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Direct observation of medical residents

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https://www.readbyqxmd.com/read/29217525/integration-of-mobile-devices-to-facilitate-patient-care-and-teaching-during-family-centered-rounds
#1
Angela S Byrd, Pamela M McMahon, Richard J Vath, Michael Bolton, Melissa Roy
OBJECTIVES: The increasing prevalence of mobile devices in clinical settings has the potential to improve both patient care and education. The benefits are particularly promising in the context of family-centered rounds in inpatient pediatric settings. We aimed to increase mobile device usage by inpatient rounding teams by 50% in 6 months. We hoped to demonstrate that use of mobile devices would improve access to patient care and educational information and to determine if use would improve efficiency and perceptions of clinical teaching...
December 7, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29202985/surgical-resident-involvement-in-foot-and-ankle-surgery
#2
Christopher E Gross, David Chang, Samuel B Adams, Selene G Parekh, Jordan D Bohnen
BACKGROUND: Surgical resident participation in the operating room is necessary for education and progression toward safe and independent practice. However, the impact of resident involvement on patient outcomes in foot and ankle surgery is unknown. METHODS: The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database (2005-2012) was used to identify common foot and ankle procedures (by Current Procedural Taxonomy (CPT) code) performed by orthopedic surgeons...
December 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29202742/milestones-based-direct-observation-tools-in-internal-medicine-resident-continuity-clinic
#3
Jonathan P B Berz, Teresa Cheng, Lisa M Quintiliani
BACKGROUND: With milestones-based assessment, there is an increased need for tools to facilitate direct observation of clinical trainees. This study was designed to compare a Mini-CEX tool to new direct observation tools (DOTs) linked to internal medicine milestones. METHODS: A web based survey was used to examine satisfaction and usefulness of DOTs compared to the Mini-CEX. Residents and preceptors were surveyed three times over 6 months with half serving as control (using mini-CEX) compared to those using the DOTs...
December 4, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29180547/the-full-scope-of-family-physicians-work-is-not-reflected-by-current-procedural-terminology-codes
#4
Richard A Young, Sandy Burge, Kaparaboyna Ashok Kumar, Jocelyn Wilson
BACKGROUND: The purpose of this study was to characterize the content of family physician (FP) clinic encounters, and to count the number of visits in which the FPs addressed issues not explicitly reportable by 99211 to 99215 and 99354 Current Procedural Terminology (CPT) codes with current reimbursement methods and based on examples provided in the CPT manual. METHODS: The data collection instrument was modeled on the National Ambulatory Medical Care Survey. Trained assistants directly observed every other FP-patient encounter and recorded every patient concern, issue addressed by the physician (including care barriers related to health care systems and social determinants), and treatment ordered in clinics affiliated with 10 residencies of the Residency Research Network of Texas...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29157753/validit%C3%A3-et-reproductibilit%C3%A3-de-deux-grilles-d%C3%A2-observation-des-comp%C3%A3-tences-cliniques-des-internes-en-des-de-m%C3%A3-decine-interne
#5
P Pottier, F Cohen Aubart, O Steichen, M Desprets, M Pha, A Espitia, S Georgin-Lavialle, A Morel, J B Hardouin
INTRODUCTION: The revision of the French medical studies' third cycle ought to be competency-based. In internal medicine, theoretical and practical knowledge will be assessed online with e-learning and e-portfolio. In parallel, a reflection about clinical skills assessment forms is currently ongoing. In this context, our aim was to assess the reproducibility and validity of two assessment forms based on direct clinical observation. METHOD: A prospective and multicentric study has been conducted from November 2015 to October 2016 aiming at evaluating the French translations of the MINI-Clinical Examination Exercice (MINI-CEX) and the Standardized Patient Satisfaction Questionnaire (SPSQ)...
November 17, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29128038/emergency-physicians-who-produce-higher-relative-value-units-per-hour-spend-similar-amounts-of-time-at-patient-bedsides-as-their-colleagues
#6
Michael Breyer, Heather Farley, Greg Neyman, Wendy Nichols, John Kendall
BACKGROUND: Emergency physicians (EPs) are expected to deliver quality care while maintaining high levels of efficiency and productivity as measured by the relative value unit (RVU). OBJECTIVES: We sought to determine whether academic EPs with higher RVUs spend less time at the bedside than their colleagues. METHODS: This was a prospective, observational, cohort study. A 13-item task list was generated, pilot-tested, and placed onto a computerized tablet...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29099312/learning-laparoscopic-skills-observation-or-practice
#7
Françoise Schmitt, Aurora Mariani, Emilie Eyssartier, Jean-Claude Granry, Guillaume Podevin
OBJECTIVE: The aim of this study was to assess the respective roles of observation and direct practice in the retention of laparoscopic skills. MATERIALS AND METHODS: Eighteen fifth-year medical students were included in a two-session laparoscopic learning course. During the first session, each participant was given four tasks to complete from the "Basic skills" and "Essential tasks" modules of the Simbionix LAP Mentor™, and another four tasks for observation only...
November 3, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29075375/gender-differences-in-attending-physicians-feedback-to-residents-a-qualitative-analysis
#8
Anna S Mueller, Tania M Jenkins, Melissa Osborne, Arjun Dayal, Daniel M O'Connor, Vineet M Arora
BACKGROUND : Prior research has shown a gender gap in the evaluations of emergency medicine (EM) residents' competency on the Accreditation Council for Graduate Medical Education (ACGME) milestones, yet the practical implications of this are not fully understood. OBJECTIVE : To better understand the gender gap in evaluations, we examined qualitative differences in the feedback that male and female residents received from attending physicians. METHODS : This study used a longitudinal qualitative content analysis of narrative comments by attending physicians during real-time direct observation milestone evaluations of residents...
October 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29063899/clinicians-related-determinants-of-anticoagulation-therapy-and-prophylaxis-in-nigeria
#9
Raphael Anakwue, Theresa Nwagha, Ogba J Ukpabi, Ndudim Obeka, Emmanuel Onwubuya, Uwa Onwuchekwa, Benjamin Azubuike, Innocent Okoye
BACKGROUND: Thromboembolic and hypercoagulable diseases are common life-threatening but treatable problems in hospital practice. Fortunately, anticoagulation is an efficacious management practice indicated for arterial, venous, and intracardiac thromboembolism. Clinicians in developing countries may have gaps in their knowledge of anticoagulation therapy/prophylaxis which could affect their clinical decision. OBJECTIVES: The study examined the knowledge and attitude of clinicians to anticoagulation therapy/prophylaxis in some tertiary hospitals in Nigeria...
October 2017: Annals of African Medicine
https://www.readbyqxmd.com/read/29056069/quantifying-the-relationship-between-capability-and-health-in-older-people-can-t-map-won-t-map
#10
Matthew Franklin, Katherine Payne, Rachel A Elliott
BACKGROUND: Intuitively, health and capability are distinct but linked concepts. This study aimed to quantify the link between a measure of health status (EQ-5D-3L) and capability (ICECAP-O) using regression-based methods. METHODS: EQ-5D-3L and ICECAP-O data were collected from a sample of older people ( n = 584), aged over 65 years, requiring a hospital visit and/or care home resident, and recruited to one of 3 studies forming the Medical Crisis in Older People (MCOP) program in England...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28991844/criterion-based-assessment-in-a-norm-based-world-how-can-we-move-past-grades
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
November 1, 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
#20
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
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