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Direct observation of medical residents

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https://www.readbyqxmd.com/read/29652043/-the-hardware-techniques-for-the-restoration-of-the-gait-stereotype-in-the-patients-following-total-hip-replacement-the-personalized-approach
#1
E S Koneva, K V Lyadov, T V Shapovalenko, E V Zhukova, V G Polushkin
BACKGROUND: total hip replacement has long ago become the «golden standard» for the treatment of dysplastic coxarthrosis in thousands of the patients receiving it every year. In the meantime, the analysis of the specialized literature gives evidence of the lack of a systematic and personified approach to the rehabilitation treatment. AIM: The objective of the present study was to improve medical rehabilitation of the patients following the total hip replacement and to develop the personalized programs for walking modality reconstruction taking into consideration the age and the body weight of the patients...
April 9, 2018: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/29615354/improved-access-to-health-care-in-massachusetts-after-2006-massachusetts-healthcare-reform-law-is-associated-with-a-significant-decrease-in-mortality-among-vascular-surgery-patients
#2
Mohammad H Eslami, Katherine Moll Reitz, Denis V Rybin, Gheorghe Doros, Alik Farber
BACKGROUND: Access to medical care, by adequate insurance coverage, has a direct impact on outcomes for patients undergoing vascular procedures. We evaluated in-hospital mortality for patients undergoing index vascular procedures before and after the Massachusetts Healthcare Reform Law (MHRL) in 2006, which mandated insurance for all Massachusetts residents, both in Massachusetts and throughout the United States. METHODS: The National Inpatient Sample was queried to identify patients undergoing interventions for peripheral arterial disease, carotid artery stenosis, and abdominal aortic aneurysms based on International Classification of Diseases, Ninth Revision, Clinical Modification procedural and diagnostic codes...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29609893/evaluation-of-the-characteristics-of-a-workplace-assessment-form-to-assess-entrustable-professional-activities-epas-in-an-undergraduate-surgery-core-clerkship
#3
Vernon R Curran, Diana Deacon, Henry Schulz, Katherine Stringer, Craig N Stone, Norah Duggan, Heidi Coombs-Thorne
OBJECTIVE: Entrustable Professional Activities (EPAs) are explicit, directly observable tasks requiring the demonstration of specific knowledge, skills, and behaviors that learners are expected to perform without direct supervision once they have gained sufficient competence. Undergraduate level implementation of EPAs is relatively new. We examined the characteristics of a workplace assessment form (clinic card) as part of a formative programmatic assessment process of EPAs for a core undergraduate surgery rotation...
March 30, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29607335/using-newly-deceased-patients-in-teaching-clinical-skills-its-ethical-and-educational-challenges
#4
Mahboobeh Saber, Seyed Ali Enjoo, Ali Mahboudi, Seyed Ziaadin Tabei
Introduction: The newly deceased patients have long been used in medical schools to teach clinical skills without any challenges as it helps to train skilled doctors. Nowadays, the use of moulages and simulators are common in teaching clinical skills since these tools provide the opportunity for frequent practice without any pain and injury. There are specific procedures which still require the use of cadavers. However, the increased significance of patient rights has generally challenged the practicality of using the deceased bodies for this purpose...
April 2018: Journal of Advances in Medical Education & Professionalism
https://www.readbyqxmd.com/read/29584792/risk-factors-for-unfavourable-treatment-outcome-among-new-smear-positive-pulmonary-tuberculosis-cases-in-china
#5
Y Lin, D A Enarson, J Du, R A Dlodlo, C-Y Chiang, I D Rusen
Setting: Three projects of the Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB. Objectives: To assess unfavourable treatment outcomes (UTOs), including failure, died, loss to follow-up (LTFU), transferred out and unknown outcome, and to identify risk factors associated with UTOs. Design: This was a cross-sectional study using routine programme data. Results: Of 30 277 new smear-positive tuberculosis (TB) patients, 4261 (14.1%) had UTOs: 2048 (6.8%) LTFU, 1418 (4.7%) transferred out, 390 (1...
December 21, 2017: Public Health Action
https://www.readbyqxmd.com/read/29574896/resident-hesitation-in-the-operating-room-does-uncertainty-equal-incompetence
#6
Michael Ott, Alan Schwartz, Mark Goldszmidt, Georges Bordage, Lorelei Lingard
CONTEXT: In postgraduate medical programmes, the progressive development of autonomy places residents in situations in which they must cope with uncertainty. We explored the phenomenon of hesitation, triggered by uncertainty, in the context of the operating room in order to understand the social behaviours surrounding supervision and progressive autonomy. METHODS: Nine surgical residents and their supervising surgeons at a Canadian medical school were selected. Each resident-supervisor pair was observed during a surgical procedure and subsequently participated in separate post-observation, semi-structured interviews...
March 25, 2018: Medical Education
https://www.readbyqxmd.com/read/29557719/education-outcomes-in-a-duty-hour-flexibility-trial-in-internal-medicine
#7
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
https://www.readbyqxmd.com/read/29538103/harnessing-the-power-of-big-data-to-improve-graduate-medical-education-big-idea-or-bust
#8
Vineet M Arora
With the advent of electronic medical records (EMRs) fueling the rise of big data, the use of predictive analytics, machine learning, and artificial intelligence are touted as transformational tools to improve clinical care. While major investments are being made in using big data to transform health care delivery, little effort has been directed toward exploiting big data to improve graduate medical education (GME). Because our current system relies on faculty observations of competence, it is not unreasonable to ask whether big data in the form of clinical EMRs and other novel data sources can answer questions of importance in GME such as when is a resident ready for independent practice...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29519238/glyphosate-exposure-in-pregnancy-and-shortened-gestational-length-a-prospective-indiana-birth-cohort-study
#9
S Parvez, R R Gerona, C Proctor, M Friesen, J L Ashby, J L Reiter, Z Lui, P D Winchester
BACKGROUND: Glyphosate (GLY) is the most heavily used herbicide worldwide but the extent of exposure in human pregnancy remains unknown. Its residues are found in the environment, major crops, and food items that humans, including pregnant women, consume daily. Since GLY exposure in pregnancy may also increase fetal exposure risk, we designed a birth-cohort study to determine exposure frequency, potential exposure pathways, and associations with fetal growth indicators and pregnancy length...
March 9, 2018: Environmental Health: a Global Access Science Source
https://www.readbyqxmd.com/read/29485019/role-of-hand-hygiene-ambassador-and-implementation-of-directly-observed-hand-hygiene-among-residents-in-residential-care-homes-for-the-elderly-in-hong-kong
#10
Vincent C C Cheng, Hong Chen, Shuk-Ching Wong, Jonathan H K Chen, Wing-Chun Ng, Simon Y C So, Tuen-Ching Chan, Sally C Y Wong, Pak-Leung Ho, Lona Mody, Felix H W Chan, Andrew T Y Wong, Kwok-Yung Yuen
OBJECTIVE Multidrug-resistant organisms (MDROs) are increasingly reported in residential care homes for the elderly (RCHEs). We assessed whether implementation of directly observed hand hygiene (DOHH) by hand hygiene ambassadors can reduce environmental contamination with MDROs. METHODS From July to August 2017, a cluster-randomized controlled study was conducted at 10 RCHEs (5 intervention versus 5 nonintervention controls), where DOHH was performed at two-hourly intervals during daytime, before meals and medication rounds by a one trained nurse in each intervention RCHE...
February 27, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29466559/association-of-faculty-entrustment-with-resident-autonomy-in-the-operating-room
#11
Gurjit Sandhu, Julie Thompson-Burdine, Vahagn C Nikolian, Danielle C Sutzko, Kaustubh A Prabhu, Niki Matusko, Rebecca M Minter
Importance: A critical balance is sought between faculty supervision, appropriate resident autonomy, and patient safety in the operating room. Variability in the release of supervision during surgery represents a potential safety hazard to patients. A better understanding of intraoperative faculty-resident interactions is needed to determine what factors influence entrustment. Objective: To assess faculty and resident intraoperative entrustment behaviors and to determine whether faculty behaviors drive resident entrustability in the operating room...
February 21, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29413393/the-broken-lens-of-bpsd-why-we-need-to-rethink-the-way-we-label-the-behavior-of-people-who-live-with-alzheimer-disease
#12
Susan Macaulay
For the past 20 years, the behaviors of people who live with dementia (PLWD) that others find challenging or problematic have primarily been ascribed to Alzheimer disease and related dementias and have been assessed through the biomedical lens of Behavioral and Psychological Symptoms of Dementia (BPSD). This has led to the root causes of these behaviors being overlooked, which in turn leaves them unaddressed. Further, using the artificial construct of BPSD has led to many PLWD being inappropriately prescribed (off-label) medications that are largely ineffective in resolving the behaviors because they do nothing to remedy the underlying psychosocial and environmental causes...
February 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29390564/the-associations-of-stroke-transient-ischemic-attack-and-or-stroke-related-recurrent-vascular-events-with-lipoprotein-associated-phospholipase-a2-a-systematic-review-and-meta-analysis
#13
Ye Tian, Huan Jia, Sichen Li, Yanmin Wu, Li Guo, Guojun Tan, Bin Li
BACKGROUND: Studies on stroke and lipoprotein-associated phospholipase A2 (Lp-PLA2) have produced conflicting results. OBJECTIVE: The aim of the study was to assess the associations of Lp-PLA2 levels (mass and activity) with recurrent vascular events in patients with transient ischemic attack (TIA) and/or first ischemic stroke and with stroke in the general population. METHODS: The MEDLINE, Embase, the Cochrane Library, Web of Science, Science Direct, China National Knowledge Infrastructure, China Biology Medical Disc (CBMdisc), and WanFang were searched for prospective observational studies reported until January 2017...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29328018/-a-day-in-the-life-of-a-medical-resident-on-the-ward
#14
A R Schuurman, S A Bos, K de Wit, R de Graaf, W J Wiersinga
OBJECTIVE: To investigate how internal medicine residents allocate their time during a hospital dayshift on the wards. DESIGN: Prospective observational cohort study (time and motion study). METHODS: Data were collected from 36 internal medicine residents working at the Internal Medicine Department of the Academic Medical Centre in Amsterdam, the Netherlands. Trained observers monitored 22 residents using a newly developed smartphone-application, registering their dayshift activities (meetings and education, direct patient contact, administrative tasks, lunch/break, other) and location (workstation, conference room, ward and patient rooms, other)...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29324048/peer-observation-of-rounds-leads-to-collegial-discussion-of-teaching
#15
J Rush Pierce, Patrick Rendón, Deepti Rao
PROBLEM: Faculty in the Division of Hospital Medicine provide most of the clinical teaching for learners at our institution. The majority of these faculty are Assistant Professors with limited formal instruction in clinical teaching. Previous Divisional strategies to improve clinical teaching ability included discussion of effective teaching behaviors, developing written expectations for teaching faculty, and instituting seminars on effective clinical teaching. Heretofore, the Division had not utilized a direct observation exercise...
April 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29276379/average-annual-cost-of-parkinson-s-disease-in-s%C3%A3-o-paulo-brazil-with-a-focus-on-disease-related-motor-symptoms
#16
Tânia M Bovolenta, Sônia Maria Cesar de Azevedo Silva, Roberta Arb Saba, Vanderci Borges, Henrique Ballalai Ferraz, Andre C Felicio
Background: Although Parkinson's disease is the second most prevalent neurodegenerative disease worldwide, its cost in Brazil - South America's largest country - is unknown. Objective: The goal of this study was to calculate the average annual cost of Parkinson's disease in the city of São Paulo (Brazil), with a focus on disease-related motor symptoms. Subjects and methods: This was a retrospective, cross-sectional analysis using a bottom-up approach (ie, from the society's perspective)...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29248416/simulation-based-skill-training-for-trainees-in-cardiac-surgery-a-systematic-review
#17
REVIEW
Igo B Ribeiro, Janet M C Ngu, Buu-Khanh Lam, Roger A Edwards
BACKGROUND: Simulation-based training has been an important part of the solution to address the shortfalls in cardiac surgery training. This review was conducted to identify and systematically summarize existing evidence on outcomes and methodological quality of simulation-based skills training for cardiac surgery trainees. METHODS: MEDLINE, Embase, and ERIC (Education Resources Information Center) databases were searched. Studies included peer-reviewed publications with simulation-based skill training in cardiac surgery programs with outcome measures of performance...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29217525/integration-of-mobile-devices-to-facilitate-patient-care-and-teaching-during-family-centered-rounds
#18
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...
January 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29202985/surgical-resident-involvement-in-foot-and-ankle-surgery
#19
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
#20
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
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