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Direct observation of medical residents

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https://www.readbyqxmd.com/read/28225465/a-patient-centered-approach-to-developing-entrustable-professional-activities
#1
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
https://www.readbyqxmd.com/read/28183740/preventing-deaths-and-injuries-from-house-fires-a-cost-benefit-analysis-of-a-community-based-smoke-alarm-installation-programme
#2
Merissa A Yellman, Cora Peterson, Mary A McCoy, Shelli Stephens-Stidham, Emily Caton, Jeffrey J Barnard, Ted O Padgett, Curtis Florence, Gregory R Istre
BACKGROUND: Operation Installation (OI), a community-based smoke alarm installation programme in Dallas, Texas, targets houses in high-risk urban census tracts. Residents of houses that received OI installation (or programme houses) had 68% fewer medically treated house fire injuries (non-fatal and fatal) compared with residents of non-programme houses over an average of 5.2 years of follow-up during an effectiveness evaluation conducted from 2001 to 2011. OBJECTIVE: To estimate the cost-benefit of OI...
February 9, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28167407/efficient-blood-flow-visualization-using-flowline-extraction-and-opacity-modulation-based-on-vascular-structure-analysis
#3
Ohjae Kwon, Jeongjin Lee, Bohyoung Kim, Juneseuk Shin, Yeong-Gil Shin
With the recent advances regarding the acquisition and simulation of blood flow data, blood flow visualization has been widely used in medical imaging for the diagnosis and treatment of pathological vessels. In this paper, we present a novel method for the visualization of the blood flow in vascular structures. The vessel inlet or outlet is first identified using the orthogonality metric between the normal vectors of the flow velocity and vessel surface. Then, seed points are generated on the identified inlet or outlet by Poisson disk sampling...
March 1, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28129754/health-endangering-everyday-settings-and-practices-in-a-rural-segregated-roma-settlement-in-slovakia-a-descriptive-summary-from-an-exploratory-longitudinal-case-study
#4
Andrej Belak, Andrea Madarasova Geckova, Jitse P van Dijk, Sijmen A Reijneveld
BACKGROUND: Research into social root-causes of poor health within segregated Roma communities in Central and Eastern Europe, i.e. research into how, why and by whom high health-endangering settings and exposures are maintained here, is lacking. The aim of this study was to assess the local setup of health-endangering everyday settings and practices over the long-term in one such community. It is the initial part of a larger longitudinal study qualitatively exploring the social root-causes of poor Roma health status through the case of a particular settlement in Slovakia...
January 28, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28122529/monetary-costs-of-alzheimer-s-disease-in-china-protocol-for-a-cluster-randomised-observational-study
#5
Fangyu Li, Shuoqi Chen, Cuibai Wei, Jianping Jia
BACKGROUND: Alzheimer's disease (AD) is the most common type of dementia. International multilateral cost-of-illness (COI) studies have revealed that the cost of treating this disease is huge, which places a significant burden on patients' families and their healthcare systems. However, no such studies have been conducted in China. This study estimates the monetary costs of patients with AD in mainland China. METHODS: This study planned to start in October 2015 and to finish in March 2016...
January 25, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28116017/emergency-medicine-resident-orientation-how-training-programs-get-their-residents-started
#6
Jillian McGrath, Michael Barrie, David P Way
INTRODUCTION: The first formal orientation program for incoming emergency medicine (EM) residents was started in 1976. The last attempt to describe the nature of orientation programs was by Brillman in 1995. Now almost all residencies offer orientation to incoming residents, but little is known about the curricular content or structure of these programs. The purpose of this project was to describe the current composition and purpose of EM resident orientation programs in the United States...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28111067/standardized-direct-observation-assessment-tool-using-a-training-video
#7
Kathleen E Kane, Kevin R Weaver, Gavin C Barr, Gary Bonfante, Nicole L Bendock, Brian M Berry, Stephanie L Goren-Garcia, Marc B Lewbart, Allison L Raines, Gregory Smeriglio, Bryan G Kane
BACKGROUND: We developed a DVD training tool to educate physicians evaluating emergency residents on accurate Standardized Direct Observation Assessment Tool (SDOT) application. OBJECTIVE: Our goal was to assess whether this training video improved attendings' and senior residents' SDOT use. METHODS: Participants voluntarily completed SDOT evaluations based on a scripted "test" video. A DVD with "positive" and "negative" scenarios of proper SDOT use was viewed...
January 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28086754/making-the-most-of-mealtimes-m3-protocol-of-a-multi-centre-cross-sectional-study-of-food-intake-and-its-determinants-in-older-adults-living-in-long-term-care-homes
#8
Heather H Keller, Natalie Carrier, Susan Slaughter, Christina Lengyel, Catriona M Steele, Lisa Duizer, K Steve Brown, Habib Chaudhury, Minn N Yoon, Alison M Duncan, Veronique M Boscart, George Heckman, Lita Villalon
BACKGROUND: Older adults living in long term care (LTC) homes are nutritionally vulnerable, often consuming insufficient energy, macro- and micronutrients to sustain their health and function. Multiple factors are proposed to influence food intake, yet our understanding of these diverse factors and their interactions are limited. The purpose of this paper is to fully describe the protocol used to examine determinants of food and fluid intake among older adults participating in the Making the Most of Mealtimes (M3) study...
January 13, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28062350/discordance-of-patient-reported-and-clinician-ordered-resuscitation-status-in-patients-hospitalized-with-acute-decompensated-heart-failure
#9
Kathleen A Young, Sara E Wordingham, Jacob J Strand, Vėronique L Roger, Shannon M Dunlay
CONTEXT: Accurate documentation of preferences for cardiopulmonary resuscitation at hospital admission is critical to ensure that patients receive resuscitation or not in accordance with their wishes. OBJECTIVES: We sought to identify and characterize inconsistencies in patient-reported and clinician-ordered resuscitation status in patients hospitalized with acute decompensated heart failure (ADHF). METHODS: Southeastern Minnesota residents hospitalized with ADHF were prospectively enrolled into a study that included the administration of face-to-face questionnaires from January 2014 to February 2016...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28001442/-it-s-just-not-the-culture-a-qualitative-study-exploring-residents-perceptions-of-the-impact-of-institutional-culture-on-feedback
#10
Subha Ramani, Sarah E Post, Karen Könings, Karen Mann, Joel T Katz, Cees van der Vleuten
: Phenomenon: Competency-based medical education requires ongoing performance-based feedback for professional growth. In several studies, medical trainees report that the quality of faculty feedback is inadequate. Sociocultural barriers to feedback exchanges are further amplified in graduate and postgraduate medical education settings, where trainees serve as frontline providers of patient care. Factors that affect institutional feedback culture, enhance feedback seeking, acceptance, and bidirectional feedback warrant further exploration in these settings...
December 21, 2016: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/27914750/-medical-prescription-and-informed-consent-for-the-use-of-physical-restraints-in-nursing-homes-in-the-canary-islands-spain
#11
Gabriel J Estévez-Guerra, Emilio Fariña-López, Eva Penelo
OBJECTIVE: To identify the frequency of completion of informed consent and medical prescription in the clinical records of older patients subject to physical restraint, and to analyse the association between patient characteristics and the absence of such documentation. METHODS: A cross-sectional and descriptive multicentre study with direct observation and review of clinical records was conducted in nine public nursing homes, comprising 1,058 beds. RESULTS: 274 residents were physically restrained...
November 30, 2016: Gaceta Sanitaria
https://www.readbyqxmd.com/read/27903252/shifting-tides-in-the-emigration-patterns-of-canadian-physicians-to-the-united-states-a-cross-sectional-secondary-data-analysis
#12
Thomas R Freeman, Stephen Petterson, Sean Finnegan, Andrew Bazemore
BACKGROUND: The relative ease of movement of physicians across the Canada/US border has led to what is sometimes referred to as a 'brain drain' and previous analysis estimated that the equivalent of two graduating classes from Canadian medical schools were leaving to practice in the US each year. Both countries fill gaps in physician supply with international medical graduates (IMGs) so the movement of Canadian trained physicians to the US has international ramifications. Medical school enrolments have been increased on both sides of the border, yet there continues to be concerns about adequacy of physician human resources...
December 1, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27828887/comprehensive-geriatric-assessment-for-trauma-operationalizing-the-trauma-quality-improvement-program-directive
#13
Stephanie Devore, Sara E Parli, Douglas R Oyler, Andrew Bernard
Elderly patients are the fastest growing trauma demographic and present some of the most complicated clinical challenges. This feasibility study employed observational data from a geriatric cohort. Comprehensive geriatric assessments (CGAs) were performed biweekly on eligible patients, 65 years or older, who met screening criteria. Mobility, activities of daily living impairment, frailty, and depression were screened and documented, and along with summative recommendations, were entered into the medical record, communicated to the patient's primary care provider, and discussed with family...
November 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27825345/reconfiguring-health-workforce-a-case-based-comparative-study-explaining-the-increasingly-diverse-professional-roles-in-europe
#14
Antoinette de Bont, Job van Exel, Silvia Coretti, Zeynep Güldem Ökem, Maarten Janssen, Kristin Lofthus Hope, Tomasz Ludwicki, Britta Zander, Marie Zvonickova, Christine Bond, Iris Wallenburg
BACKGROUND: Over the past decade the healthcare workforce has diversified in several directions with formalised roles for health care assistants, specialised roles for nurses and technicians, advanced roles for physician associates and nurse practitioners and new professions for new services, such as case managers. Hence the composition of health care teams has become increasingly diverse. The exact extent of this diversity is unknown across the different countries of Europe, as are the drivers of this change...
November 8, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27777666/internal-medicine-residents-retention-of-knowledge-and-skills-in-bedside-ultrasound
#15
James A Town, Paul A Bergl, Akhil Narang, John F McConville
BACKGROUND : The long-term retention of knowledge and skills in bedside ultrasound by internal medicine residents after ultrasound training is not well understood. OBJECTIVE : We sought to determine whether knowledge and skills acquired from focused training in bedside ultrasound are retained over time, and whether retention is related to independent practice. METHODS : We conducted a prospective observational trial of 101 internal medicine residents at an academic medical center who participated in a bedside ultrasound workshop followed by 12 months of independent practice...
October 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/27749720/patient-centered-handovers-ethnographic-observations-of-attending-and-resident-physicians-ethnographic-observations-of-attending-and-resident-physicians
#16
Austin F Mount-Campbell, Michael F Rayo, James J OʼBrien, Theodore T Allen, Emily S Patterson
Handover communication improvement initiatives typically employ a "one size fits all" approach. A human factors perspective has the potential to guide how to tailor interventions to roles, levels of experience, settings, and types of patients. We conducted ethnographic observations of sign-outs by attending and resident physicians in 2 medical intensive care units at one institution. Digitally audiotaped data were manually analyzed for content using codes and time spent using box plots for emergent categories...
October 2016: Quality Management in Health Care
https://www.readbyqxmd.com/read/27721664/is-adherence-to-imatinib-mesylate-treatment-among-patients-with-chronic-myeloid-leukemia-associated-with-better-clinical-outcomes-in-qatar
#17
Nader I Al-Dewik, Hisham M Morsi, Muthanna M Samara, Rola S Ghasoub, Cinquea C Gnanam, Subi K Bhaskaran, Abdulqadir J Nashwan, Rana M Al-Jurf, Mohamed A Ismail, Mohammed M AlSharshani, Ali A AlSayab, Tawfeg I Ben-Omran, Rani B Khatib, Mohamed A Yassin
BACKGROUND: Despite the revolutionary success of introducing tyrosine kinase inhibitors (TKIs), such as imatinib mesylate (IM), for treating chronic myeloid leukemia (CML), a substantial proportion of patients' treatments fail. AIM: This study investigates the correlation between patient adherence and failure of TKIs' treatment in a follow-up study. METHODS: This is a follow-up study of a new cohort of CML patients. Adherence to IM is assessed using the Medication Event Monitoring System (MEMS 6 TrackCap, AARDEX Ltd)...
2016: Clinical Medicine Insights. Oncology
https://www.readbyqxmd.com/read/27638987/joint-sogc-ccmg-opinion-for-reproductive-genetic-carrier-screening-an-update-for-all-canadian-providers-of-maternity-and-reproductive-healthcare-in-the-era-of-direct-to-consumer-testing
#18
R Douglas Wilson, Isabelle De Bie, Christine M Armour, Richard N Brown, Carla Campagnolo, June C Carroll, Nan Okun, Tanya Nelson, Rhonda Zwingerman, Francois Audibert, Jo-Ann Brock, Richard N Brown, Carla Campagnolo, June C Carroll, Isabelle De Bie, Jo-Ann Johnson, Nan Okun, Melanie Pastruck, Karine Vallée-Pouliot, R Douglas Wilson, Rhonda Zwingerman, Christine Armour, David Chitayat, Isabelle De Bie, Sara Fernandez, Raymond Kim, Josee Lavoie, Norma Leonard, Tanya Nelson, Sherry Taylor, Margot Van Allen, Clara Van Karnebeek
OBJECTIVE: This guideline was written to update Canadian maternity care and reproductive healthcare providers on pre- and postconceptional reproductive carrier screening for women or couples who may be at risk of being carriers for autosomal recessive (AR), autosomal dominant (AD), or X-linked (XL) conditions, with risk of transmission to the fetus. Four previous SOGC- Canadian College of Medical Geneticists (CCMG) guidelines are updated and merged into the current document. INTENDED USERS: All maternity care (most responsible health provider [MRHP]) and paediatric providers; maternity nursing; nurse practitioner; provincial maternity care administrator; medical student; and postgraduate resident year 1-7...
August 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27628722/-sometimes-the-work-just-needs-to-be-done-socio-cultural-influences-on-direct-observation-in-medical%C3%A2-training
#19
Christopher Watling, Kori A LaDonna, Lorelei Lingard, Stephane Voyer, Rose Hatala
CONTEXT: Direct observation promises to strengthen both coaching and assessment, and calls for its increased use in medical training abound. Despite its apparent potential, the uptake of direct observation in medical training remains surprisingly limited outside the formal assessment setting. The limited uptake of observation raises questions about cultural barriers to its use. In this study, we explore the influence of professional culture on the use of direct observation within medical training...
October 2016: Medical Education
https://www.readbyqxmd.com/read/27605458/influence-of-cognitive-impairment-on-fall-risk-among-elderly-nursing-home-residents
#20
M Seijo-Martinez, J M Cancela, C Ayán, S Varela, H Vila
BACKGROUND: Information relating the severity of cognitive decline to the fall risk in institutionalized older adults is still scarce. This study aims to identify potential fall risk factors (medications, behavior, motor function, and neuropsychological disturbances) depending on the severity of cognitive impairment in nursing home residents. METHODS: A total of 1,167 nursing home residents (mean age 81.44 ± 8.26 years; 66.4% women) participated in the study. According to the MEC, (the Spanish version of the Mini-Mental State Examination) three levels of cognitive impairment were established: mild (20-24) "MCI", moderate (14-19) "MOCI", and severe (≤14) "SCI"...
September 8, 2016: International Psychogeriatrics
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