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Residency learning

Mohammed Saji Salahudeen, Prasad S Nishtala
OBJECTIVE: To summarize studies that used the international Resident Assessment home care instrument (interRAI HC) to examine study outcomes for older people. METHODS: A comprehensive systematic search was performed to identify relevant studies, using five databases from 1990 until October 2016. The Cochrane Risk-Bias assessment tool and Newcastle-Ottawa Scale was used to assess the quality of RCTs and non-RCTs, respectively. RESULTS: Based on the full-text analysis, 40 studies met the inclusion criteria out of 506 total records...
March 2, 2018: Clinical Gerontologist
Attia Bari, Rehan Ahmed Khan, Ahsan Waheed Rathore
OBJECTIVE: To evaluate the perception of postgraduate residents about the clinical educational environment and to investigate the association of their perception with different specialities and years of residency. METHODS: The study was conducted in August 2016 at The Children's Hospital, Lahore, Pakistan, and comprised postgraduate residents who were asked to complete postgraduate hospital educational environment measure questionnaire. The residents' individual perception scores were calculated and the means of both individual domain and global score of the questionnaire were compared by different specialities and different levels of residency training year...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Cynthia M Rand, Stanley J Schaffer, Nui Dhepyasuwan, Aaron Blumkin, Christina Albertin, Janet R Serwint, Paul M Darden, Sharon G Humiston, Keith J Mann, William Stratbucker, Peter G Szilagyi
BACKGROUND AND OBJECTIVES: Human papillomavirus (HPV) vaccination rates lag behind vaccination rates for other adolescent vaccines; a bundled intervention may improve HPV vaccination rates. Our objective is to evaluate the impact of quality improvement (QI) training plus a bundled practice-based intervention (provider prompts plus communication skills training plus performance feedback) on improving HPV vaccinations in pediatric resident continuity clinics. METHODS: Staff and providers in 8 resident clinics participated in a 12-month QI study...
March 14, 2018: Pediatrics
Eva Purkey, Rupa Patel, Tracey Beckett, Françoise Mathieu
OBJECTIVE: To understand the primary care experiences of women who have a history of childhood trauma and chronic disease. DESIGN: Qualitative study using in-depth interviews with directed content analysis. SETTING: Family health team in Kingston, Ont. PARTICIPANTS: Twenty-six women. METHODS: Letters of invitation were sent to eligible participants followed by a telephone survey. Women with an adverse childhood experience (ACE) score of 4 or higher and with 2 or more chronic conditions were invited to participate in a one-on-one interview...
March 2018: Canadian Family Physician Médecin de Famille Canadien
Tim Large, Amy E Krambeck
PURPOSE OF REVIEW: Holmium laser enucleation of the prostate (HoLEP) has been a mainstay therapy for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH) for nearly 20 years. We briefly review current and sentinel publications that provide outcomes data after HoLEP. RECENT FINDINGS: Current literature continues to support HoLEP as a versatile and durable surgical option for men with LUTS secondary to BPH. Despite evidence supporting durable symptom relief beyond 10 years even in large prostate glands, HoLEP is still not widely available to all patients...
March 13, 2018: Current Opinion in Urology
Carl D Stevens
The sudden, dramatic collapse of the seven-year struggle in Congress to repeal and replace the Affordable Care Act holds important lessons for all would-be reformers, including those advocating fundamental changes in medical education. In this Invited Commentary, the author draws parallels between reform initiatives in health policy and those in medical education, highlighting that, in both settings, stakeholders rarely support "repeal" in the absence of a superior replacement, even when they view the status quo as deeply flawed...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Vineet M Arora
With the advent of electronic medical records (EMRs) fueling the rise of big data, the use of predictive analytics, machine learning, and artificial intelligence are touted as transformational tools to improve clinical care. While major investments are being made in using big data to transform health care delivery, little effort has been directed toward exploiting big data to improve graduate medical education (GME). Because our current system relies on faculty observations of competence, it is not unreasonable to ask whether big data in the form of clinical EMRs and other novel data sources can answer questions of importance in GME such as when is a resident ready for independent practice...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Philipp Abe, Hannah M Wüst, Sebastian J Arnold, Serge A van de Pavert, Ralf Stumm
Adult hippocampal neurogenesis is implicated in learning and memory processing. It is tightly controlled at several levels including progenitor proliferation as well as migration, differentiation and integration of new neurons. Hippocampal progenitors and immature neurons reside in the subgranular zone (SGZ) and are equipped with the CXCL12-receptor CXCR4 which contributes to defining the SGZ as neurogenic niche. The atypical CXCL12-receptor CXCR7 functions primarily by sequestering extracellular CXCL12 but whether CXCR7 is involved in adult neurogenesis has not been assessed...
March 14, 2018: Glia
Courtney Rogers, Joy Johnson, Brianne Nueslein, David Edmunds, Rupa S Valdez
As chronic conditions are on the rise in the USA, management initiatives outside of the inpatient setting should be explored to reduce associated cost and access disparities. Chronic conditions disproportionately affect African American public housing residents due to the effects of historical marginalization on the manifestation of economic and social problems exacerbating health disparities and outcomes. Informed by participatory research action tenets, this study focused on identifying the challenges to management of chronic conditions and developing community-envisioned initiatives to address these challenges in a predominantly African American public housing community...
March 12, 2018: Journal of Racial and Ethnic Health Disparities
Kazuma Yunoki, Tetsuro Sakai
An increasing number of reports indicate the efficacy of simulation training in anesthesiology resident education. Simulation education helps learners to acquire clinical skills in a safe learning environment without putting real patients at risk. This useful tool allows anesthesiology residents to obtain medical knowledge and both technical and non-technical skills. For faculty members, simulation-based settings provide the valuable opportunity to evaluate residents' performance in scenarios including airway management and regional, cardiac, and obstetric anesthesiology...
March 9, 2018: Journal of Anesthesia
Suneetha Kadiyala, Audrey Prost, Helen Harris-Fry, Meghan O'Hearn, Ronali Pradhan, Shibananth Pradhan, Naba Kishore Mishra, Suchitra Rath, Nirmala Nair, Shibanand Rath, Prasantha Tripathy, Sneha Krishnan, Peggy Koniz-Booher, Heather Danton, Diana Elbourne, Joanna Sturgess, Emma Beaumont, Hassan Haghparast-Bidgoli, Jolene Skordis-Worrall, Satyanarayan Mohanty, Avinash Upadhay, Elizabeth Allen
BACKGROUND: Maternal and child undernutrition have adverse consequences for pregnancy outcomes and child morbidity and mortality, and they are associated with low educational attainment, economic productivity as an adult, and human wellbeing. 'Nutrition-sensitive' agriculture programs could tackle the underlying causes of undernutrition. METHODS/DESIGN: This study is a four-arm cluster randomised controlled trial in Odisha, India. Interventions are as follows: (1) an agricultural extension platform of women's groups viewing and discussing videos on nutrition-sensitive agriculture (NSA) practices, and follow-up visits to women at home to encourage the adoption of new practices shown in the videos; (2) women's groups viewing and discussing videos on NSA and nutrition-specific practices, with follow-up visits; and (3) women's groups viewing and discussing videos on NSA and nutrition-specific practices combined with a cycle of Participatory Learning and Action meetings, with follow-up visits...
March 9, 2018: Trials
M Douglas Jones, Traci Yamashita, Randal G Ross, Jennifer Gong
BACKGROUND: Although medical school programs oriented toward postgraduate specialty training have the potential to reduce the duration and cost of medical school for US medical students, success depends on the ability of students to predict their postgraduate specialties. It is clear that first-year choices are poorly predictive, but it is not known when predictions become sufficiently reliable to support specialty-oriented learning programs. We therefore examined the predictive value of specialty preferences expressed at the ends of the first, second and third years of medical school and asked whether concurrent expressions of confidence in choices improved predictive ability...
March 9, 2018: BMC Medical Education
Muhammed Veli, Aydogan Ozcan
We present a cost-effective and portable platform based on contact lenses for non-invasively detecting Staphylococcus aureus, which is part of the human ocular microbiome and resides on the cornea and conjunctiva. Using Staphylococcus aureus-specific antibodies and a surface chemistry protocol that is compatible with human tear, contact lenses are designed to specifically capture Staphylococcus aureus. After the bacteria capture on the lens, and right before its imaging, the captured bacteria are tagged with surface-functionalized polystyrene microparticles...
March 9, 2018: ACS Nano
Erynne A Faucett, Jonnae Y Barry, Hilary C McCrary, Ahlam A Saleh, Audrey B Erman, Stacey L Ishman
Importance: To date, there have been no reports in the current literature regarding the use of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in otolaryngology residency training. An evaluation may help educators address these core competencies in the training curriculum. Objectives: To examine the quantity and nature of otolaryngology residency training literature through a systematic review and to evaluate whether this literature aligns with the 6 core competencies...
March 8, 2018: JAMA Otolaryngology—Head & Neck Surgery
Gabrielle Wong-Parodi, M Beatrice Dias, Michael Taylor
BACKGROUND: Air quality affects us all and is a rapidly growing concern in the 21st century. We spend the majority of our lives indoors and can be exposed to a number of pollutants smaller than 2.5 microns (particulate matter, PM2.5 ) resulting in detrimental health effects. Indoor air quality sensors have the potential to provide people with the information they need to understand their risk and take steps to reduce their exposure. One such sensor is the Speck sensor developed at the Community Robotics, Education and Technology Empowerment Lab at Carnegie Mellon University...
March 8, 2018: JMIR MHealth and UHealth
Yuval D Bar-Or, Henry E Fessler, Dipan A Desai, Sammy Zakaria
INTRODUCTION: Many residents and fellows complete graduate medical education having received minimal unbiased financial planning guidance. This places them at risk of making ill-informed financial decisions, which may lead to significant harm to them and their families. Therefore, we sought to provide fellows with comprehensive unbiased financial education and empower them to make timely, constructive financial decisions. METHODS: A self-selected cohort of cardiovascular disease, pulmonary and critical care, and infectious disease fellows (n = 18) at a single institution attended a live, eight-hour interactive course on personal finance...
January 1, 2018: Curēus
Jessica M Goldonowicz, Michael S Runyon, Mark J Bullard
BACKGROUND: To investigate the value of a novel simulation-based palliative care educational intervention within an emergency medicine (EM) residency curriculum. METHODS: A palliative care scenario was designed and implemented in the simulation program at an urban academic emergency department (ED) with a 3-year EM residency program. EM residents attended one of eight high-fidelity simulation sessions, in groups of 5-6. A standardized participant portrayed the patient's family member...
March 7, 2018: BMC Palliative Care
Jill M Bowman Peterson, Briar Duffy, Alisa Duran, Sophia P Gladding
BACKGROUND: Current health care costs are unsustainable, with a large percentage of waste attributed to doctor practices. Medical educators are developing curricula to address value-based care (VBC) in education. There is, however, a paucity of curricula and assessments addressing levels higher than 'knows' at the base of Miller's pyramid of assessment. Our objective was to: (1) teach residents the principles of VBC using active learning strategies; and (2) develop and pilot a tool to assess residents' ability to apply principles of VBC at the higher level of 'knows how' on Miller's pyramid...
March 6, 2018: Clinical Teacher
Heather Moquin, Cydnee Seneviratne, Lorraine Venturato
Background: Undergraduate nursing placement in aged care is forecast to grow in importance with the increasing aging population, and to help to reverse trends in student lack of interest in gerontology careers. However, there is a need to better understand undergraduate nursing students' experiences on placement with older adults, as well as key features of quality learning within residential aged care. The aim of this study was to explore how nursing students understand learning within residential aged care...
2018: BMC Nursing
Weichao Yang, Kui Xu, Jijian Lian, Lingling Bin, Chao Ma
Flood is a serious challenge that increasingly affects the residents as well as policymakers. Flood vulnerability assessment is becoming gradually relevant in the world. The purpose of this study is to develop an approach to reveal the relationship between exposure, sensitivity and adaptive capacity for better flood vulnerability assessment, based on the fuzzy comprehensive evaluation method (FCEM) and coordinated development degree model (CDDM). The approach is organized into three parts: establishment of index system, assessment of exposure, sensitivity and adaptive capacity, and multiple flood vulnerability assessment...
March 2, 2018: Journal of Environmental Management
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