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resident supervision

Aaron L Grant, Claire Temple-Oberle
OBJECTIVE: The purpose of this study is to determine the utility of self-assessment in microsurgical training using a previously validated rating scale. DESIGN: A prospective study of surgical residents taking a hands-on 5-day microsurgical training course. Learners completed multiple self-assessments of their technical skills using the University of Western Ontario Microsurgical Acquisition/Assessment instrument. Simultaneously, preceptors assessed the learners using the same scale...
October 17, 2016: Journal of Surgical Education
Jae Hyun Kwon, Chang Hwan Sohn, Jae Ho Lee, Bum Jin Oh
OBJECTIVE: The supply of emergency medicine (EM) specialists has not been able to meet demand in the past decade. This study comparatively analyzed clinical findings to provide fundamental data to inform efficient utilization of a limited number of EM specialists. METHODS: This retrospective study included 54,204 patients who visited the emergency department of a tertiary care medical center from March 1 to December 31, 2012. The experimental specialist-supervised (SS) group included patients supervised by an EM specialist, while the control specialist-on-call (SOC) group included patients attended by a senior resident of EM with an EM specialist on call...
March 2016: Clin Exp Emerg Med
Chen Zhan, Natalia Grundtvig, Bent Helmuth Klug
OBJECTIVES: Recent studies suggest that lung ultrasound is a good, radiation-free alternative to chest radiography in children with pneumonia. We investigated how bedside lung ultrasound performed by a pediatric resident compared with chest radiography in children with suspected pneumonia. METHODS: This was a prospective study comparing bedside lung ultrasound to chest radiography as the reference standard. Children aged 0 to 15 years with suspected pneumonia at a pediatric emergency department were included and underwent chest radiography and lung ultrasound...
October 4, 2016: Pediatric Emergency Care
Marc A Auerbach, Marjorie Lee White, Sweta Bhargava, Pavan Zaveri, Elizabeth B Seelbach, Rebekah A Burns, Renuka Mehta, Brett McAninch, Daniel Fein, Todd P Chang, David O Kessler
OBJECTIVES: Few published studies describe graduating pediatric residents' procedural skills or success rates. This information would help guide supervisors' decisions about graduating residents' preparedness, training, and supervision needs. This study aimed to measure success rates for graduating pediatric residents performing infant lumbar puncture (LP) during the final months of their training and to describe their experiences performing and supervising infant LPs during the course of their training...
October 6, 2016: Pediatric Emergency Care
Neeraj Nagpal
Physicians and Internists in India have tended to brush under the carpet legal issues affecting their profession. Of concern to all Physicians is the judgment in a recent case where the NCDRC has stated that if MD Medicine Physicians write Physician & Cardiologist on their letterhead it is Quackery. What is MD Medicine degree holder in India qualified and trained to treat ? These are issues which need debate and that can only be initiated once we recognize that there is a problem. Either an MD Medicine is a cardiologist or he is not...
February 2016: Journal of the Association of Physicians of India
H W Nijhof, R Silvis, R C L M Vuylsteke, S J Oosterling, H Rijna, H B A C Stockmann
BACKGROUND: Colorectal resections are increasingly performed laparoscopically, and training in laparoscopic resections in the Netherlands has shifted from a post-residency fellowship to training in residency. The question remains if this supervised surgery affects short-term patient outcome. METHODS: Between January 2010 and July 2014, 523 consecutive patients, who underwent laparoscopic colorectal resection, were selected from a prospective single-center database...
October 4, 2016: Surgical Endoscopy
John B Ortolani, Daniel R Tershak, John J Ferrara, Charles J Paget
The American Society for Gastrointestinal Endoscopy (ASGE)/American College of Gastroenterology Task Force (ACGTF) on Quality in Endoscopy released updated quality benchmarks for colonoscopy in 2015. Our initial study concluded that surgery residents could perform safe and competent screening colonoscopy within a structured endoscopy curriculum. In this follow-up study, we sought to determine whether surgery residents could achieve the increased adenoma detection rate (ADR) benchmarks endorsed by the ASGE/ACGTF...
September 2016: American Surgeon
Fabio Garofalo, Pau Mota-Moya, Andrew Munday, Sébastien Romy
BACKGROUND: Total extraperitoneal (TEP) hernia repair has been shown to offer less pain, shorter postoperative hospital stay and earlier return to work when compared to open surgery. Our institution routinely performs TEP procedures for patients with primary or recurrent inguinal hernias. The aim of this study was to show that supervised senior residents can safely perform TEP repairs in a teaching setting. METHODS: All consecutive patients treated for inguinal hernias by laparoscopic approach from October 2008 to June 2012 were retrospectively analyzed from a prospective database...
September 15, 2016: World Journal of Surgery
Osamu Nomura, Hiroki Mishina, Yoshinori Kobayashi, Akira Ishiguro, Hirokazu Sakai, Hiroyuki Kato
Duty hour regulations have been placed in residency programs to address mental health concerns and to improve wellness. Here, we elucidate the prevalence of depressive symptoms after implementing an overnight call shift system and the factors associated with burnout or depression among residents.A sequential exploratory mixed methods study was conducted in a tertiary care pediatric and perinatal hospital in Tokyo, Japan. A total of 41 pediatric residents participated in the cross-sectional survey. We determined and compared the prevalence of depressive symptoms and the number of actual working hours before and after implementing the shift system...
September 2016: Medicine (Baltimore)
Eléonore Bayen, Florence Laigle-Donadey, Myrtille Prouté, Khê Hoang-Xuan, Marie-Eve Joël, Jean-Yves Delattre
PURPOSE: Informal caregivers (ICs) provide care and improve the quality of life of patients with malignant brain tumor. We analyze the impact of their involvement on themselves from a triple perspective. METHODS: Home-dwelling patients with primary malignant brain tumor underwent a medical examination. ICs burden was evaluated by a self-administered postal questionnaire. Objective burden (Informal Care Time, ICT), subjective burden (Zarit Burden Inventory, ZBI), and financial burden (valuation of lost earnings using the Replacement and Opportunity Cost Methods, RCM, OCM) were evaluated...
September 13, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Elizabeth B Klerman, Scott A Beckett, Christopher P Landrigan
BACKGROUND: In 2011 the U.S. Accreditation Council for Graduate Medical Education began limiting first year resident physicians (interns) to shifts of ≤16 consecutive hours. Controversy persists regarding the effectiveness of this policy for reducing errors and accidents while promoting education and patient care. Using a mathematical model of the effects of circadian rhythms and length of time awake on objective performance and subjective alertness, we quantitatively compared predictions for traditional intern schedules to those that limit work to ≤ 16 consecutive hours...
2016: BMC Medical Education
K Martakis, K Czabanowska, P Schröder-Bäck
BACKGROUND: Ethics education rarely exists in pediatric resident curricula, although ethical conflicts are common in the clinical practice. Ethics education can prepare residents to successfully handle these conflicts. AIM: We searched for methods in teaching ethics to clinical and especially pediatric residents, and identified recurring barriers to ethics teaching and solutions to overcome them. DESIGN: Literature from 4 electronic databases with peer-reviewed articles was screened in 3 phases and analyzed...
September 2016: Klinische Pädiatrie
Gaetano Luglio, Francesco Terracciano, Mariano Cesare Giglio, Michele Sacco, Roberto Peltrini, Viviana Sollazzo, Emanuela Spadarella, Cristina Bucci, Giovanni Domenico De Palma, Luigi Bucci
INTRODUCTION: Fecal diversion is considered an effective procedure to protect bowel anastomosis at high risk for leak. Some concerns exist regarding the risk for a significant morbidity associated to ileostomy creation itself and moreover to its closure. Surgical expertise and closure techniques are considered potential factors influencing morbidity. Aim of the study is to present a single-institution experience with ileostomy closures, in a teaching hospital, whereas ileostomy reversal is mainly performed by young residents...
September 6, 2016: International Journal of Colorectal Disease
Katherine S McGilton, Charlene H Chu, Alexander C Shaw, Rosalind Wong, Jenny Ploeg
AIM: The aim of this integrative review was to describe the organisational, unregulated nurse, and resident outcomes associated with effective supervisory performance of regulated nurses (registered nurses or registered practical nurses) in long-term care homes. BACKGROUND: While there are data on the influence of regulated nurse staffing levels on resident outcomes, the influence of effective supervisory performance of regulated nurses on resident and organisational outcomes, nursing assistant outcomes have yet to be comprehensively explored...
August 29, 2016: Journal of Nursing Management
Brian C Drolet, Vickram J Tandon, Rachel Sargent, Kamaris Loor, Scott T Schmidt, Paul Y Liu
BACKGROUND: In academic institutions, residents make substantial contributions to clinical productivity. However, billing cannot be generated unless there is direct attending physician supervision of these services. The purpose of this study was to quantify clinical services provided by residents at a large academic medical center. METHODS: The authors performed a review of all consultations to the plastic surgery service between January 1 and December 31, 2014...
September 2016: Plastic and Reconstructive Surgery
Portia Thurmond, Sanchita Bose, Lori B Lerner
INTRODUCTION: Holmium laser ablation of the prostate (HoLAP) is a surgical approach for treatment of benign prostatic hyperplasia (BPH). Limited evidence suggests laser ablation/vaporization is inferior to enucleation with respect to reoperation rates. Our objective was to determine if properly performed laser ablation results in outcomes similar to enucleation. MATERIALS AND METHODS: A total of 198 patients with moderate to severe lower urinary tract symptoms and/or acute urinary retention had holmium laser enucleation of the prostate (HoLEP) or HoLAP between 2008 and 2014...
August 2016: Canadian Journal of Urology
Nicholas L Holt, Kacey C Neely, John C Spence, Valerie Carson, Shannon R Pynn, Kassi A Boyd, Meghan Ingstrup, Zac Robinson
BACKGROUND: Children's engagement in active free play has declined across recent generations. Therefore, the purpose of this study was to examine perceptions of intergenerational changes in active free play among families from rural areas. We addressed two research questions: (1) How has active free play changed across three generations? (2) What suggestions do participants have for reviving active free play? METHODS: Data were collected via 49 individual interviews with members of 16 families (15 grandparents, 16 parents, and 18 children) residing in rural areas/small towns in the Province of Alberta (Canada)...
2016: BMC Public Health
Robert A Sharpe, Leah L Kammerdiener, Kendall W Wannamaker, Jie Fan, Elizabeth D Sharpe
AIMS: To compare outcomes of resident-performed Ahmed valve surgery vs trabeculectomy in a Veteran Affairs medical facility. MATERIALS AND METHODS: A retrospective cohort of 103 eyes in 91 patients receiving Ahmed valve (valve) or trabeculectomy (trab) performed at a Veterans Administration Medical Center by residents in their third year of training. The primary outcomes included intraocular pressure (IOP), treatment failure, and complications over 1 year. RESULTS: Of 103 eyes, 44 received valve and 59 received trab...
May 2016: Journal of Current Glaucoma Practice
Kirsten Ribu, Tulpesh Patel
People with development disorders, for instance autism, need structured plans to help create predictability in their daily lives. Digital plans can facilitate enhanced independency, learning, and quality of life, but existing apps are largely general purpose and lack the flexibility required by this specific but heterogeneous user group. Universal design is both a goal and a process and should be based on a holistic approach and user-centered design, interacting with the users in all stages of the development process...
2016: Studies in Health Technology and Informatics
Marta A King, Carrie A Phillipi, Paula M Buchanan, Linda O Lewin
OBJECTIVE: The written history and physical exam (H&P) is an underutilized source of medical trainee assessment. The authors describe development and validity evidence for Pediatric History and Physical Exam Evaluation (P-HAPEE) rubric: a novel tool for evaluating written H&Ps. METHODS: Through an iterative process, the authors drafted, revised, and implemented the 10-item rubric at three academic institutions in 2014. Eighteen attending physicians and 5 senior residents each scored 10 3(rd) year medical student H&Ps...
August 10, 2016: Academic Pediatrics
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