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Direct observation of medical residents

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https://www.readbyqxmd.com/read/28523117/evaluation-of-pediatric-residents-attitudes-toward-ethical-conflict-a-cross-sectional-study-in-tehran-iran
#1
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
https://www.readbyqxmd.com/read/28501114/evaluation-of-palliative-care-training-and-skills-retention-by-medical-students
#2
Priti P Parikh, Mary T White, Lynne Buckingham, Kathryn M Tchorz
BACKGROUND: Training in palliative and end-of-life care has been introduced in medical education; however, the impact of such training and the retention of skills and knowledge have not been studied in detail. This survey study examines long-term follow-up on end-of-life communication skills training, evaluation, and skills retention in medical students. MATERIALS AND METHODS: During the surgical clerkship, all third-year medical students received communication skills training in palliative care using simulated patients...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28489618/core-competencies-or-a-competent-core-a-scoping-review-and-realist-synthesis-of-invasive-bedside-procedural-skills-training-in-internal-medicine
#3
Ryan Brydges, Lynfa Stroud, Brian M Wong, Eric S Holmboe, Kevin Imrie, Rose Hatala
PURPOSE: Invasive bedside procedures are core competencies for internal medicine, yet no formal training guidelines exist. The authors conducted a scoping review and realist synthesis to characterize current training for lumbar puncture, arthrocentesis, paracentesis, thoracentesis, and central venous catheterization. They aimed to collate how educators justify using specific interventions, establish which interventions have the best evidence, and offer directions for future research and training...
May 9, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28481570/integrated-behavioral-health-training-for-primary-care-clinicians-five-lessons-learned-from-a-negative-study
#4
Matthew P Martin
INTRODUCTION: There are very few studies examining the effectiveness of integrated behavioral health training for primary care clinicians. The purpose of this article is to review the findings of a negative study examining the effectiveness of medical resident training in integrated behavioral health and offer specific ideas for future research in workforce development. METHODS: Twenty-three family medicine residents from a community-based residency program in the mid-Atlantic region completed a required rotation in which they consulted with behavioral health in primary care, observed psychotherapy, read behavioral medicine books, and received individual instruction...
May 8, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28469889/a-quality-improvement-approach-to-standardization-and-sustainability-of-the-hand-off-process
#5
Craig Fryman, Carine Hamo, Siddharth Raghavan, Nirvani Goolsarran
There is mounting evidence that communication and hand-off failures are a root cause of two-thirds of sentinel events in hospitals. Several studies have shown that non-standardized hand-offs have yielded poor patient outcomes and adverse events. At Stony Brook University Hospital, there were numerous reported adverse events related to poor hand-off during the transfer of patient responsibility from one resident caregiver to the next. A resident-conducted root cause analysis identified lack of a standardized hand-off process and formal training on safe and efficient hand-off among caregivers as key contributing factors...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28461641/healthcare-use-and-direct-cost-of-giant-cell-arteritis-a-population-based-study
#6
Matthew J Koster, Sara J Achenbach, Cynthia S Crowson, Hilal Maradit-Kremers, Eric L Matteson, Kenneth J Warrington
OBJECTIVE: To determine the healthcare use and direct medical cost of giant cell arteritis (GCA) in a population-based cohort. METHODS: A well-defined, retrospective population-based cohort of Olmsted County, Minnesota, USA, residents diagnosed with GCA from 1982-2009 was compared to a matched referent cohort from the same population. Standardized cost data (inflation-adjusted to 2014 US dollars) for 1987-2014 and outpatient use data for 1995-2014 were obtained...
May 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28433827/a-comparison-of-medication-administration-errors-from-original-medication-packaging-and-multi-compartment-compliance-aids-in-care-homes-a-prospective-observational-study
#7
Julia Fiona-Maree Gilmartin-Thomas, Felicity Smith, Rory Wolfe, Yogini Jani
BACKGROUND: No published study has been specifically designed to compare medication administration errors between original medication packaging and multi-compartment compliance aids in care homes, using direct observation. OBJECTIVES: Compare the effect of original medication packaging and multi-compartment compliance aids on medication administration accuracy. DESIGN: Prospective observational. SETTING: Ten Greater London care homes...
March 28, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28433120/additional-cost-because-of-pneumonia-in-nursing-home-residents-results-from-the-incidence-of-pneumonia-and-related-consequences-in-nursing-home-resident-study
#8
Nadège Costa, Emiel O Hoogendijk, Michael Mounié, Robert Bourrel, Yves Rolland, Bruno Vellas, Laurent Molinier, Matteo Cesari
OBJECTIVES: Pneumonia is a frequent condition in older people. Our aim was to examine the total healthcare cost related to pneumonia in nursing home (NH) residents over a 1-year follow-up period. DESIGN: This was a prospective, longitudinal, observational, and multicenter study that was a part of the Incidence of Pneumonia and related Consequences in Nursing Home Resident study. SETTING: Thirteen NHs located in Languedoc Roussillon and Midi-Pyrénées regions in France were included...
May 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28418449/association-of-a-communication-training-program-with-use-of-antipsychotics-in-nursing-homes
#9
Jennifer Tjia, Jacob N Hunnicutt, Laurie Herndon, Carolyn R Blanks, Kate L Lapane, Susan Wehry
Importance: Off-label antipsychotic prescribing in nursing homes (NHs) is common and is associated with increased risk of mortality in older adults. Prior large-scale, controlled trials in the NH setting failed to show meaningful reductions in antipsychotic use. Objective: To quantify the influence of a large-scale communication training program on NH antipsychotic use called OASIS. Design, Setting, and Participants: This investigation was a quasi-experimental longitudinal study of NHs in Massachusetts enrolled in the OASIS intervention...
April 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28411323/practice-patterns-for-the-prophylaxis-and-treatment-of-acute-radiation-dermatitis-in-the-united-states
#10
Patricia Lucey, Christos Zouzias, Loren Franco, Sravana K Chennupati, Shalom Kalnicki, Beth N McLellan
PURPOSE: Due to the inconclusive evidence for available treatment options, management of radiation dermatitis (RD) varies among practitioners. This study defines and reviews the current treatment patterns for RD in the USA, providing guidance for practicing physicians as well as directions for future research. METHODS: An online survey of 21 questions was emailed to all 5626 members of the 2013 American Society for Radiation Oncology (ASTRO) directory, which included radiation oncologists, residents, fellows, physician assistants, nurse practitioners, registered nurses and other care providers...
April 14, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28401622/predicting-mortality-in-the-emergency-department-external-validation-and-derivation-of-a-clinical-prediction-tool
#11
Rajat N Moman, Caitlin Loprinzi Brauer, Katherine M Kelsey, Rachel D Havyer, Christine M Lohse, M Fernanda Bellolio
BACKGROUND: he Choosing Wisely campaign has called for better engagement of palliative and hospice care services for patients in the emergency department (ED). PREDICT is a clinical prediction tool that was derived in an Australian ED cohort. It assesses a patient's risk of mortality at one year to select those who would benefit from advanced care planning. Such goals of care discussion can improve patients' ability to communicate what they want out of their healthcare and, in cases of end-of-life, potentially reduce the number of futile interventions...
April 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28349373/a-time-motion-study-of-residents-and-medical-students-performing-patient-discharges-from-general-internal-medicine-wards-a-disjointed-interrupted-process
#12
Arjun Sharma, Vivian Lo, Lauren Lapointe-Shaw, Christine Soong, Peter Eugene Wu, Robert Clark Wu
Patients are at high risk for adverse events after discharge from a hospital admission. As a critical and often time-consuming aspect of care for hospitalized patients, the purpose of this study was to describe the physician time, events and workflow in performing a patient discharge. On General Internal Medicine (GIM) wards at two academic medical centers in Toronto, a time-motion study was performed on 11 residents and 2 medical students performing 32 patient discharges. Using a paper data collection tool, a research associate aimed to capture the distribution of activities and the nature and frequency of workflow interruptions during patient discharges from the perspective of resident and medical student housestaff...
March 27, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28344722/assessment-of-emergency-medicine-residents-a-systematic-review
#13
REVIEW
Isabelle N Colmers-Gray, Kieran Walsh, Teresa M Chan
BACKGROUND: Competency-based medical education is becoming the new standard for residency programs, including Emergency Medicine (EM). To inform programmatic restructuring, guide resources and identify gaps in publication, we reviewed the published literature on types and frequency of resident assessment. METHODS: We searched MEDLINE, EMBASE, PsycInfo and ERIC from Jan 2005 - June 2014. MeSH terms included "assessment," "residency," and "emergency medicine." We included studies on EM residents reporting either of two primary outcomes: 1) assessment type and 2) assessment frequency per resident...
February 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28330444/incidence-and-time-trends-of-type-2-diabetes-mellitus-in-youth-aged-5-19-years-a-population-based-registry-in-zhejiang-china-2007-to-2013
#14
Haibin Wu, Jieming Zhong, Min Yu, Hao Wang, Weiwei Gong, Jin Pan, Fangrong Fei, Meng Wang, Li Yang, Ruying Hu
BACKGROUND: The incidence of type 2 diabetes mellitus (T2DM) has been increasing globally over the past two decades in children and adolescents. There are currently a dearth of comprehensive population-based estimates of T2DM incidence and time trends in Chinese youth. METHODS: A population-based diabetes registry system in 30 representative districts in Zhejiang has been established for diabetes surveillance. All newly cases diagnosed by physicians in local hospitals and wards were registered using the registry system through web services and direct network report...
March 22, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28281117/game-based-training-improves-the-surgeon-s-situational-awareness-in-the-operation-room-a-randomized-controlled-trial
#15
Maurits Graafland, Willem A Bemelman, Marlies P Schijven
BACKGROUND: Equipment-related malfunctions directly relate to one-fourth of the adverse events in the surgical theater. A serious game trains residents to recognize and respond to equipment problems in minimally invasive surgery (MIS). These include disturbed vision, gas transport, electrocautery, and pathophysiological disturbances. This randomized controlled trial explores whether game-based training improves surgical residents' response to equipment-related problems during surgery...
March 9, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28264090/comparison-of-male-vs-female-resident-milestone-evaluations-by-faculty-during-emergency-medicine-residency-training
#16
Arjun Dayal, Daniel M O'Connor, Usama Qadri, Vineet M Arora
Importance: Although implicit bias in medical training has long been suspected, it has been difficult to study using objective measures, and the influence of sex and gender in the evaluation of medical trainees is unknown. The emergency medicine (EM) milestones provide a standardized framework for longitudinal resident assessment, allowing for analysis of resident performance across all years and programs at a scope and level of detail never previously possible. Objective: To compare faculty-observed training milestone attainment of male vs female residency training...
May 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28257399/addressing-the-health-and-wellness-needs-of-vulnerable-rockaway-residents-in-the-wake-of-hurricane-sandy-findings-from-a-health-coaching-and-community-health-worker-program
#17
David Russell, Mia R Oberlink, Shivani Shah, Lauren Evans, Karen Bassuk
OBJECTIVES: To describe the design and participants of a program that employed health coaches and community health workers to address the social, health, and long-term disaster recovery needs of Rockaway residents roughly 2 years after Hurricane Sandy made landfall. DESIGN: Baseline and exit questionnaires, containing demographic, health, and health care utilization measures, were administered to participants at the start and end of the program. Enrollment and encounter information was captured in program administrative records...
March 1, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28250486/developing-competency-in-post-graduate-students-of-anaesthesiology-for-taking-informed-consent-for-elective-caesarean-section
#18
Kamla Harshad Mehta, Vandana Saurin Shah, Kirti Dhirajlal Patel
BACKGROUND AND AIMS: Post-graduate medical students (residents) generally lack effective communication skills required to obtain informed consent. The aim of this study was to assess role play and group discussion as teaching/learning tools for improving residents' knowledge on informed consent and competency in communicating while taking informed consent. METHODS: This prospective, observational study was conducted on 30 anaesthesia residents. They were first observed while obtaining informed consent and their basic knowledge regarding communication skills was checked with a pre-test questionnaire...
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28238704/effectiveness-of-a-perioperative-transthoracic-ultrasound-training-program-for-students-and-residents
#19
Juliet June Ray, Jonathan P Meizoso, Valerie Hart, Davis Horkan, Vicente Behrens, Krishnamurti A Rao, Charles A Karcutskie, Joshua Lenchus, Carl I Schulman, Roman Dudaryk
OBJECTIVE: Focused ultrasound (US) is being incorporated across all levels of medical education. Although many comprehensive US courses exist, their scope is broad, requiring expert instructors, access to simulation, and extensive time commitment by the learner. We aim to compare learning across levels of training and specialties using a goal-directed, web-based course without live skills training. DESIGN: A prospective observational study of students and residents from medicine, surgery, and anesthesiology...
February 23, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28225465/a-patient-centered-approach-to-developing-entrustable-professional-activities
#20
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...
February 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
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