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Direct observation of medical residents

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https://www.readbyqxmd.com/read/28991844/criterion-based-assessment-in-a-norm-based-world-how-can-we-move-past-grades
#1
Anne G Pereira, Majka Woods, Andrew P J Olson, Suzanne van den Hoogenhof, Briar L Duffy, Robert Englander
In the United States, the medical education community has begun a shift from the Flexnerian time-based model to a competency-based medical education model. The graduate medical education (GME) community is substantially farther along in this transition than is the undergraduate medical education (UME) community.GME has largely adopted the use of competencies and their attendant milestones and increasingly is employing the framework of entrustable professional activities (EPAs) to assess trainee competence. The UME community faces several challenges to successfully navigating a similar transition...
October 3, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28988460/toolbox-of-assessment-tools-of-technical-skills-in-otolaryngology-head-and-neck-surgery-a-systematic-review
#2
REVIEW
Mathilde Labbé, Meredith Young, Lily H P Nguyen
OBJECTIVE: To support the development of programs of assessment of technical skills in the operating room (OR), we systematically reviewed the literature to identify assessment tools specific to otolaryngology-head and neck surgery (OTL-HNS) core procedures and summarized their characteristics. METHODS: We systematically searched Embase, MEDLINE, PubMed, and Cochrane to identify and report on assessment tools that can be used to assess residents' technical surgical skills in the operating room for OTL-HNS core procedures...
October 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28937513/entrustment-evidence-used-by-expert-gynecologic-surgical-teachers-to-determine-residents-autonomy
#3
Xiaodong Phoenix Chen, Amy M Sullivan, Joan M Bengtson, John L Dalrymple
OBJECTIVE: To identify entrustment evidence used by expert gynecologic surgical teachers to determine obstetrics and gynecology residents' level of autonomy in the operating room. METHODS: A qualitative interview study was undertaken from March to November 2016. Four selection criteria were used to define and purposefully sample expert gynecologic surgical teachers across the United States to represent all four geographic regions. All interviews were audio-recorded and transcribed...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28886191/clinical-chemistry-reference-intervals-of-healthy-adult-populations-in-gojjam-zones-of-amhara-national-regional-state-northwest-ethiopia
#4
Zewdie Mekonnen, Asmare Amuamuta, Wondemagegn Mulu, Mulat Yimer, Yohannes Zenebe, Yesuf Adem, Bayeh Abera, Wondemu Gebeyehu, Yakob Gebregziabher
BACKGROUND: Reference interval is crucial for disease screening, diagnosis, monitoring, progression and treatment efficacy. Due to lack of locally derived reference values for the parameters, clinicians use reference intervals derived from western population. But, studies conducted in different African countries have indicated differences between locally and western derived reference values. Different studies also indicated considerable variation in clinical chemistry reference intervals by several variables such as age, sex, geographical location, environment, lifestyle and genetic variation...
2017: PloS One
https://www.readbyqxmd.com/read/28869159/a-comparison-of-objective-assessment-data-for-the-united-states-and-international-medical-graduates-in-a-general-surgery-residency
#5
Francisco Cardenas Lara, Nimesh D Naik, T K Pandian, Becca L Gas, Suzanne Strubel, Rachel Cadeliña, Stephanie F Heller, David R Farley
OBJECTIVE: To compare objective assessment scores between international medical graduates (IMGs) and United States Medical Graduates. Scores of residents who completed a preliminary year, who later matched into a categorical position, were compared to those who matched directly into a categorical position at the Mayo Clinic, Rochester. DESIGN: Postgraduate year (PGY) 1 to 5 residents participate in a biannual multistation, OSCE-style assessment event as part of our surgical training program...
August 28, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28864400/effects-of-transcranial-direct-current-stimulation-on-neurosurgical-skill-acquisition-a-randomized-controlled-trial
#6
Patrick Ciechanski, Adam Cheng, Steven Lopushinsky, Kent Hecker, Liu Shi Gan, Stefan Lang, Kourosh Zareinia, Adam Kirton
BACKGROUND: Recent changes in surgical training environments may have limited opportunities for trainees to gain proficiency in skill. Complex skills such as neurosurgery required extended periods of training. Methods to enhance surgical training are required to overcome duty-hour restrictions, to ensure skill proficiency is met. Transcranial direct-current stimulation (tDCS) can enhance motor skill learning but is untested in surgical procedural training. We aimed to determine the effects of tDCS on simulation-based neurosurgical skill acquisition...
August 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28772096/prospective-identification-of-patients-at-risk-for-unwarranted-variation-in-treatment
#7
Amy S Kelley, Evan Bollens-Lund, Kenneth E Covinsky, Jonathan S Skinner, R Sean Morrison
BACKGROUND: Understanding factors associated with treatment intensity may help ensure higher value healthcare. OBJECTIVE: To investigate factors associated with Medicare costs among prospectively identified, seriously ill older adults and examine if baseline prognosis influences the impact of these factors. DESIGN/SUBJECTS: Prospective observation of Health and Retirement Study cohort with linked Medicare claims. MEASUREMENTS: We identified people with incident serious illness (a serious medical condition, for example, metastatic cancer or functional impairment); calculated subjects' one-year mortality risk; and then followed them for one year...
August 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28732397/combined-sewer-overflow-events-and-childhood-emergency-department-visits-a-case-crossover-study
#8
Cole Brokamp, Andrew F Beck, Louis Muglia, Patrick Ryan
In localities with combined sewer systems, combined sewer overflow (CSO) events frequently occur following high precipitation and can result in the release of untreated sewage and industrial wastewater into surface waters. We hypothesized that either direct contact with or proximity to aerosolized CSO effluent would increase the risk for childhood emergency department (ED) visits for asthma, gastrointestinal (GI) illnesses, and skin and soft tissue infections (SSTIs) in Cincinnati, OH, USA. ED visits for 2010-2014 due to GI diseases, asthma, and SSTIs were extracted from the Cincinnati Children's Hospital Medical Center electronic health records...
December 31, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28668663/prevalence-and-determinants-of-poor-food-intake-of-residents-living-in-long-term-care
#9
Heather H Keller, Natalie Carrier, Susan E Slaughter, Christina Lengyel, Catriona M Steele, Lisa Duizer, Jill Morrison, K Stephen Brown, Habib Chaudhury, Minn N Yoon, Alison M Duncan, Veronique Boscart, George Heckman, Lita Villalon
OBJECTIVE: Poor food intake is known to lead to malnutrition in long-term care homes (LTCH), yet multilevel determinants of food intake are not fully understood, hampering development of interventions that can maintain the nutritional status of residents. This study measures energy and protein intake of LTCH residents, describes prevalence of diverse covariates, and the association of covariates with food intake. DESIGN: Multisite cross-sectional study. SETTING: Thirty-two nursing homes from 4 provinces in Canada...
June 28, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28651976/observational-learning-during-simulation-based-training-in-arthroscopy-is-it-useful-to-novices
#10
Marie-Eve LeBel, John Haverstock, Sayra Cristancho, Lucia van Eimeren, Gavin Buckingham
OBJECTIVE: Observing experts constitutes an important and common learning experience for surgical residents before operating under direct guidance. However, studies suggest that exclusively observing experts may induce suboptimal motor learning, and watching errors from non-experts performing simple motor tasks may generate better performance. We investigated whether observational learning is transferrable to arthroscopy learning using virtual reality (VR) simulation. SETTING/DESIGN: In our surgical simulation laboratory, we compared students learning basic skills on a VR arthroscopy simulator after watching an expert video demonstration of VR arthroscopy tasks or a non-expert video demonstration of the same tasks to a Control group without video demonstration...
June 23, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28633171/examining-accuracy-of-self-assessment-of-in-training-examination-performance-in-a-context-of-guided-self-assessment
#11
Oksana Babenko, Denise Campbell-Scherer, Shirley Schipper, John Chmelicek, Tanya Barber, Kimberley Duerksen, Shelley Ross
BACKGROUND AND OBJECTIVES: In our family medicine residency program, we have established a culture of guided self-assessment through a systematic approach of direct observation of residents and documentation of formative feedback. We have observed that our residents have become more accurate in self-assessing their clinical performance. The objective of this study was to examine whether this improved accuracy extended to residents' self-assessment of their medical knowledge and clinical reasoning on the In-Training Examination (ITE)...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28610692/a-didactic-experiment-showing-the-compton-scattering-by-means-of-a-clinical-gamma-camera
#12
Ernesto Amato, Lucrezia Auditore, Alfredo Campennì, Fabio Minutoli, Mariapaola Cucinotta, Alessandro Sindoni, Sergio Baldari
We describe a didactic approach aimed to explain the effect of Compton scattering in nuclear medicine imaging, exploiting the comparison of a didactic experiment with a gamma camera with the outcomes from a Monte Carlo simulation of the same experimental apparatus. We employed a (99m)Tc source emitting 140.5keV photons, collimated in the upper direction through two pinholes, shielded by 6mm of lead. An aluminium cylinder was placed on the source at 50mm of distance. The energy of the scattered photons was measured on the spectra acquired by the gamma camera...
June 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28585405/type-of-oral-solid-medication-packaging-and-medication-preparation-time-in-nursing-homes-a-direct-observation-study
#13
C M Cready, C Hudson, K Dreyer
WHAT IS KNOWN AND OBJECTIVE: Medication administration is a substantial portion of the workday in nursing homes, with the medication preparation step being the most time-consuming. However, little is known about how medication preparation time is affected by the type of packaging used for oral solid medications (ie, tablets/capsules). We examined the effects of two types of packaging. As fewer steps are associated with strip packaging compared to bingo card packaging, we hypothesized that the increase in medication preparation seconds per resident with each additional oral solid medication would be smaller when strip packaging was used...
June 5, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28557946/a-patient-centered-approach-to-developing-entrustable-professional-activities
#14
Carlos El-Haddad, Arvin Damodaran, H Patrick McNeil, Wendy Hu
PURPOSE: The medical education community is rapidly accepting the use of entrustable professional activities (EPAs) as a means of assessing residents. Stakeholder engagement is advised in developing EPAs, but no studies have investigated the role of patient input. In this qualitative study, the authors investigated what patient input may add to designing a patient-centered EPA. METHOD: The authors chose "management of acute low back pain (LBP)" as a common, important clinical task on which to base the patient-centered EPA...
June 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28557935/constructing-a-shared-mental-model-for-faculty-development-for-the-core-entrustable-professional-activities-for-entering-residency
#15
Michele A Favreau, Linda Tewksbury, Carla Lupi, William B Cutrer, Janet A Jokela, Lalena M Yarris
In 2014, the Association of American Medical Colleges identified 13 Core Entrustable Professional Activities for Entering Residency (Core EPAs), which are activities that entering residents might be expected to perform without direct supervision. This work included the creation of an interinstitutional concept group focused on faculty development efforts, as the processes and tools for teaching and assessing entrustability in undergraduate medical education (UME) are still evolving. In this article, the authors describe a conceptual framework for entrustment that they developed to better prepare all educators involved in entrustment decision making in UME...
June 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28557735/inpatient-hospital-factors-and-resident-time-with-patients-and-families
#16
Lauren Ann Destino, Melissa Valentine, Farnoosh H Sheikhi, Amy J Starmer, Christopher P Landrigan, Lee Sanders
OBJECTIVES: To define hospital factors associated with proportion of time spent by pediatric residents in direct patient care. METHODS: We assessed 6222 hours of time-motion observations from a representative sample of 483 pediatric-resident physicians delivering inpatient care across 9 pediatric institutions. The primary outcome was percentage of direct patient care time (DPCT) during a single observation session (710 sessions). We used one-way analysis of variance to assess a significant difference in the mean percentage of DPCT between hospitals...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28551053/socio-environmental-risk-factors-for-medically-attended-agricultural-injuries-in-wisconsin-dairy-farmers
#17
Jeffrey J VanWormer, Kathrine L Barnes, Stephen C Waring, Matthew C Keifer
BACKGROUND: Accidents are common in the agricultural industry, particularly among dairy farmers. How said farmers get hurt is well established, but far less is known about how distal, socio-environmental factors influence injuries. This study examined associations between medically-attended agricultural injuries and: (1) personal sociodemographic characteristics, and (2) farm environment features and general safety practices. METHODS: A cross-sectional survey was implemented with linked data from electronic health records on prior agricultural injuries that occurred between 01/01/2002-12/31/2015...
July 2017: Injury
https://www.readbyqxmd.com/read/28549706/long-term-effectiveness-of-a-multifactorial-fall-and-fracture-prevention-program-in-bavarian-nursing-homes-an-analysis-based-on-health-insurance-claims-data
#18
Claudia Schulz, Ivonne Lindlbauer, Kilian Rapp, Clemens Becker, Hans-Helmut König
OBJECTIVE: Femoral fractures are frequently consequences of falls in nursing homes and are associated with considerable costs and unfavorable outcomes such as immobility and mortality. The purpose of this study was to examine the long-term effectiveness of a multifactorial fall and fracture prevention program in nursing homes in terms of reducing femoral fractures. DESIGN: Retrospective cohort study. SETTING: Nursing homes. PARTICIPANTS: Health insurance claims data for 2005-2013 including 85,148 insurants of a sickness fund (Allgemeine Ortskrankenkasse Bayern), aged 65 years or older and living in 802 nursing homes in Bavaria, Germany...
June 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28535891/impact-of-rheumatoid-arthritis-in-the-public-health-system-in-santa-catarina-brazil-a-descriptive-and-temporal-trend-analysis-from-1996-to-2009
#19
Rafael Kmiliauskis Santos Gomes, Fabio Antero Pires, Moacyr Roberto Cuce Nobre, Mauricio Felippi de Sá Marchi, Jennifer Cristina Kozechen Rickli
INTRODUCTION: There are few studies that carried out a descriptive and trend analysis based on available data from the Unified Health System (SUS) between pre- and post-free dispensing of pharmacological treatment of rheumatoid arthritis (RA) from the perspective of the public health system, in terms of the direct cost of the disease among adults and elderly residents of the State of Santa Catarina, Brazil. This study aims to characterize the direct cost of medical and surgical procedures before and after the dispensing of drugs in this state...
May 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/28523117/evaluation-of-pediatric-residents-attitudes-toward-ethical-conflict-a-cross-sectional-study-in-tehran-iran
#20
Maliheh Kadivar, Marjan Mardani-Hamooleh, Shiva Shayestefar
Ethical conflicts are recognized as critical aspects in assessing competence in clinical communication. Moreover, pediatrics residents may face more problems, compared to other disciplines; due to the specific characteristics of the age group receiving services as well as the presence of their families. This study has been conducted with the aim of determining the attitude and perspective of pediatric residents toward ethical conflicts in the field of pediatrics. This descriptive, cross-sectional study was carried out on all residents of Tehran University of Medical Sciences (90 residents), selected through census method, in 2014...
2017: Journal of Medical Ethics and History of Medicine
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