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https://www.readbyqxmd.com/read/28351066/bringing-rounds-back-to-the-patient-a-one-year-evaluation-of-the-chiefs-service-model-for-inpatient-teaching
#1
Nadia L Bennett, Judd D Flesch, Peter Cronholm, James B Reilly, Jack Ende
PURPOSE: The Chiefs' Service (CS), a structured approach to inpatient teaching rounds, focuses on resident education and patient-centered care without disrupting patient census sizes or admitting cycles. It has five key elements: morning huddles; bedside rounds; diagnostic "time-outs"; day-of-discharge rounds; and postdischarge follow-up rounds. The authors hypothesized the CS model would be well received by residents and considered more effective than more-traditional rounds. METHOD: The CS was implemented on Penn Presbyterian Medical Center's general medicine inpatient service using a quasi-experimental design...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28346963/point-of-care-testing-in-neurosurgery
#2
Christopher Beynon, Lars Wessels, Andreas W Unterberg
Coagulation disorders can have a major impact on the outcome of neurosurgical patients. The central nervous system is located within the closed space of the skull, and therefore, intracranial hemorrhage can lead to intracranial hypertension. Acute brain injury has been associated with alterations of various hemostatic parameters. Point-of-care (POC) techniques such as rotational thromboelastometry are able to identify markers of coagulopathy which are not reflected by standard assessment of hemostasis (e.g...
March 27, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28346619/scope-of-practice-and-family-medicine-match-rates-results-from-a-cera-clerkship-directors-survey
#3
David Anthony, Jordan White, Katherine Margo, Derjung M Tarn
BACKGROUND AND OBJECTIVES: Family medicine clerkship directors depend on community preceptors to teach and attract medical students to family medicine. Many community preceptors do not provide the full range of family medicine services, and some are not family physicians. This study aimed to determine the types of practices in which family medicine clerkship students train and whether scope of practice is associated with family medicine Match rates. METHODS: Data were collected as part of the 2014 Council of Academic Family Medicine Educational Research Alliance (CERA) Family Medicine Clerkship Director Survey...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28346604/blended-learning-educational-format-for-third-year-pediatrics-clinical-rotation
#4
Erik E Langenau, Robert Lee, Marci Fults
CONTEXT: Traditional medical education is shifting to incorporate learning technologies and online educational activities with traditional face-to-face clinical instruction to engage students, especially at remote clinical training sites. OBJECTIVE: To describe and evaluate the effectiveness of the blended learning format (combining online and face-to-face instruction) for third-year osteopathic medical students during their pediatric rotation. METHODS: Third-year medical students who completed the 4-week clerkship in pediatrics during the 2014-2015 academic year were divided into a standard learning group and a blended learning group with online activities (discussion boards, blogs, virtual patient encounters, narrated video presentations, and online training modules)...
April 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28344722/assessment-of-emergency-medicine-residents-a-systematic-review
#5
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/28344714/moral-distress-and-burnout-in-internal-medicine-residents
#6
Sharareh Sajjadi, Monica Norena, Hubert Wong, Peter Dodek
BACKGROUND: Residents frequently encounter situations in their workplace that may induce moral distress or burnout. The objective of this study was to measure overall and rotation-specific moral distress and burnout in medical residents, and the relationship between demographics and moral distress and burnout. METHODS: The revised Moral Distress Scale and the Maslach Burnout Inventory (Human Service version) were administered to Internal Medicine residents in the 2013-2014 academic year at the University of British Columbia...
February 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28342777/teaching-and-assessing-professionalism-in-radiology-resident-education
#7
REVIEW
Aine Marie Kelly, Larry D Gruppen, Patricia B Mullan
Radiologists in teaching hospitals and in practices with residents rotating through are involved in the education of their residents. The Accreditation Council for Graduate Medical Education requires evidence that trainees are taught and demonstrate competency not only in medical knowledge and in patient care-the historic focus of radiology education-but also in the so-called non-interpretative core competencies, which include professionalism and interpersonal skills. In addition to accreditation agencies, the prominent assessment practices represented by the American Board of Radiology core and certifying examinations for trainees, as well as Maintenance of Certification for practitioners, are planning to feature more non-interpretative competency assessment, including professionalism to a greater extent...
March 22, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28340157/cervical-lateral-glide-neural-mobilization-is-effective-in-treating-cervicobrachial-pain-a-randomized-waiting-list-controlled-clinical-trial
#8
David Rodríguez-Sanz, César Calvo-Lobo, Francisco Unda-Solano, Irene Sanz-Corbalán, Carlos Romero-Morales, Daniel López-López
Background.:  Cervicobrachial pain (CP) is a high-incidence and prevalent condition. Cervical lateral glide (CLG) is a firstline treatment of CP. There is a current lack of enough high-quality randomized controlled double-blind clinical trials that measure the effectiveness of neural tissue mobilization techniques such as the CLG and its specific effect over CP. Objectives.:  The aim of the present study was to assess the effect of CLG neural mobilization in treating subjects who suffer from CP, compared with the complete absence of treatment...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339758/safety-and-efficacy-of-the-new-bidirectional-rotational-evolution%C3%A2-mechanical-lead-extraction-sheath-results-from-a-multicentre-italian-registry
#9
Patrizio Mazzone, Federico Migliore, Emanuele Bertaglia, Domenico Facchin, Elisabetta Daleffe, Vittorio Calzolari, Martino Crosato, Francesco Melillo, Francesco Peruzza, Alessandra Marzi, Nicoleta Sora, Paolo Della Bella
Aims: The aim of this prospective multicentre study is to evaluate safety and efficacy of the new bidirectional rotational mechanical lead extraction (LE) sheath (Evolution RL, Cook Medical, USA) in chronically implanted leads (>1-year-old leads). Methods and results: Between September 2013 and June 2016, a total of 238 leads in 124 consecutive patients were removed by using the new Evolution RL rotational mechanical sheath. Indications for LE were cardiac device infection in 63 (50...
February 23, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339494/facility-type-and-primary-care-performance-in-sub-district-health-promotion-hospitals-in-northern-thailand
#10
Nithra Kitreerawutiwong, Sue Jordan, David Hughes
BACKGROUND: Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses...
2017: PloS One
https://www.readbyqxmd.com/read/28334591/crossing-the-communication-chasm-challenges-and-opportunities-in-transitions-of-care-from-the-hospital-to-the-primary-care-clinic
#11
Nicholas A Rattray, Jason J Sico, LeeAnn M Cox, Alissa L Russ, Marianne S Matthias, Richard M Frankel
BACKGROUND: Transitions of care from specialty and acute settings to primary care abound. Compared to the continuity in end-of-shift handoffs, care transitions involve provider communication between practices and facilities with their own cultures and bureaucracies. Using the transition from acute care to outpatient primary care for stroke/transient ischemic attack (TIA) patients as a case study, this qualitative research explored communication practices and institutional arrangements among clinical providers responsible for longitudinal management of hypertension...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334327/autologous-vs-irradiated-homologous-costal-cartilage-as-graft-material-in-rhinoplasty
#12
Jee Hye Wee, Sue Jean Mun, Woo Sung Na, Heejin Kim, Joo Hyun Park, Dong-Kyu Kim, Hong-Ryul Jin
Importance: Studies comparing surgical results of rhinoplasty using autologous costal cartilage (ACC) and irradiated homologous costal cartilage (IHCC) are rare. Objectives: To compare the clinical results of major augmentation rhinoplasty using ACC vs IHCC and analyze the histologic properties of both types of cartilage. Design, Setting, and Participants: A retrospective clinical study was conducted among patients who had undergone rhinoseptoplasty using ACC or IHCC from January 1, 2009, to December 31, 2014...
March 23, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28332415/longitudinal-integrated-clerkships-in-the-community
#13
Andy McKeown, Ravi Parekh
Longitudinal Integrated Clerkships (LICs) are beginning to replace traditional short undergraduate rotations in general practice. LIC's differ from traditional rotations in that they are longer, they involve sustained relationships between students, patients and health professionals; and they integrate various strands of medical education. From early development in the US and Australia, LICs are now a fast-growing phenomenon across the world. We present three papers that seek to explain what LICs are, the evidence for their effectiveness and the practicalities of establishing or delivering a longitudinal integrated clerkship...
March 23, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28329124/sleep-and-alertness-in-medical-interns-and-residents-an-observational-study-on-the-role-of-extended-shifts
#14
Mathias Basner, David F Dinges, Judy A Shea, Dylan S Small, Jingsan Zhu, Laurie Norton, Adrian J Ecker, Cristina Novak, Lisa M Bellini, Kevin G Volpp
Study Objectives: Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Methods: Sleep-wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy...
February 24, 2017: Sleep
https://www.readbyqxmd.com/read/28328232/learning-by-doing-the-md-pa-interprofessional-education-rural-rotation
#15
Ryan T Palmer, Curt Stilp
While much investment has gone into developing interprofessional education (IPE) curriculum for healthcare professional students, many of these efforts have focused on classroom rather than clinical environments. Implementing robust IPE experiences into clinical training is often complicated by obstacles such as differing rotating schedules and differing curricular requirements. The Combined Medical-Physician Assistant Student Rural Rotation (Med-PARR) at the Oregon Health and Science University takes a practical approach to these challenges...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28327273/factors-affecting-orthopedic-residency-selection-a-cross-sectional-survey
#16
Jason Strelzow, Robert Petretta, Henry M Broekhuyse
BACKGROUND: Annually, orthopedic residency programs rank and recruit the best possible candidates. Little evidence exists identifying factors that potential candidates use to select their career paths. Recent literature from nonsurgical programs suggests hospital, social and program-based factors influence program selection. We sought to determine what factors influence the choice of an orthopedic career and a candidate's choice of orthopedic residency program. METHODS: We surveyed medical student applicants to orthopedic programs and current Canadian orthopedic surgery residents (postgraduate year [PGY] 1-5)...
April 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28327147/medical-student-changes-in-self-regulated-learning-during-the-transition-to-the-clinical-environment
#17
Kenneth K Cho, Brahm Marjadi, Vicki Langendyk, Wendy Hu
BACKGROUND: Self-regulated learning (SRL), which is learners' ability to proactively select and use different strategies to reach learning goals, is associated with academic and clinical success and life-long learning. SRL does not develop automatically in the clinical environment and its development during the preclinical to clinical learning transition has not been quantitatively studied. Our study aims to fill this gap by measuring SRL in medical students during the transitional period and examining its contributing factors...
March 21, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28322758/increased-seat-dump-angle-in-a-manual-wheelchair-is-associated-with-changes-in-thoracolumbar-lordosis-and-scapular-kinematics-during-propulsion
#18
Beth A Cloud, Kristin D Zhao, Arin M Ellingson, Ahmad Nassr, Anthony J Windebank, Kai-Nan An
OBJECTIVE: To quantify and compare spinal curvature and shoulder kinematics throughout the manual wheelchair propulsion cycle for individuals with spinal cord injury (SCI) who were seated at 2 different seat dump angles. DESIGN: Single-group, repeated-measures study. SETTING: Academic medical center. PARTICIPANTS: Twenty-eight individuals completed the telephone screening; 21 were eligible and completed the study. INTERVENTIONS: Participants' personal manual wheelchairs were modified to have seat dump angles of 0° or 14°, with a vertical backrest...
March 18, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28321387/free-mucosal-graft-reconstruction-of-the-septum-after-nasoseptal-flap-harvest-a-novel-technique-using-a-posterior-septal-free-mucosal-graft
#19
Frederick Yoo, Edward C Kuan, Marvin Bergsneider, Marilene B Wang
Objectives The nasoseptal flap (NSF) has become the workhorse for reconstruction in endoscopic endonasal skull-base surgery. The NSF, though useful in reconstruction, may lead to significant donor site morbidity. Published techniques to reduce the donor site morbidity, free mucosal grafts, and septal rotational flaps have shown to reduce crusting and remucosalization times. We present a novel technique utilizing posterior septal mucosa as a free mucosal graft for reconstruction of the anterior septal donor site...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28319634/late-onset-bexarotene-induced-cd4-lymphopenia-in-a-cutaneous-t-cell-lymphoma-patient
#20
Karin Eshagh, Laura S Romero, Jessica K So, Xianfeng Frank Zhao
Various infections, autoimmune diseases, medications, and total-body irradiation are known factors associated with CD4 lymphopenia, defined as a CD4 T-cell count below 300 cells/mL or less than 20% of total lymphocytes. We report a rare case of a patient with cutaneous T-cell lymphoma (CTCL) who developed profound CD4 lymphopenia in the setting of long-term bexarotene therapy. Bexarotene is a third-generation retinoid that inhibits epithelial cell proliferation and is approved for treatment of advanced CTCL (stages IIB-IVB) in adult patients who have failed at least 1 prior systemic therapy...
February 2017: Cutis; Cutaneous Medicine for the Practitioner
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