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https://www.readbyqxmd.com/read/28426466/physician-variation-in-time-to-antimicrobial-treatment-for-septic-patients-presenting-to-the-emergency-department
#1
Ithan D Peltan, Kristina H Mitchell, Kristina E Rudd, Blake A Mann, David J Carlbom, Catherine L Hough, Thomas D Rea, Samuel M Brown
OBJECTIVES: Delayed initiation of appropriate antimicrobials is linked to higher sepsis mortality. We investigated interphysician variation in septic patients' door-to-antimicrobial time. DESIGN: Retrospective cohort study. SETTING: Emergency department of an academic medical center. SUBJECTS: Adult patients treated with antimicrobials in the emergency department between 2009 and 2015 for fluid-refractory severe sepsis or septic shock...
April 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28426396/current-status-of-and-recommendations-for-nutrition-education-in-gastroenterology-fellowship-training-in-canada
#2
Jing Hu, Maitreyi Raman, Leah Gramlich
PURPOSE: Knowledge and skill in the area of nutrition are a key competency for the gastroenterologist. However, standards for nutrition education for gastroenterology fellows in Canada do not exist, and gastroenterologists in training and in practice do not feel confident in their knowledge or skill as it relates to nutrition. This study was undertaken to identify the current status of nutrition education in gastroenterology (GI) fellowship training programs in Canada and to provide insight into the development of nutrition educational goals, processes, and evaluation...
April 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28425611/a-simple-assessment-tool-for-evaluation-of-cadaveric-temporal-bone-dissection
#3
Sarah E Mowry, Erika Woodson, Samuel Gubbels, Matt Carfrae, Marlan R Hansen
EDUCATIONAL OBJECTIVE: Objective metrics in skilled-based educational courses allow trainees and instructors to assess performance and monitor progress. The objective is to validate a concise, easy-to-use instrument for assessment of resident skill during a timed cadaveric temporal-bone (CTB) dissection. STUDY DESIGN: Retrospective analysis. METHODS: An instrument was developed to assess resident performance on a yearly timed microdissection of CTB...
April 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28424805/cruising-through-the-journey-without-getting-drowned-the-saga-of-a-phd-student-in-the-netherlands
#4
Louise van Galen, Joyce Wachelder
Young medical trainees all over the world are encouraged to investigate unknown areas of medicine that need clarification. This often leads them to undertake a PhD (Doctor of Philosophy). Being curious, critical, and creative are necessary competences which enable us to engender scientific research within acute (internal) medicine. Worldwide, huge numbers of professionals are pursuing a PhD, with the aim of receiving a 'Doctor'-title. These PhD trajectories vary distinctly between countries. Since the distances in the scientific world are getting smaller and it is becoming more easy to work with each other across borders, it might be interesting to know what it requires to become an academic 'doctor' overseas...
2017: Acute Medicine
https://www.readbyqxmd.com/read/28424804/acute-medicine-finishing-school-preparing-for-the-next-step
#5
Tehmeena Khan, Nicholas Murch
The transition from registrar to consultant in medicine is one that trainees feel ill prepared for and can be extremely stressful. We devised the concept of an Acute Medicine "Finishing School" for senior trainees in London training programmes and ran sessions on CV writing, a simulated consultant interview, consultant job planning, responding to complaints and an out of hospital emergency scenario. Our feedback survey indicated that our delegates' confidence levels in all of the above aspects increased following the sessions...
2017: Acute Medicine
https://www.readbyqxmd.com/read/28424776/socially-responsible-surgery-building-recognition-and-coalition
#6
Tyler D Robinson, Thiago M Oliveira, Theresa R Timmes, Jacqueline M Mills, Nichole Starr, Matthew Fleming, Megan Janeway, Diane Haddad, Feroze Sidhwa, Ryan D Macht, Douglas F Kauffman, Tracey A Dechert
IMPORTANCE: Socially responsible surgery (SRS) integrates surgery and public health, providing a framework for research, advocacy, education, and clinical practice to address the social barriers of health that decrease surgical access and worsen surgical outcomes in underserved patient populations. These patients face disparities in both health and in health care, which can be effectively addressed by surgeons in collaboration with allied health professionals. OBJECTIVE: We reviewed the current state of surgical access and outcomes of underserved populations in American rural communities, American urban communities, and in low- and middle-income countries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28421654/short-term-outcomes-of-small-incision-cataract-surgery-provided-by-a-regional-population-in-the-pacific
#7
Riyaz Bhikoo, Hans Vellara, Salome Lolokabaira, Neil Murray, Biu Sikivou, Charles McGhee
BACKGROUND: To describe patient demographics, visual and surgical outcomes of a cohort undergoing Small Incision Cataract Surgery (SICS) at a Pacific regional ophthalmic training facility. DESIGN: Prospective, longitudinal study conducted at the Pacific Eye Institute, Fiji. PARTICIPANTS: 156 patients underwent SICS. METHODS: Preoperatively, a complete ophthalmic examination, including pachymetry and macular Optical Coherence Tomography (OCT) performed by two independent investigators...
April 19, 2017: Clinical & Experimental Ophthalmology
https://www.readbyqxmd.com/read/28420914/simulation-training-using-cadaver-sheep-chest-in-pleuroscopy-a-step-towards-skills-enhancement
#8
Talha Mahmud, Tajwar Nasir, Muhammad Saqib, Muhammad Aasim, Nasir Siddique
OBJECTIVE: For assessing the use of if simulation training on animal cadavers as a useful tool for training in pleuroscopy. METHODS: The email-based cross-sectional study was conducted in December 2014 at Shaikh Zayed Hospital, Federal Postgraduate Medical Institute, Lahore, Pakistan, and comprised respiratory physicians and trainees after their participation in a two-day hands-on training course on pleuroscopy and pleural medical procedures. The responses were analysed and the responses of physicians and trainees were compared...
April 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28419202/genomic-characterization-of-usa300-mrsa-to-evaluate-intraclass-transmission-and-recurrence-of-ssti-among-high-risk-military-trainees
#9
Eugene V Millar, Gregory K Rice, Emad M Elassal, Carey D Schlett, Jason W Bennett, Cassie L Redden, Deepika Mor, Natasha N Law, David R Tribble, Theron Hamilton, Michael W Ellis, Kimberly A Bishop-Lilly
Background.: Military trainees are at increased risk for methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infection (SSTI). Whole genome sequencing (WGS) can refine our understanding of MRSA transmission and microevolution in congregate settings. Methods.: We conducted a prospective case-control study of SSTI among US Army Infantry trainees at Fort Benning, GA from July 2012-December 2014. We identified clusters of USA300 MRSA SSTI within select training classes and performed WGS on clinical isolates...
April 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28418754/evaluating-the-effect-of-virtual-reality-temporal-bone-simulation-on-mastoidectomy-performance-a-meta-analysis
#10
Justin T Lui, Monica Y Hoy
Background The increasing prevalence of virtual reality simulation in temporal bone surgery warrants an investigation to assess training effectiveness. Objectives To determine if temporal bone simulator use improves mastoidectomy performance. Data Sources Ovid Medline, Embase, and PubMed databases were systematically searched per the PRISMA guidelines. Review Methods Inclusion criteria were peer-reviewed publications that utilized quantitative data of mastoidectomy performance following the use of a temporal bone simulator...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418599/use-of-the-harmonic-scalpel-for-delorme-s-procedure
#11
David Parés, Ioanna Drami, Katie Adams, Ugo Grossi, Ibnauf Suliman, Charles H Knowles
AIM: There are many surgical techniques to deal with external rectal prolapse but perineal procedures have the advantage of reduced invasiveness. Therefore, despite concerns regarding high recurrence rates, the technique is still used by many surgeons. METHOD: This manuscript and video describe our early clinical experience using the harmonic scalpel in eleven consecutive patients who underwent a Delorme's procedure for external rectal prolapse. RESULTS: The median age of patients was 76 years (range 30-94)...
April 18, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28418205/it-s-not-just-what-you-know-junior-trainees-approach-to-follow-up-and-documentation
#12
Dani C Cadieux, Mark Goldszmidt
CONTEXT: In teaching hospitals, junior trainees (first-year residents and third-year medical students) are responsible for patient follow-up and documentation under the supervision of senior team members. In order to support trainees in their role, supervisors need to understand how trainees approach these tasks and how they can be coached to develop best practices. OBJECTIVES: The purpose of our study was to explore the range of practices used by junior trainees in clinical settings...
April 18, 2017: Medical Education
https://www.readbyqxmd.com/read/28411714/evaluating-the-venous-experience-in-vascular-surgery-training
#13
Michael C Siah, Steven D Abramowitz, Paul Haser, John Ricotta, Edward Y Woo, Robyn Macsata
OBJECTIVE: There is an increasing recognition and treatment of venous disease in the United States; results of the Society for Vascular Surgery 2014 membership survey showed that venous disease represents 18.8% of a vascular surgeon's current practice. Despite this, there are no operative objectives or case requirements specific to venous disease for vascular surgery trainees. The objective of this study was to examine the current venous surgical training experience of graduating vascular surgery trainees...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28410992/ethical-issues-in-education-medical-trainees-and-the-global-health-experience
#14
REVIEW
Susan P Raine
With interest in global health experiences (GHEs) by medical trainees remaining high, the number of global health programs offering educational experiences in resource limited settings has proliferated. Development and implementation of GHEs has outpaced the critical evaluation of ethical considerations inherent in these programs. Global health programs must adhere to the four principles of beneficence, nonmaleficence, respect of autonomy, and justice in crafting a GHE focused on maximizing the experience of the learners, host country, and patients...
March 15, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28410718/analysis-of-competency-in-phacoemulsification-trainees-using-the-cumulative-sum-analysis
#15
Nicole Shu-Wen Chan, Aliza Jap, Younian Yang, Shu-Pei Tan, Soon-Phaik Chee
PURPOSE: To determine the number of cases required to achieve competency in phacoemulsification in terms of the posterior capsule rupture rate. SETTING: Singapore National Eye Centre, Singapore. DESIGN: Retrospective cohort study. METHODS: The posterior capsule rupture rate of the first 300 phacoemulsification cases performed by each trainee in the Singapore National Eye Centre (2004 to 2012) was charted using cumulative sum graphs...
March 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28410637/the-influence-of-physician-and-patient-gender-on-risk-assessment-for-lung-cancer-resection
#16
Mark K Ferguson, Megan Huisingh-Scheetz, Katherine Thompson, Kristen Wroblewski, Jeanne Farnan, Julissa Acevedo
BACKGROUND: Women do not receive appropriate surgical therapy for lung cancer as often as men. Patient gender may influence treatment recommendations; less is known about the effect of physician gender on recommendations. METHODS: Gender-neutral vignettes representing low-risk, average-risk, and high-risk candidates for lung resection were paired with concordant videos of standardized patients (SPs). Cardiothoracic trainees and practicing thoracic surgeons read a vignette, provided an initial estimate of the percentage risk of major adverse events after lung resection, viewed a video (randomized to male or female SP), provided a final estimate of risk, and ranked the importance of the video in the final risk estimate...
April 12, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28409072/reconceptualizing-benchmarks-for-residency-training
#17
EDITORIAL
Chandrew Rajakumar
Postgraduate medical education (PGME) is currently transitioning to a competency-based framework. This model clarifies the desired outcome of residency training - competence. However, since the popularization of Ericsson's work on the effect of time and deliberate practice on performance level, his findings have been applied in some areas of residency training. Though this may be grounded in a noble effort to maximize patient well-being, it imposes unrealistic expectations on trainees. This work aims to demonstrate the fundamental flaws of this application and therefore the lack of validity in using Ericsson's work to develop training benchmarks at the postgraduate level as well as expose potential harms in doing so...
March 2, 2017: Curēus
https://www.readbyqxmd.com/read/28408726/integrated-surgical-academic-training-in-the-uk-a-cross-sectional-survey
#18
Natalie S Blencowe, James C Glasbey, Philip J McElnay, Aneel Bhangu, Vimal J Gokani, Rhiannon L Harries
OBJECTIVES: This study aimed to explore variations in the provision of integrated academic surgical training across the UK. DESIGN: This is an online cross-sectional survey (consisting of 44 items with a range of free-text, binomial and 5-point Likert scale responses) developed by the Association of Surgeons in Training. SETTING: A self-reported survey instrument was distributed to academic surgical trainees across the UK (n=276). PARTICIPANTS: 143 (51...
April 13, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28407069/managing-transient-ischaemic-attacks-in-australia-a-qualitative-study
#19
Andrew R Davey, Daniel S Lasserson, Christopher R Levi, Parker J Magin
Background.: Stroke risk after transient ischaemic attack (TIA) is highest in the first few days. It is greatly reduced by commencing commonly used medications. Current Australian guidelines recommend that all TIAs be managed urgently by secondary-care specialists (mandatory for high-risk TIAs). The majority of TIAs present to general practice which creates a dilemma when specialist care is not readily accessible. There is a lack of evidence relating to the determinants of general practitioners' (GPs) actions in this situation...
April 12, 2017: Family Practice
https://www.readbyqxmd.com/read/28406552/auckland-regional-emergency-medicine-trainee-mentoring-uptake-survey
#20
Gordon Michael Mike Nicholls, Emma Lawrey, Peter Jones
OBJECTIVE: The primary objective of this study is to quantify how many Auckland region emergency medicine (EM) trainees would like a formal mentoring programme. The secondary objectives were to quantify how many Auckland region EM trainees would like to participate in a formal mentoring programme; to determine trainees' current understanding of mentoring; how trainees prefer mentors to be allocated; why trainees may want a mentor; what mentees perceive would be good qualities in a mentor; and trainees' prior experience with mentoring...
April 12, 2017: Emergency Medicine Australasia: EMA
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