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April 2018: Radiology
Sanjay V Desai, David A Asch, Lisa M Bellini, Krisda H Chaiyachati, Manqing Liu, Alice L Sternberg, James Tonascia, Alyssa M Yeager, Jeremy M Asch, Joel T Katz, Mathias Basner, David W Bates, Karl Y Bilimoria, David F Dinges, Orit Even-Shoshan, David M Shade, Jeffrey H Silber, Dylan S Small, Kevin G Volpp, Judy A Shea
Background Concern persists that inflexible duty-hour rules in medical residency programs may adversely affect the training of physicians. Methods We randomly assigned 63 internal medicine residency programs in the United States to be governed by standard duty-hour policies of the 2011 Accreditation Council for Graduate Medical Education (ACGME) or by more flexible policies that did not specify limits on shift length or mandatory time off between shifts. Measures of educational experience included observations of the activities of interns (first-year residents), surveys of trainees (both interns and residents) and faculty, and intern examination scores...
March 20, 2018: New England Journal of Medicine
Neill Storrar, David Hope, Helen Cameron
PURPOSE: Competency-based medical education (CBME) seeks to prepare undergraduate and postgraduate trainees for clinical practice. Its major emphasis is on outcomes, but questions about how best to reach these remain. One key issue is the need to integrate what matters most to students when setting educational goals: this is crucial if we are to design curricula that trainees understand and engage with, and that promote successful achievement of competencies. METHOD: We interviewed medical students in years 4 and 6 of a 6-year medical degree and used thematic analysis to understand their main educational priorities and how these fit with the aims of CBME...
March 20, 2018: Medical Teacher
Aine Cafferkey, Elizabeth Coyle, David Greaney, Sinead Harte, Niamh Hayes, Miriam Langdon, Birgitt Straub, Crina Burlacu
BACKGROUND: Simulation-based education is a modern training modality that allows healthcare professionals to develop knowledge and practice skills in a safe learning environment. The College of Anaesthetists of Ireland (CAI) was the first Irish postgraduate medical training body to introduce mandatory simulation training into its curriculum. Extensive quality assurance and improvement data has been collected on all simulation courses to date. AIMS: Describe The College of Anaesthetists of Ireland Simulation Training (CAST) programme and report the analysis of course participants' feedback...
March 20, 2018: Irish Journal of Medical Science
Elif Bilgic, Madoka Takao, Pepa Kaneva, Satoshi Endo, Toshitatsu Takao, Yusuke Watanabe, Katherine M McKendy, Liane S Feldman, Melina C Vassiliou
BACKGROUND: Needs assessment identified a gap regarding laparoscopic suturing skills targeted in simulation. This study collected validity evidence for an advanced laparoscopic suturing task using an Endo StitchTM device. METHODS: Experienced (ES) and novice surgeons (NS) performed continuous suturing after watching an instructional video. Scores were based on time and accuracy, and Global Operative Assessment of Laparoscopic Surgery. Data are shown as medians [25th-75th percentiles] (ES vs NS)...
March 1, 2018: Surgical Innovation
Steven J Weissbart, Alan J Wein, Ariana L Smith
PURPOSE OF REVIEW: There are advantages and disadvantages of subspecialty certification for physicians, trainees, patients, and society at large. As female pelvic medicine and reconstructive surgery (FPMRS) became the second subspecialty of urology to offer subspecialty certification, understanding the effects of FPMRS subspecialty certification on the healthcare system is important. RECENT FINDINGS: While subspecialty certification may improve training, identify experts, and ultimately lead to improved patient outcomes, certification might also be unnecessary for some physicians, weaken residency training, and limit the number of physicians who are deemed qualified to offer certain treatments...
March 19, 2018: Current Urology Reports
Vik Veer, Henry Zhang, Jolien Beyers, Olivier Vanderveken, Bhik Kotecha
PURPOSE: The purpose of this international survey is to ascertain the current practice of drug-induced sleep endoscopy (DISE) for patients with sleep-disordered breathing (SDB) by Otolaryngologists in the United Kingdom and Belgium. We compare the results with recommendations from the European Position Paper on drug-induced sleep endoscopy. METHODS: An online questionnaire was circulated to Consultant Otolaryngologists, independent practitioners, and trainees across the two countries...
March 19, 2018: European Archives of Oto-rhino-laryngology
Tarek Malas, Talal Al-Atassi, Tim Brandys, Viren Naik, Harry Lapierre, Buu-Khanh Lam
OBJECTIVE: There is mounting evidence supporting the benefit of surgical simulation on the learning of skills independently and in a patient-safe environment. The objective of this study was to examine the effect of visualization of surgical steps via instructional media on performance of an end-to-side microvascular anastomosis. METHODS: Thirty-two first- and second-year surgical trainees from the University of Ottawa received an expert-guided, didactic lecture on vascular anastomosis and performed an end-to-side anastomosis on a procedural model to assess baseline skills...
April 2018: Journal of Thoracic and Cardiovascular Surgery
Trudy Mooren, Yoke Rabaia, Suzan Mitwalli, Relinde Reiffers, Rosemarijn Koenen, Marguerithe de Man
BACKGROUND: Families with a child who has a disability have extra difficulties, particularly when services are hard to reach or less available. In a collaborative project, the Institute of Community and Public Health, the Palestinian community-based rehabilitation programme, and international non-governmental organisations cooperated to share and develop expertise and knowledge on increasing families' resilience through establishing family groups. This contribution focuses on the use of the Multi-Family Approach (MFA) in a Palestinian context...
February 21, 2018: Lancet
Chul Y Chung, Mark D Alson, Richard Duszak, Andrew J Degnan
Medical coding and billing processes in the United States are complex, cumbersome and poorly understood by radiologists. Despite the direct implications of radiology documentation on reimbursement, trainees and practicing radiologists typically receive limited relevant training. This article summarizes the payer structure including the state-based Children's Health Insurance Programs, discusses the essential processes by which radiologists request and receive reimbursement, details the mechanisms of coding diagnoses using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes and imaging services using Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, and explores reimbursement and coding-related issues specific to pediatric radiology...
March 19, 2018: Pediatric Radiology
Sriram Garudeswaran, Sohyung Cho, Ikechukwu Ohu, Ali K Panahi
Recent technological progress offers the opportunity to significantly transform conventional open surgical procedures in ways that allow minimally invasive surgery (MIS) to be accomplished by specific operative instruments' entry into the body through key-sized holes rather than large incisions. Although MIS offers an opportunity for less trauma and quicker recovery, thereby reducing length of hospital stay and attendant costs, the complex nature of this procedure makes it difficult to master, not least because of the limited work area and constricted degree of freedom...
2018: Minimally Invasive Surgery
Michael E Reschen, Andrea Mazzella, Edward Sharples
Background and aims: Dysfunction of a kidney transplant often requires histological sampling by percutaneous ultrasound-guided core needle biopsy. Transplant biopsy is more specialized than native kidney biopsy, the indications and complications are less well defined and in England are performed mainly by nephrologists. The aims of the study were to evaluate the adequacy and complication rate in living and deceased donor recipients according to training status of the nephrologist, assess the accuracy of physicians in predicting rejection, the threshold creatinine rise for biopsy, and the change in drug management post-biopsy...
April 2018: Annals of Medicine and Surgery
Cheryl I Anderson, Marc D Basson, Muhammad Ali, Alan T Davis, Robert L Osmer, Michael K McLeod, Pam S Haan, Robert G Molnar, Andi N Peshkepija, John C Hardaway, Karen A Chojnacki, Christopher C Pfeifer, Jeffrey M Gauvin, Mark W Jones, M Ashraf Mansour
BACKGROUND: It is increasingly important for faculty to teach deliberately and provide timely, detailed and formative feedback on surgical trainee performance. We initiated a multicenter study to improve resident evaluative processes and enhance teaching and learning behaviors while engaging residents in their education. METHODS: Faculty from seven U.S. postgraduate training programs rated resident operative performances using the perioperative briefing, intraoperative teaching, debriefing model (BID) and rated patient visits/academic performances using the entrustable professional activities (EPAs) model via a web-based platform...
March 15, 2018: Journal of the American College of Surgeons
Akshay Sood, Daniel Cole, Shaheen Alanee
Acute scrotum is a urologic emergency with many aetiologies. Acute scrotum in setting of acute pancreatitis is a rare occurrence and results from an effusion of pancreatic juices into the inguinal canal along a retroperitoneal tract. Knowledge regarding the existence of this obscure condition is essential for its diagnosis. It is thus important for medical professionals, particularly internists, surgical trainees and emergency physicians, to be aware of the condition and the options for its management.
March 17, 2018: BMJ Case Reports
Bhaskar K Somani, Ben Van Cleynenbreugel, Ali Gozen, Jaun Palou, Sas Barmoshe, Shekhar Biyani, Josep M Gaya, Giles Hellawell, Gio Pini, Faba R Oscar, Rafael Sanchez Salas, Petr Macek, Andreas Skolarikos, Christian Wagner, Viktor Eret, Stephen Haensel, Giampaolo Siena, Marek Schmidt, Max Klitsch, Stepan Vesely, Achilles Ploumidis, Silvia Proietti, Guido Kamphuis, Theodore Tokas, Rob Geraghty, Dominico Veneziano
BACKGROUND: The European School of Urology (ESU) started the European Urology Residents Education Programme (EUREP) in 2003 for final year urology residents, with hands-on training (HOT) added later in 2007. OBJECTIVE: To assess the geographical reach of EUREP, trainee demographics, and individual quality feedback in relation to annual methodology improvements in HOT. DESIGN, SETTING, AND PARTICIPANTS: From September 2014 to October 2017 (four EUREP courses) several new features have been applied to the HOT format of the EUREP course: 1:1 training sessions (2015), fixed 60-min time slots (2016), and standardised teaching methodology (2017)...
March 14, 2018: European Urology Focus
Omar B Da'ar, Abdulaziz Alshaya
This study estimated whether continued programming of a highly specialized four-year dentistry residency training in Saudi Arabia was cost-beneficial. We utilized a purposive sampling to administer a survey to trainees in major cities. Additionally, we used publically available market information about general practitioners. We employed Benefit-Cost Analysis accounting approach as a conceptual framework. Using general practitioners as the base category, we grouped overall social analytical perspectives into resident trainees and rest of society...
February 19, 2018: Evaluation and Program Planning
Aneeq Zia, Irfan Essa
PURPOSE: Manual feedback in basic robot-assisted minimally invasive surgery (RMIS) training can consume a significant amount of time from expert surgeons' schedule and is prone to subjectivity. In this paper, we explore the usage of different holistic features for automated skill assessment using only robot kinematic data and propose a weighted feature fusion technique for improving score prediction performance. Moreover, we also propose a method for generating 'task highlights' which can give surgeons a more directed feedback regarding which segments had the most effect on the final skill score...
March 16, 2018: International Journal of Computer Assisted Radiology and Surgery
James Rourke, Shabnam Asghari, Oliver Hurley, Mohamed Ravalia, Michael Jong, Wanda Parsons, Norah Duggan, Katherine Stringer, Danielle O'Keefe, Scott Moffatt, Wendy Graham, Carolyn Sturge Sparkes, Janelle Hippe, Kristin Harris Walsh, Donald McKay, Asoka Samarasena
CONTEXT: This report describes the community context, concept and mission of The Faculty of Medicine at Memorial University of Newfoundland (Memorial), Canada, and its 'pathways to rural practice' approach, which includes influences at the pre-medical school, medical school experience, postgraduate residency training, and physician practice levels. Memorial's pathways to practice helped Memorial to fulfill its social accountability mandate to populate the province with highly skilled rural generalist practitioners...
March 2018: Rural and Remote Health
Flavio Pereira, Roger de Moraes, Diogo Van Bavel, Andrea De Lorenzo, Eduardo Tibirica
Introduction: The main aim of the present study is to evaluate the effects of strenuous exercise, related to special military training for riot control, on systemic microvascular endothelial function and skin capillary density. Materials and Methods: Endothelium-dependent microvascular reactivity was evaluated in the forearm skin of healthy military trainees (age 23.4 ± 2.3 yr; n = 15) using laser speckle contrast imaging coupled with cutaneous acetylcholine (ACh) iontophoresis and post-occlusive reactive hyperemia (PORH)...
March 14, 2018: Military Medicine
Ganbold Lundeg, Amanda Baric, David C Pescod, Keith Pescod
Anesthesia in Mongolia has undergone a period of major development over the past 17 years, thanks to the work of the Mongolian Society of Anesthesiologists (MSA) and the support of the World Federation of Societies of Anaesthesiologists and the Australian Society of Anaesthetists. The specialty has made major advances in training and in its standing among medical specialties in Mongolia. The MSA has produced members who are leaders in the development of anesthesia as well as emergency medicine and critical care...
April 2018: Anesthesia and Analgesia
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