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https://www.readbyqxmd.com/read/28634908/an-entrustable-professional-activity-epa-based-framework-to-prepare-fourth-year-medical-students-for-internal-medicine-careers
#1
D Michael Elnicki, Meenakshy K Aiyer, Maria L Cannarozzi, Alexander Carbo, Paul R Chelminski, Shobhina G Chheda, Saumil M Chudgar, Heather E Harrell, L Chad Hood, Michelle Horn, Karnjit Johl, Gregory C Kane, Diana B McNeill, Marty D Muntz, Anne G Pereira, Emily Stewart, Heather Tarantino, T Robert Vu
The purpose of the fourth year of medical school remains controversial. Competing demands during this transitional phase cause confusion for students and educators. In 2014, the Association of American Medical Colleges (AAMC) released 13 Core Entrustable Professional Activities for Entering Residency (CEPAERs). A committee comprising members of the Clerkship Directors in Internal Medicine and the Association of Program Directors in Internal Medicine applied these principles to preparing students for internal medicine residencies...
June 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28631199/practical-interventions-to-enhance-resident-ownership-of-patient-care
#2
Thomas Soeprono, Jesse Markman, Michael Grodesky, Deborah Cowley
OBJECTIVE: In the modern training environment, some question whether trainees have the opportunity to develop ownership of patient care, which includes concepts such as advocacy, autonomy, commitment, communication, follow-through, knowledge about the patient, responsibility, and teamwork. Despite descriptions of what ownership is, there is little discussion of how to foster ownership during residency. The objective of this study was to solicit psychiatry resident and faculty perspectives on ways to enhance resident ownership in training...
June 19, 2017: Academic Psychiatry
https://www.readbyqxmd.com/read/28607940/orthopaedic-resident-preparation-and-confidence-in-treating-on-field-injuries
#3
Jonathan D Hodax, Andrew D Sobel, Steven DeFroda, Alison B Chambers, Michael J Hulstyn
BACKGROUND: Orthopaedic surgery residents may cover athletic events, although the training provided to prepare residents for this role and oversight from attending physicians during these activities is not well understood. PURPOSE: To survey orthopaedic residents about the training provided by their residency program for on-field athletic coverage and to understand their levels of preparation for this role and confidence in treating commonly encountered on-field conditions...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28607848/progressive-surgical-autonomy-in-a-plastic-surgery-resident-clinic
#4
Kristopher M Day, Jillian K Scott, Lani Gao, Tara M Lee, Jimmy L Waldrop, Larry A Sargent, J Woody Kennedy, Jason P Rehm, Mark A Brzezienski
BACKGROUND: Resident clinics are thought to catalyze educational milestone achievement through opportunities for progressively autonomous surgical care, but studies are lacking for general plastic surgery resident clinics (PSRCs). We demonstrate the achievement of increased surgical autonomy and continuity of care in a PSRC. METHODS: A retrospective review of all patients seen in a PSRC from October 1, 2010, to October 1, 2015, was conducted. Our PSRC is supervised by faculty plastic surgery attendings, though primarily run by chief residents in an accredited independent plastic surgery training program...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28606597/resident-involvement-in-microsurgery-an-american-college-of-surgeons-national-surgical-quality-improvement-program-analysis
#5
Kevin T Jubbal, Daniel Chang, Shayan A Izaddoost, William Pederson, Dmitry Zavlin, Anthony Echo
OBJECTIVE: In the current healthcare climate, there is increased focus on medical errors, patient outcomes, and the influence of resident participation on these metrics. Other studies have examined the influence of resident involvement on surgical outcomes, but the arena of microsurgery, with added complexity and learning curve, has yet to be investigated. DESIGN: A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database was performed to find patients undergoing procedures with free tissue transfer by screening for Current Procedural Terminology codes...
June 9, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28604093/safety-and-efficacy-of-3-pediatric-midazolam-moderate-sedation-regimens
#6
Rachel Gentz, Paul Casamassimo, Homa Amini, Dan Claman, Megann Smiley
Our aim was to characterize effectiveness and complications in children receiving oral midazolam alone, nasal midazolam alone, or oral midazolam with other sedatives. Children received oral midazolam alone, nasal midazolam, or oral midazolam in combination with other sedative medications. All subjects received a presedation history and physical examination and were sedated per protocol by any of 28 resident providers under attending supervision. Sedations were rated for success and complications by clinicians...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28603555/challenges-in-implementing-an-exercise-intervention-within-residential-psychiatric-care-a-mixed-methods-study
#7
Joseph Firth, Rebekah Carney, Michelle Pownall, Paul French, Rebecca Elliott, Jack Cotter, Alison R Yung
Physical exercise is increasingly recognized as an important component of psychiatric care, although the feasibility of implementing exercise in residential care settings is not well understood. We evaluated the feasibility of a 10-week intervention of weekly fitness classes (delivered by a personal trainer) and other exercise activities using a mixed-methods approach. This was offered to across four residential care services, to all 51 residents who had severe mental illness (SMI). Of these, 27.5% consented to the exercise intervention...
March 2017: Mental Health and Physical Activity
https://www.readbyqxmd.com/read/28596445/development-of-a-new-care-model-for-hospitalized-children-with-medical-complexity
#8
Christine M White, Joanna E Thomson, Angela M Statile, Katherine A Auger, Ndidi Unaka, Matthew Carroll, Karen Tucker, Derek Fletcher, David E Hall, Jeffrey M Simmons, Patrick W Brady
Children with medical complexity are a rapidly growing inpatient population with frequent, lengthy, and costly hospitalizations. During hospitalization, these patients require care coordination among multiple subspecialties and their outpatient medical homes. At a large freestanding children's hospital, a new inpatient model of care was developed in an effort to consistently provide coordinated, family-centered, and efficient care. In addition to expanding the multidisciplinary team to include a pharmacist, dietician, and social worker, the team redesign included: (1) medication reconciliation rounds, (2) care coordination rounds, and (3) multidisciplinary weekly handoff with outpatient providers...
June 8, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28578980/clinical-skills-passport-a-method-to-increase-participation-in-clinical-skills-by-medical-students-during-a-surgery-clerkship
#9
Thomas E Read
OBJECTIVE: To prospectively evaluate the effect of introducing a clinical skills "passport" on medical students' reporting of their experience with basic clinical skills. DESIGN: A prospective longitudinal intervention study was conducted. Medical students were administered a questionnaire at the conclusion of their 12-week surgery clerkship regarding their experience with 15 clinical skills, inquiring whether they had "learned on surgery clerkship", "learned before surgery clerkship", or "not learned"...
June 1, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28578443/learning-environment-of-the-saudi-psychiatry-board-training-program
#10
Abdulaziz T Alshomrani, Ahmad N AlHadi
To assess the learning environment of the Saudi psychiatry board program using the Dutch Residency Educational Climate Test (D-RECT) and to explore residents' perception of different domains of the learning environment. Methods: This was a descriptive cross-sectional study. The D-RECT instrument was distributed to all residents at all training sites of the Saudi psychiatry training program. It is a reliable and valid instrument to measure educational environment at the postgraduate level. Mean scores are presented, t-tests, analysis of variance, and post hoc analysis were used to compare subgroups and pearson's correlation was used to assess relationships...
June 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28569238/analyzing-breath-samples-of-hypoglycemic-events-in-type-1-diabetes-patients-towards-developing-an-alternative-to-diabetes-alert-dogs
#11
Amanda P Siegel, Ali Daneshkhah, Dana S Hardin, Sudhir Shrestha, Kody Varahramyan, Mangilal Agarwal
Diabetes is a disease that involves dysregulation of metabolic processes. Patients with type 1 diabetes (T1D) require insulin injections and measured food intake to maintain clinical stability, manually tracking their results by measuring blood glucose levels. Low blood glucose levels, hypoglycemia, can be extremely dangerous and can result in seizures, coma, or even death. Canines trained as diabetes alert dogs (DADs) have demonstrated the ability to detect hypoglycemia from breath, which led us to hypothesize that hypoglycemia, a metabolic dysregulation leading to low blood glucose levels, could be identified through analyzing volatile organic compounds (VOCs) contained within breath...
June 1, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28560526/resident-training-in-bariatric-surgery-a-national-survey-in-the-netherlands
#12
Gabrielle H van Ramshorst, Mirjam A Kaijser, Jean-Pierre E N Pierie, Bart A van Wagensveld
PURPOSE: Surgical procedures for morbid obesity, including laparoscopic Roux-en-Y gastric bypass (LRYGB), are considered standardized laparoscopic procedures. Our goal was to determine how bariatric surgery is trained in the Netherlands. MATERIALS AND METHODS: Questionnaires were sent to lead surgeons from all 19 bariatric centers in the Netherlands. At least two residents or fellows were surveyed for each center. Dutch residents are required to collect at least 20 electronic Objective Standard Assessment of Technical Skills (OSATS) observations per year, which include the level of supervision needed for specific procedures...
May 30, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28557945/how-entrustment-is-informed-by-holistic-judgments-across-time-in-a-family-medicine-residency-program-an-ethnographic-nonparticipant-observational-study
#13
Margaretha H Sagasser, Cornelia R M G Fluit, Chris van Weel, Cees P M van der Vleuten, Anneke W M Kramer
PURPOSE: Entrustment has mainly been conceptualized as delegating discrete professional tasks. Because residents provide most of their patient care independently, not all resident performance is visible to supervisors; the entrustment process involves more than granting discrete tasks. This study explored how supervisors made entrustment decisions based on residents' performance in a long-term family medicine training program. METHOD: A qualitative nonparticipant observational study was conducted in 2014-2015 at competency-based family medicine residency programs in the Netherlands...
June 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28557937/implementing-an-entrustable-professional-activities-framework-in-undergraduate-medical-education-early-lessons-from-the-aamc-core-entrustable-professional-activities-for-entering-residency-pilot
#14
Kimberly Lomis, Jonathan M Amiel, Michael S Ryan, Karin Esposito, Michael Green, Alex Stagnaro-Green, Janet Bull, George C Mejicano
In 2014, the Association of American Medical Colleges (AAMC) published a list of 13 Core Entrustable Professional Activities for Entering Residency (Core EPAs) that medical school graduates might be expected to perform, without direct supervision, on the first day of residency. Soon after, the AAMC commissioned a five-year pilot with 10 medical schools across the United States, seeking to implement the Core EPA framework to improve the transition from undergraduate to graduate medical education.In this article, the pilot team presents the organizational structure and early results of collaborative efforts to provide guidance to other institutions planning to implement the Core EPA framework...
June 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28557935/constructing-a-shared-mental-model-for-faculty-development-for-the-core-entrustable-professional-activities-for-entering-residency
#15
Michele A Favreau, Linda Tewksbury, Carla Lupi, William B Cutrer, Janet A Jokela, Lalena M Yarris
In 2014, the Association of American Medical Colleges identified 13 Core Entrustable Professional Activities for Entering Residency (Core EPAs), which are activities that entering residents might be expected to perform without direct supervision. This work included the creation of an interinstitutional concept group focused on faculty development efforts, as the processes and tools for teaching and assessing entrustability in undergraduate medical education (UME) are still evolving. In this article, the authors describe a conceptual framework for entrustment that they developed to better prepare all educators involved in entrustment decision making in UME...
June 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28541234/psychiatric-specialty-training-in-greece
#16
EDITORIAL
M Margariti, V Kontaxakis, D Ploumpidis
The reform and development of psychiatric services require, in addition to financial resources, reserves in specialized human resources. The role of psychiatrists in this process, and at reducing the consequences of mental morbidity is evident. Psychiatrists are required to play a multifaceted role as clinicians, as experts in multidisciplinary team environments and as advisors in the recognition of public needs in mental health issues, as teachers and mentors for students and other health professionals, as researchers in order to enrich our knowledge in the scientific field of psychiatry, and as public health specialists in the development of the mental health services system...
January 2017: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/28537510/remote-autopsy-services-a-feasibility-study-on-nine-cases
#17
Aleksandar Vodovnik, Mohammad Reza F Aghdam, Dan Gøran Espedal
Introduction We have conducted a feasibility study on remote autopsy services in order to increase the flexibility of the service with benefits for teaching and interdepartmental collaboration. Methods Three senior staff pathologists, one senior autopsy technician and one junior resident participated in the study. Nine autopsies were performed by the autopsy technician or resident, supervised by the primary pathologist, through the secure, double encrypted video link using Jabber Video (Cisco) with a high-speed broadband connection...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28526512/privacy-trainee-rights-and-accountability-in-radiology-education
#18
REVIEW
Cory M Pfeifer
RATIONALE AND OBJECTIVES: Academic radiologists commonly hold multiple simultaneous roles within the landscape of physician training. This paper analyzes theoretical scenarios describing relationships between medical students, residents, and physician educators in radiology. MATERIALS AND METHODS: The scenarios presented involve medical student supervision, radiology resident recruitment, and resident termination with respect to relevant ethical, regulatory, and legal considerations...
June 2017: Academic Radiology
https://www.readbyqxmd.com/read/28522893/hearcare-hearing-and-communication-assistance-for-resident-engagement
#19
REVIEW
Catherine V Palmer, Reem Mulla, Elizabeth Dervin, Kathleen Costigan Coyan
Impaired hearing is related to poor health outcomes, including compromised cognitive function, in aging individuals. Hearing loss is the third most common chronic health condition after arthritis and heart disease in older adults and the fourth most detrimental condition related to quality of life in older adults. Only 18% of aging adults who have impactful hearing loss actually use custom-fit amplification. Therefore, the majority of aging individuals entering senior living facilities will have untreated hearing loss...
May 2017: Seminars in Hearing
https://www.readbyqxmd.com/read/28520667/supervision-needs-following-veteran-and-service-member-moderate-to-severe-traumatic-brain-injury-a-va-tbi-model-systems-study
#20
Erin K Bailey, Risa Nakase-Richardson, Nitin Patel, Christina Dillahunt-Aspillaga, Susan A Ropacki, Angelle M Sander, Lillian Stevens, Xinyu Tang
OBJECTIVE: To characterize supervision levels across residential settings at 1 year post-TBI and explore predictors of supervision in a Veteran and Service-member population. SETTING: Five VA Polytrauma Rehabilitation Centers. PARTICIPANTS: A total of 302 individuals enrolled in the VA TBI Model Systems (TBIMS) research program. DESIGN: Prospective, longitudinal, multisite. MAIN MEASURES: Primary residence and supervision levels measured via scores on the Supervision Rating Scale...
May 17, 2017: Journal of Head Trauma Rehabilitation
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