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Physician training

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https://www.readbyqxmd.com/read/29457382/an-international-multi-specialty-validation-study-of-the-igg4-related-disease-responder-index
#1
Zachary S Wallace, Arezou Khosroshahi, Mollie D Carruthers, Cory A Perugino, Hyon Choi, Corrado Campochiaro, Emma L Culver, Frank Cortazar, Emanuel Dellatorre, Mikael Ebbo, Ana Fernandes, Luca Frulloni, Philip Hart, Omer Karadag, Shigeyuki Kawa, Mitsuhiro Kawano, Myung-Hwan Kim, Marco Lanzillotta, Shoko Matsui, Kazuichi Okazaki, Jay H Ryu, Takako Saeki, Nicolas Schleinitz, Paula Tanasa, Hisanori Umehara, George Webster, Wen Zhang, John H Stone
OBJECTIVE: IgG4-related disease (IgG4-RD) can cause fibro-inflammatory lesions in nearly any organ, leading to organ dysfunction and failure. The IgG4-RD Responder Index (RI) was developed to help investigators assess the efficacy of treatment in a structured manner. We sought to validate the RI in a multi-national investigation. METHODS: The RI guides investigators through assessments of disease activity and damage in 25 domains, incorporating higher weights for disease manifestations that require treatment urgently or that worsen despite treatment...
February 18, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29457248/duty-hours-restriction-for-our-surgical-trainees-an-ethical-obligation-or-a-bad-idea
#2
REVIEW
Christopher A Adin, Callie A Fogle, Steven L Marks
To ensure patient safety and protect the well-being of interns and residents, the Accreditation Council for Graduate Medical Education (ACGME) issued guidelines in 2003 limiting the working hours of physician trainees. Although many supported the goals of the ACGME, institutions struggled to restructure their programs and hire staff required by this unfunded mandate. Numerous studies have analyzed the effects of duty hours restrictions on patient outcomes and physician training over the past 15 years. Most agree that duty hours restrictions improved well-being of house officers, but these improvements came at the expense of continuity, and patient hand-offs led to medical errors...
February 19, 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29456087/successful-interprofessional-approach-to-development-of-a-resuscitative-endovascular-balloon-occlusion-of-the-aorta-program-at-a-community-trauma-center
#3
Zaffer Qasim, Kevin Bradley, Heather Panichelli, Josie Robinson, Susan Coffey Zern
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a relatively innovative procedure designed to control critical non-compressible torso hemorrhage. In the United States, this procedure is currently in active use at only a small number of trauma centers. OBJECTIVE: We describe how we developed our REBOA program at an independent academic-affiliated community trauma center. DISCUSSION: Through a close interprofessional and multidisciplinary collaboration led by emergency physicians and trauma surgeons, we were able to successfully develop our program...
February 15, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29455475/nutrition-education-in-the-care-of-patients-with-chronic-kidney-disease-and-end-stage-renal-disease
#4
Cheryl A M Anderson, Hoang Anh Nguyen
Diet counseling and nutrition education are recommended in the prevention and management of chronic kidney disease (CKD) and end-stage renal disease (ESRD). The importance of effectively addressing nutrition with patients has grown given the increasing prevalence of obesity, hypertension, and diabetes; conditions which influence CKD/ESRD. Dietary advice for individuals with CKD/ESRD can be seen as complex; and successful dietary management requires careful planning, periodic assessment of nutritional status, as well as monitoring of dietary compliance...
February 18, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29455310/germans-learn-how-to-save-lives-a-nationwide-cpr-education-initiative
#5
Manuela Malsy, Richard Leberle, Bernhard Graf
BACKGROUND: Sudden cardiac death is one of the most frequent causes of death in Germany and the third leading cause of death in the industrialized world. Yet, the percentage of people providing first aid in the case of sudden cardiac arrest in Germany is alarmingly low by international comparison. Training Germans or reminding them of the simple but effective steps of resuscitation, so that everybody can save a live in an emergency. METHODS: For the campaign 'Resuscitation Week', physicians and paramedics trained passers-by in cardiovascular resuscitation free of charge...
February 17, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29455253/incorporation-of-the-fluoroless-c-arm-trainer-at-the-american-urological-association-hands-on-training-percutaneous-renal-access
#6
Yasser A Noureldin, David M Hoenig, Philip Zhao, Sammy E Elsamra, Joshua Stern, Geoffrey Gaunay, Piruz Motamedinia, Zeph Okeke, Ardeshir R Rastinehad, Robert M Sweet
OBJECTIVES: To assess for usefulness and validity evidence for incorporating the C-Arm Trainer (CAT) simulator into the annual AUA hands on course for training percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: The course started with a didactic session followed by four stations for training the "bull's eye" technique using the CAT simulator. Each station included a pre-test, 30-min practice on the simulator, and post-test. All participants were assessed using a 4-item checklist...
February 17, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29454788/advances-and-challenges-in-endoscopic-training
#7
Kevin A Waschke, Walter Coyle
One of the challenges of the current era is ensuring that endoscopic training is accomplished effectively in the face of multiple competing demands. As healthcare delivery evolves, with rising patient complexity and increasing productivity requirements, there is mounting pressure on the time available for training in the clinical setting. The practice of endoscopy itself continues to expand to include increasingly complex procedures (e.g. therapeutic endoscopic ultrasound (EUS), endoscopic submucosal dissection (ESD), peroral endoscopic myotomy (POEM), etc...
February 15, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29453706/family-experiences-with-the-diagnosis-of-autism-spectrum-disorder-system-barriers-and-facilitators-of-efficient-diagnosis
#8
M Martinez, K C Thomas, C S Williams, R Christian, E Crais, R Pretzel, S R Hooper
This paper examines family experiences with the efficiency of ASD diagnosis. Children were age 8 or younger with ASD (n = 450). Outcomes were delay from first parent concern to diagnosis, shifting diagnoses, and being told child did not have ASD. Predictors were screening, travel distance, and problems finding providers. Logit models were used to examine associations. Screening was associated with reduced delay in diagnosis; problems finding providers were associated with greater delay. Screening, travel distance, and delay in diagnosis were associated with shifting diagnoses and being told child did not have ASD...
February 16, 2018: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/29453330/interphysician-agreement-on-subclassification-of-myocardial-infarction
#9
Anton Gard, Bertil Lindahl, Gorav Batra, Nermin Hadziosmanovic, Marcus Hjort, Karolina Elisabeth Szummer, Tomasz Baron
OBJECTIVE: The universal definition of myocardial infarction (MI) differentiates MI due to oxygen supply/demand mismatch (type 2) from MI due to plaque rupture (type 1) as well as from myocardial injuries of non-ischaemic or multifactorial nature. The purpose of this study was to investigate how often physicians agree in this classification and what factors lead to agreement or disagreement. METHODS: A total of 1328 patients diagnosed with MI at eight different Swedish hospitals 2011 were included...
February 16, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29453235/a-workforce-survey-on-developmental-behavioral-pediatrics
#10
Carolyn Bridgemohan, Nerissa S Bauer, Britt A Nielsen, Anne DeBattista, Holly S Ruch-Ross, Linda B Paul, Nancy Roizen
BACKGROUND AND OBJECTIVES: Developmental-behavioral conditions are common, affecting ∼15% of US children. The prevalence and complexity of these conditions are increasing despite long wait times and a limited pipeline of new providers. We surveyed a convenience sample of the developmental-behavioral pediatric (DBP) workforce to determine current practices, workforce trends, and future needs. METHODS: An electronic survey was e-mailed to 1568 members of the American Academy of Pediatrics Section on Developmental and Behavioral Pediatrics and Council on Children with Disabilities, the Society for Developmental and Behavioral Pediatrics, and the National Association of Pediatric Nurse Practitioners Developmental and Behavioral Mental Health Special Interest Group...
February 16, 2018: Pediatrics
https://www.readbyqxmd.com/read/29452702/the-value-proposition-of-simulation-based-education
#11
David A Cook, Dana K Andersen, John R Combes, David L Feldman, Ajit K Sachdeva
Simulation has become an integral part of physician education, and abundant evidence confirms that simulation-based education improves learners' skills and behaviors and is associated with improved patient outcomes. The resources required to implement simulation-based education, however, have led some stakeholders to question the overall value proposition of simulation-based education. This paper summarizes the information from a special panel on this topic and defines research priorities for the field. Future work should focus on both outcomes and costs, with robust measurement of resource investments, provider performance (in both simulation and real settings), patient outcomes, and impact on the health care organization...
February 13, 2018: Surgery
https://www.readbyqxmd.com/read/29452409/recruitment-and-retention-of-trainee-physicians-a-retrospective-analysis-of-the-motivations-and-influences-on-career-choice-of-trainee-physicians
#12
C Ryan, E Ward, M Jones
Background: Across the UK there are vacant physician posts at every level. This increases workload and stress for those who remain, in turn making substantive jobs less attractive. Aim: To understand the influences on career choice and retention in training of current trainee physicians. Methods: An online survey, with a combination of closed and free text questions, was developed to assess factors that affected career choices. This was sent to all core and higher specialty trainees in Scotland and Associate or Collegiate members of the Royal College of Physicians Edinburgh not training in Scotland...
February 14, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29452056/promoting-addiction-medicine-teaching-through-functional-mentoring-by-co-training-generalist-chief-residents-with-faculty-mentors
#13
Daniel P Alford, Brittany L Carney, Angela H Jackson, Belle Brett, Carly Bridden, Michael Winter, Jeffrey H Samet
BACKGROUND: Generalist physicians should play a vital role in identifying and managing individuals with substance use but are inadequately trained to do so. METHODS: This 5 year (2008-2012) controlled educational study assessed whether internal medicine and family medicine chief residents' (CRs) addiction medicine teaching increased by co-training with faculty mentors at a Chief Resident Immersion Training (CRIT) program in addiction medicine. All CRIT CR attendees identified a residency program faculty mentor to support addiction medicine teaching after CRIT through functional mentoring with a focus on developing and implementing an Addiction Medicine Teaching Project ("Teaching Project")...
February 16, 2018: Substance Abuse
https://www.readbyqxmd.com/read/29451637/facing-death-in-the-clinical-practice-a-view-from-nurses-in-mexico
#14
Ma Luisa Marván, Luis F Oñate-Ocaña, Patricio Santillán-Doherty, Asunción Álvarez-Del Río
OBJECTIVE: To explore the views of nurses on death in their practice, and their perception about physicians' actions dealing with terminally ill patients. MATERIALS AND METHODS: Two hundred ninety-five nurses with experience caring for terminally ill patients responded to a questionnaire developed for this study. RESULTS: The majority of participants considered that terminally ill patients should know about their prognosis. Although nearly all nurses said that when a patient brings up the subject and they talk with the patient about death, several of the nurses find it difficult to establish a relationship with these patients...
November 2017: Salud Pública de México
https://www.readbyqxmd.com/read/29450842/mental-health-during-residency-training-assessing-the-barriers-to-seeking-care
#15
Alexandra L Aaronson, Katherine Backes, Gaurava Agarwal, Joshua L Goldstein, Joan Anzia
OBJECTIVES: Resident and fellow physicians are at elevated risk for developing depression compared to the general population; however, they are also less likely to utilize mental health services. We sought to identify the barriers to seeking mental health treatment among residents across all specialties at a large academic medical center in Chicago, IL. METHODS: Residents and fellows from all programs were asked to complete an anonymous self-report questionnaire...
February 14, 2018: Academic Psychiatry
https://www.readbyqxmd.com/read/29449819/knowledge-is-power-for-medical-assistants-crystallized-and-fluid-intelligence-as-predictors-of-vocational-knowledge
#16
Anne Moehring, Ulrich Schroeders, Oliver Wilhelm
Medical education research has focused almost entirely on the education of future physicians. In comparison, findings on other health-related occupations, such as medical assistants, are scarce. With the current study, we wanted to examine the knowledge-is-power hypothesis in a real life educational setting and add to the sparse literature on medical assistants. Acquisition of vocational knowledge in vocational education and training (VET) was examined for medical assistant students ( n = 448). Differences in domain-specific vocational knowledge were predicted by crystallized and fluid intelligence in the course of VET...
2018: Frontiers in Psychology
https://www.readbyqxmd.com/read/29447893/iphone-otoscopes-currently-available-but-reliable-for-tele-otoscopy-in-the-hands-of-parents
#17
Manan Udayan Shah, Maheep Sohal, Tulio A Valdez, Christopher R Grindle
OBJECTIVES: Tele-otoscopy has been validated for tympanostomy surveillance and remote diagnosis when images are recorded by trained professionals. The CellScope iPhone Otoscope is a device that may be used for tele-otoscopy and it enables parents to record their children's ear examinations and send the films for remote physician diagnosis. This study aims to determine the ability to diagnose, and the reliability of the diagnosis when utilizing video exams obtained by a parent versus video exams obtained by an otolaryngologist...
March 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29447544/-asking-but-not-screening-assessing-physicians-and-nurses-substance-related-clinical-behaviors
#18
Jon Agley, Joan M Carlson, Angela M McNelis, Ruth A Gassman, Rhonda Schwindt, David Crabb, Julie Vannerson
BACKGROUND: Screening, brief intervention, and referral to treatment (SBIRT) is a promising public health approach for problematic substance use. A core component of SBIRT is the use of formal screening tools to categorize a patient's likely level of risk in order to provide an appropriately-matched service. Training in formal screening is included in many SBIRT training programs, but infrequently is emphasized. OBJECTIVES: To assess pre-training levels of SBIRT-related clinical behaviors, including screening, this study examined a secondary dataset collected from internal medicine residents and graduate nurse practitioner students...
February 15, 2018: Substance Use & Misuse
https://www.readbyqxmd.com/read/29447297/development-of-a-decision-aid-for-cardiopulmonary-resuscitation-and-invasive-mechanical-ventilation-in-the-intensive-care-unit-employing-user-centered-design-and-a-wiki-platform-for-rapid-prototyping
#19
Ariane Plaisance, Holly O Witteman, Annie LeBlanc, Jennifer Kryworuchko, Daren Keith Heyland, Mark H Ebell, Louisa Blair, Diane Tapp, Audrey Dupuis, Carole-Anne Lavoie-Bérard, Carrie Anna McGinn, France Légaré, Patrick Michel Archambault
BACKGROUND: Upon admission to an intensive care unit (ICU), all patients should discuss their goals of care and express their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. OBJECTIVES: To adapt an existing decision aid about CPR to create a wiki-based decision aid individually adapted to each patient's risk factors; and to document the use of a wiki platform for this purpose...
2018: PloS One
https://www.readbyqxmd.com/read/29447259/medical-professionalism-of-foreign-born-and-foreign-trained-physicians-under-close-scrutiny-a-qualitative-study-with-stakeholders-in-germany
#20
Corinna Klingler, Fatiha Ismail, Georg Marckmann, Katja Kuehlmeyer
Hospitals in Germany employ increasing numbers of foreign-born and foreign-trained (FB&FT) physicians. Studies have investigated how FB&FT physicians experience their professional integration into the German healthcare system, however, the perspectives of stakeholders working with and shaping the work experiences of FB&FT physicians in German hospitals have so far been neglected. This study explores relevant stakeholders' opinions and attitudes towards FB&FT physicians-which likely influence how these physicians settle in-and how these opinions were formed...
2018: PloS One
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