specialties website. A thematic analysis of the ICS, PBLI, PROF, and SBP milestones was performed to determine unique and common themes across these competencies and across specialties...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29162327/e-learning-teaches-attendings-how-to-objectively-assess-pediatric-urology-trainees-surgery-skills-for-orchiopexy
#3
Nicolas Fernandez, Max Maizels, Walid Farhat, Edwin Smith, Dennis Liu, Michael Chua, Yasin Bhanji
INTRODUCTION: Established methods to train pediatric urology surgery by residency training programs require updating in response to administrative changes such as new, reduced trainee duty hours. Therefore, new objective methods must be developed to teach trainees. We approached this need by creating e-learning to teach attendings objective assessment of trainee skills using the Zwisch scale, an established assessment tool. The aim of this study was to identify whether or not e-learning is an appropriate platform for effective teaching of this assessment tool, by assessing inter-rater correlation of assessments made by the attendings after participation in the e-learning...
November 9, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29162061/medical-student-attitudes-and-educational-interventions-to-prevent-neurophobia-a-longitudinal-study
#4
Lisa Shiels, Pratish Majmundar, Aleksander Zywot, John Sobotka, Christine S M Lau, Tuula O Jalonen
BACKGROUND: With an aging American population, the burden of neurologic disease is intensifying and the decline in neurology residents and practicing neurologists is leaving these patients helpless and unable to find care. 'Neurophobia', a chronic illness that begins early in medical school, has been identified as a cause for the low number of neurology residents. METHODS: A longitudinal study surveyed medical students at the beginning of their first year (M1) and then again at the beginning of their second year (M2)...
November 21, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29160858/hyperplanar-morphological-clustering-of-a-hippocampus-by-using-volumetric-computerized-tomography-in-early-alzheimer-s-disease
#5
Sarawut Suksuphew, Paramate Horkeaw
Background: On diagnosing Alzheimer's disease (AD), most existing imaging-based schemes have relied on analyzing the hippocampus and its peripheral structures. Recent studies have confirmed that volumetric variations are one of the primary indicators in differentiating symptomatic AD from healthy aging. In this study, we focused on deriving discriminative shape-based parameters that could effectively identify early AD from volumetric computerized tomography (VCT) delineation, which was previously almost intangible...
November 21, 2017: Brain Sciences
https://www.readbyqxmd.com/read/29159857/methylphenidate-for-children-and-adolescents-with-autism-spectrum-disorder
#6
REVIEW
Nancy Sturman, Laura Deckx, Mieke L van Driel
BACKGROUND: Children with autistic spectrum disorder (ASD) frequently present with inattention, impulsivity and hyperactivity, which are the cardinal symptoms of attention deficit hyperactivity disorder (ADHD). The effectiveness of methylphenidate, a commonly used ADHD treatment, is therefore of interest in these children. OBJECTIVES: To assess the effects of methylphenidate for symptoms of ADHD (inattention, impulsivity and hyperactivity) and ASD (impairments in social interaction and communication, and repetitive, restricted or stereotypical behaviours) in children and adolescents aged 6 to 18 years with ASD...
November 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29159602/competitive-advantage-of-mba-for-physician-executives-a-systematic-literature-review
#7
REVIEW
Anthony D Turner, Stanislaw P Stawicki, Weidun Alan Guo
In response to systemic challenges facing the US healthcare system, many medical students, residents and practicing physicians are pursuing a Master in Business Administration (MBA) degree. The value of such proposition remains poorly defined. The aim of this review is to analyze current literature pertaining to the added value of MBA training for physician executives (PEs). We hypothesized that physicians who supplement their clinical expertise with business education gain a significant competitive advantage...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29157753/validit%C3%A3-et-reproductibilit%C3%A3-de-deux-grilles-d%C3%A2-observation-des-comp%C3%A3-tences-cliniques-des-internes-en-des-de-m%C3%A3-decine-interne
#8
P Pottier, F Cohen Aubart, O Steichen, M Desprets, M Pha, A Espitia, S Georgin-Lavialle, A Morel, J B Hardouin
INTRODUCTION: The revision of the French medical studies' third cycle ought to be competency-based. In internal medicine, theoretical and practical knowledge will be assessed online with e-learning and e-portfolio. In parallel, a reflection about clinical skills assessment forms is currently ongoing. In this context, our aim was to assess the reproducibility and validity of two assessment forms based on direct clinical observation. METHOD: A prospective and multicentric study has been conducted from November 2015 to October 2016 aiming at evaluating the French translations of the MINI-Clinical Examination Exercice (MINI-CEX) and the Standardized Patient Satisfaction Questionnaire (SPSQ)...
November 17, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29154851/effect-of-surgeon-s-experience-on-complications-from-laparoscopic-hysterectomy
#9
Naveiro-Fuentes Mariña, Rodríguez-Oliver Antonio, Fernández-Parra Jorge, González-Paredes Aida, Aguilar-Romero Teresa, Mozas-Moreno Juan
OBJECTIVE: To analyze the effect of learning in two surgeons on complications and conversion to laparotomy during total and subtotal laparoscopic hysterectomy. MATERIAL AND METHODS: We analyzed retrospectively 236 total and subtotal laparoscopic hysterectomies done by two surgeons from the time they first performed the procedure. The interventions were classified in three groups based on the surgeon's experience: the first 75 hysterectomies ("novice period"), the subsequent 75 hysterectomies ("intermediate"), and the subsequent 86 hysterectomies ("routine period")...
November 14, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/29153192/surgical-otoplasty-an-evidence-based-approach-to-prominent-ears-correction
#10
REVIEW
Kenneth J Stewart, Luca Lancerotto
Otoplasty is one of the first procedures learned during residency. A myriad of surgical techniques and nuances exist. Many have merit, some are ineffective, some destructive, and some frankly fanciful. Adopting an effective and safe technique should be based on proven efficacy and effectiveness to avoid early disappointments. We present a review of traditional otoplasty techniques and more recent innovations. Their pros and cons are discussed in view of the relative risks/benefits balance. Recurrence rates are low for most techniques...
February 2018: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/29150090/graph-based-representation-of-behavior-in-detection-and-prediction-of-daily-living-activities
#11
Piotr Augustyniak, Grażyna Ślusarczyk
Various surveillance systems capture signs of human activities of daily living (ADLs) and store multimodal information as time line behavioral records. In this paper, we present a novel approach to the analysis of a behavioral record used in a surveillance system designed for use in elderly smart homes. The description of a subject's activity is first decomposed into elementary poses - easily detectable by dedicated intelligent sensors - and represented by the share coefficients. Then, the activity is represented in the form of an attributed graph, where nodes correspond to elementary poses...
November 10, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/29148082/insights-into-flood-coping-appraisals-of-protection-motivation-theory-empirical-evidence-from-germany-and-france
#12
Philip Bubeck, W J Wouter Botzen, Jonas Laudan, Jeroen C J H Aerts, Annegret H Thieken
Protection motivation theory (PMT) has become a popular theory to explain the risk-reducing behavior of residents against natural hazards. PMT captures the two main cognitive processes that individuals undergo when faced with a threat, namely, threat appraisal and coping appraisal. The latter describes the evaluation of possible response measures that may reduce or avert the perceived threat. Although the coping appraisal component of PMT was found to be a better predictor of protective intentions and behavior, little is known about the factors that influence individuals' coping appraisals of natural hazards...
November 17, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/29141966/nutritional-factors-affecting-adult-neurogenesis-and-cognitive-function
#13
REVIEW
Shibu M Poulose, Marshall G Miller, Tammy Scott, Barbara Shukitt-Hale
Adult neurogenesis, a complex process by which stem cells in the hippocampal brain region differentiate and proliferate into new neurons and other resident brain cells, is known to be affected by many intrinsic and extrinsic factors, including diet. Neurogenesis plays a critical role in neural plasticity, brain homeostasis, and maintenance in the central nervous system and is a crucial factor in preserving the cognitive function and repair of damaged brain cells affected by aging and brain disorders. Intrinsic factors such as aging, neuroinflammation, oxidative stress, and brain injury, as well as lifestyle factors such as high-fat and high-sugar diets and alcohol and opioid addiction, negatively affect adult neurogenesis...
November 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/29140917/medical-trainees-experiences-of-treating-people-with-chronic-pain-a-lost-opportunity-for-medical-education
#14
Kathleen Rice, Jae Eun Ryu, Cynthia Whitehead, Joel Katz, Fiona Webster
PURPOSE: Evidence suggests that physicians' opinions about chronic pain patients become progressively negative over the course of medical training, leading to a decline in empathy for these patients. Few qualitative studies have focused on this issue and thus the experiences shaping this process remain unexplored. This study addressed how medical trainees learn about chronic pain management through informal and formal curricula. METHOD: This study adopted a descriptive qualitative interview-based approach informed by the theoretical lens of the hidden curriculum...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29137723/the-promise-and-problems-of-non-physician-practitioners-in-general-surgery-education-results-of-a-multi-center-mixed-methods-study-of-faculty
#15
James E Coverdill, Jeff Scott Shelton, Adnan Alseidi, David C Borgstrom, Daniel L Dent, Russell Dumire, Jonathan Fryer, Thomas H Hartranft, Steven B Holsten, M Timothy Nelson, Mohsen M Shabahang, Stanley R Sherman, Paula M Termuhlen, Randy J Woods, John D Mellinger
BACKGROUND: Nurse Practitioners and Physician Assistants - called non-physician practitioners or NPPs - are common, but little is known about their educational promise and problems. METHODS: General surgery faculty in 13 residency programs were surveyed (N = 279 with a 71% response rate) and interviewed (N = 43) about experiences with NPPs. The survey documents overall patterns and differences by program type and primary service; interviews point to deeper rationales and concerns...
November 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29137720/improving-surgical-residents-communication-in-disclosing-complications-a-qualitative-analysis-of-simulated-physician-and-patient-surrogate-conversations
#16
Carolina Fernandez Branson, Jeffrey G Chipman
BACKGROUND: In this study, we explore surgical resident communication with simulated patient surrogates (SPs), in an Objective Structured Clinical Examination (OSCE). METHODS: We use discourse analysis (DA), a qualitative approach to analyzing language, to evaluate our residents' interactions with simulated patient surrogates. After identifying problematic communication patterns, we apply communication theory to discuss our findings and provide suggestions for improvement...
November 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29135773/tree-based-claims-algorithm-for-measuring-pretreatment-quality-of-care-in-medicare-disabled-hepatitis-c-patients
#17
Viktor V Chirikov, Fadia T Shaya, Ebere Onukwugha, C Daniel Mullins, Susan dosReis, Charles D Howell
BACKGROUND: To help broaden the use of machine-learning approaches in health services research, we provide an easy-to-follow framework on the implementation of random forests and apply it to identify quality of care (QC) patterns correlated with treatment receipt among Medicare disabled patients with hepatitis C virus (HCV). METHODS: Using Medicare claims 2006-2009, we identified 1936 patients with 6 months continuous enrollment before HCV diagnosis. We ran a random forest on 14 pretreatment QC indicators, extracted the forest's representative tree, and aggregated its terminal nodes into 4 QC groups predictive of treatment...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29133500/hatpins
#18
Irene Koplinka-Loehr
Hatpins is a first-person narrative that delves into a physician's experience of a patient death during the early years of residency. The essay reflects on the conflicted physician-patient relationships that can develop even over the short tenure of residency. While residency seeks to create medically prepared and compassionate physicians, this piece speaks to the importance of the often subtle learning that comes from ethical, social, and cultural aspects of both the lives and deaths of our patients.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133335/barriers-and-facilitators-to-learn-and-improve-through-morbidity-and-mortality-conferences-a-qualitative-study
#19
Marit S de Vos, Jaap F Hamming, Perla J Marang-van de Mheen
OBJECTIVES: To explore barriers and facilitators to successful morbidity and mortality conferences (M&M), driving learning and improvement. DESIGN: This is a qualitative study with semistructured interviews. Inductive, thematic content analysis was used to identify barriers and facilitators, which were structured across a pre-existing framework for change in healthcare. SETTING: Dutch academic surgical department with a long tradition of M&M...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132340/what-do-japanese-residents-learn-from-treating-dying-patients-the-implications-for-training-in-end-of-life-care
#20
Kazuko Arai, Takuya Saiki, Rintaro Imafuku, Chihiro Kawakami, Kazuhiko Fujisaki, Yasuyuki Suzuki
BACKGROUND: How medical residents' experiences with care for dying patients affect their emotional well-being, their learning outcomes, and the formation of their professional identities is not fully understood. We examine residents' emotional states and learning occurring during the provision of care to dying patients and specifically discuss the impact of providing end-of-life (EOL) care on professional identity formation. METHODS: Semi-structured interviews were conducted with 13 residents who had graduated in the last 3 to 5 years...
November 13, 2017: BMC Medical Education
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