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Carmen Rosa Noroña, Michelle L Acker
Recent implementation science in mental health has focused on identifying the most effective strategies to disseminate and implement evidence-based treatments (EBTs) into real-world practice settings. The learning collaborative training methodology and its use of expert trainers/consultants have become increasingly popular as one of these approaches. Moreover, there is preliminary evidence that ongoing expert consultation may increase the adoption, learning, and sustainability of EBTs by an already practicing workforce and, consequently, help trainers, practitioners, and organizations address implementation barriers...
October 26, 2016: Infant Mental Health Journal
Aliza B Solomon, Rachel Reed, Keith Benkov, Joseph Kingsbery, Sarah S Lusman, Lisa B Malter, Jeremiah Levine, Simon Rabinowitz, Martin Wolff, Sondra Zabar, Elizabeth Weinshel
BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) has described six core competencies with which trainees should demonstrate proficiency. Using the Objective Structured Clinical Exam (OSCE), we aimed to assess four of these competencies among Pediatric GI fellows (PG). METHODS: Eight first-year PG's from six medical centers in the New York area participated in a four-station OSCE with trained standardized patient (SP) actors. The cases included an "ED Consult" for lower GI bleeding; "Breaking Bad News" focusing on CF nutritional complications; "Second Opinion" for abdominal pain; "Transition of Care" for inflammatory bowel disease...
October 25, 2016: Journal of Pediatric Gastroenterology and Nutrition
Esther Helmich, Huei-Ming Yeh, Adina Kalet, Mohamed Al-Eraky
Becoming a doctor is fundamentally about developing a new, professional identity as a physician, which in and of itself may evoke many emotions. Additionally, medical trainees are increasingly moving from one cultural context to another and are challenged with navigating the resulting shifts in their professional identify. In this Article, the authors aim to address medical professional identity formation from a polyvocal, multidisciplinary, cross-cultural perspective. They delineate the cultural approaches to medical professionalism, reflect on professional identity formation in different cultures and on different theories of identity development, and advocate for a context-specific approach to professional identity formation...
October 25, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
D Sharathkumar Sanketh, Samuel Raj Srinivasan, Shankargouda Patil, Kannan Ranganathan
AIM: In the present study, we simulated clinical scenarios by explicitly describing the history and clinical and histological features of hypothetical patients presenting with oral lichen planus (OLP), oral lichenoid lesion, and epithelial dysplasia in a self-designed questionnaire. By doing so, we aimed to elicit a diagnosis from oral pathologists and trainees, analyze their responses, appraise issues, and propose solutions regarding the diagnosis of OLP. METHODS: The questionnaire was distributed to 100 oral pathologists and trainees in South India...
October 26, 2016: Journal of Investigative and Clinical Dentistry
Ryan C Johnson, Michael W Ellis, Carey D Schlett, Eugene V Millar, Patrick T LaBreck, Deepika Mor, Emad M Elassal, Jeffrey B Lanier, Cassie L Redden, Tianyuan Cui, Nimfa Teneza-Mora, Danett K Bishop, Eric R Hall, Kimberly A Bishop-Lilly, D Scott Merrell
: Military trainees are at high risk for skin and soft-tissue infections (SSTIs). Although Staphylococcus aureus is associated with purulent SSTI, it is unclear to what degree this pathogen causes nonpurulent cellulitis. To inform effective prevention strategies and to provide novel insights into SSTI pathogenesis, we aimed to determine the etiology of SSTI in this population. We conducted a prospective observational study in US Army Infantry trainees with SSTI (cutaneous abscesses and cellulitis) from July 2012 through December 2014...
2016: PloS One
Bradley Genovese, Steven Yin, Sohail Sareh, Michael DeVirgilio, Laith Mukdad, Jessica Davis, Veronica J Santos, Peyman Benharash
With changes in work hour limitations, there is an increasing need for objective determination of technical proficiency. Electromagnetic hand-motion analysis has previously shown only time to completion and number of movements to correlation with expertise. The present study was undertaken to evaluate the efficacy of hand-motion-tracking analysis in determining surgical skill proficiency. A nine-degree-of-freedom sensor was used and mounted on the superior aspect of a needle driver. A one-way analysis of variance and Welch's t test were performed to evaluate significance between subjects...
October 2016: American Surgeon
Emily E Whitgob, Rebecca L Blankenburg, Alyssa L Bogetz
PURPOSE: Trainee mistreatment remains an important and serious medical education issue. Mistreatment toward trainees by the medical team has been described; mistreatment by patients and families has not. Motivated by discrimination towards a resident by a family in their emergency department, the authors sought to identify strategies for trainees and physicians to respond effectively to mistreatment by patients and families. METHOD: A purposeful sample of pediatric faculty educational leaders was recruited from April-June 2014 at Stanford University...
November 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Meghan M McConnell, Sandra Monteiro, Molly M Pottruff, Alan Neville, Geoff R Norman, Kevin W Eva, Kulamakan Kulasegaram
PURPOSE: Training to become a physician is an emotionally laden experience. Research in cognitive psychology indicates that emotions can influence learning and performance, but the materials used in such research (e.g., word lists) rarely reflect the complexity of material presented in medical school. The present study examined whether emotions influence learning of basic science principles. METHOD: Fifty-five undergraduate psychology students were randomly assigned to write about positive, negative, or neutral life events for nine minutes...
November 2016: Academic Medicine: Journal of the Association of American Medical Colleges
S Beth Bierer, Elaine F Dannefer
PURPOSE: The move toward competency-based education will require medical schools and postgraduate training programs to restructure learning environments to motivate trainees to take personal ownership for learning. This qualitative study explores how medical students select and implement study strategies while enrolled in a unique, nontraditional program that emphasizes reflection on performance and competence rather than relying on high-stakes examinations or grades to motivate students to learn and excel...
November 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Sharon E Card, Heather D Clark, Michelle Elizov, Narmin Kassam
General internal medicine (GIM), like other generalist specialties, has struggled to maintain its identity in the face of mounting sub-specialization over the past few decades. In Canada, the path to licensure for general internists has been through the completion of an extra year of training after three core years of internal medicine. Until very recently, the Royal College of Physicians and Surgeons of Canada (RCPSC) did not recognize GIM as a distinct entity. In response to a societal need to train generalist practitioners who could care for complex patients in an increasingly complex health care setting, the majority of universities across Canada voluntarily developed structured GIM training programs independent of RCPSC recognition...
October 24, 2016: Journal of General Internal Medicine
Nicholas Weida, Lcdr Dinchen Jardine, Benjamin Kennedy, Amy Beane, Timothy Daskivich
BACKGROUND : Resident attitudes toward the Accreditation Council for Graduate Medical Education (ACGME) likely influence the ACGME's effectiveness in its role of ensuring compliance with its requirements. Beyond perceptions of duty hour limits and their enforcement, there is a lack of data on resident perceptions of the ACGME and its role. OBJECTIVE : We explored resident attitudes toward the ACGME and developed recommendations for improved outreach to the resident community to improve perceptions...
October 2016: Journal of Graduate Medical Education
Mary Ellen J Goldhamer, Keith Baker, Amy P Cohen, Debra F Weinstein
BACKGROUND: Multi-source evaluation has demonstrated value for trainees, but is not generally provided to residency or fellowship program directors (PDs). OBJECTIVE: To develop, implement, and evaluate a PD multi-source evaluation process. METHODS: Tools were developed for PD evaluation by trainees, department chairs, and graduate medical education (GME) leadership. Evaluation questions were based on PD responsibilities, including Accreditation Council for Graduate Medical Education (ACGME) requirements...
October 2016: Journal of Graduate Medical Education
Karsten A van Loon, Pim W Teunissen, Erik W Driessen, Fedde Scheele
BACKGROUND : Entrustable professional activities (EPAs) seek to translate essential physician competencies into clinical practice. Until now, it is not known whether EPA-based curricula offer enhanced assessment and feedback to trainees. OBJECTIVE : This study examined program directors' and senior residents' justifications for entrustment decisions and what role generic, cross-specialty competencies (such as communication skills, collaboration, and understanding health care systems) play in these decisions...
October 2016: Journal of Graduate Medical Education
Richard A Feinberg, Amanda L Clauser
BACKGROUND : In graduate medical education, assessment results can effectively guide professional development when both assessment and feedback support a formative model. When individuals cannot directly access the test questions and responses, a way of using assessment results formatively is to provide item keyword feedback. OBJECTIVE : The purpose of the following study was to investigate whether exposure to item keyword feedback aids in learner remediation...
October 2016: Journal of Graduate Medical Education
Raphael Rabinowitz, Jeanne Farnan, Oliver Hulland, Lisa Kearns, Michele Long, Bradley Monash, Priti Bhansali, H Barrett Fromme
BACKGROUND : Attending rounds is a key component of patient care and education at teaching hospitals, yet there is an absence of studies addressing trainees' perceptions of rounds. OBJECTIVE : To determine perceptions of pediatrics and internal medicine residents about the current and ideal purposes of inpatient rounds on hospitalist services. METHODS : In this multi-institutional qualitative study, the authors conducted focus groups with a purposive sample of internal medicine and pediatrics residents at 4 teaching hospitals...
October 2016: Journal of Graduate Medical Education
Bilal H Kirmani, Michael V Holmes, Andrew D Muir
BACKGROUND: The long-term outcomes of off-pump coronary artery bypass grafting (CABG) are the subject of speculation. Our institution has >15 years of experience performing CABG both off-pump (OPCAB) and on cardiopulmonary bypass (CPB). Our null hypothesis was that there would be no difference in a long-term composite of death and revascularisation between the 2 methods. METHODS: We performed a retrospective cohort study of all isolated CABG at our institution from 2001 to 2015...
October 25, 2016: Circulation
Melanie J Lewis, Rose Ellis, Sunil K Adusumilli, Ian Cameron
INTRODUCTION: The New South Wales Rural Resident Medical Officer Cadetship Program began in 1988 as a strategy to increase the numbers of junior doctors in rural hospitals. This article outlines the results of an evaluation undertaken in 2014. Specifically, it will look at where former cadets who entered the program between 1989 and 2010 were working in 2014, what training programs they chose and their attitudes toward the program. METHOD: Data were collected using a semi-structured questionnaire sent to all the former cadets who entered the program from 1989 until 2010...
October 2016: Rural and Remote Health
Laura Jenkins, Jeremy Cosgrove, Paul Chappell, Ammar Kheder, Dilraj Sokhi, Markus Reuber
The diagnostic distinction between epilepsy and psychogenic nonepileptic seizures (PNES) can be challenging. Previous studies have demonstrated that experts in conversation analysis can identify linguistic and interactional features in transcripts and recordings of interviews with patients that reliably distinguish between epilepsy and PNES. In this study, ten senior neurology trainees took part in a one-day intervention workshop about linguistic and interactional differences in the conversation behavior of patients with epilepsy and those with PNES...
October 21, 2016: Epilepsy & Behavior: E&B
Alexander B Stone, Christopher L Wu, Elizabeth C Wick, Deborah B Hobson, Michael C Grant
No abstract text is available yet for this article.
November 2016: Regional Anesthesia and Pain Medicine
Abdul H Sultan, Ash Monga, Joseph Lee, Anton Emmanuel, Christine Norton, Giulio Santoro, Tracy Hull, Bary Berghmans, Stuart Brody, Bernard T Haylen
INTRODUCTION AND HYPOTHESIS: The terminology for anorectal dysfunction in women has long been in need of a specific clinically-based Consensus Report. METHODS: This Report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted on Committee by experts in their fields to form a Joint IUGA/ICS Working Group on Female Anorectal Terminology...
October 24, 2016: International Urogynecology Journal
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