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Resident ambulatory education

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https://www.readbyqxmd.com/read/28439357/resident-dyads-providing-transition-care-to-adolescents-and-young-adults-with-chronic-illnesses-and-neurodevelopmental-disabilities
#1
Richard J Chung, Joan Jasien, Gary R Maslow
BACKGROUND: Youth with special health care needs often experience difficulty transitioning from pediatric to adult care. These difficulties may derive in part from lack of physician training in transition care and the challenges health care providers experience establishing interdisciplinary partnerships to support these patients. OBJECTIVE: This educational innovation sought to improve pediatrics and adult medicine residents' interdisciplinary communication and collaboration...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439353/improving-timely-resident-follow-up-and-communication-of-results-in-ambulatory-clinics-utilizing-a-web-based-audit-and-feedback-module
#2
Joel C Boggan, Aparna Swaminathan, Samantha Thomas, David L Simel, Aimee K Zaas, Jonathan G Bae
BACKGROUND: Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barriers to reporting, given competing clinical responsibilities. OBJECTIVE: This study aimed to improve the rates of communicating test results to patients in resident ambulatory clinics. METHODS: We performed an internal medicine, residency-wide, pre- and postintervention, quality improvement project using audit and feedback...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28379934/electronic-medical-records-medical-students-and-ambulatory-family-physicians-a-multi-institution-study
#3
Jordan White, David Anthony, Vince WinklerPrins, Steven Roskos
PURPOSE: Medical students commonly encounter electronic medical records (EMRs) in their ambulatory family medicine clerkships, but how students interact with this technology varies tremendously and presents challenges to students and preceptors. Little research to date has evaluated the impact of EMRs on medical student education in the ambulatory setting; this three-institution study aimed to identify behaviors of ambulatory family medicine preceptors as they relate to EMRs and medical students...
April 4, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28261405/successful-implementation-of-a-direct-observation-program-in-an-ambulatory-block-rotation
#4
Jeremy Smith, Elizabeth Jacobs, Zhanhai Li, Bennett Vogelman, Yingqi Zhao, David Feldstein
BACKGROUND : Direct observation of clinical skills is a cornerstone of competency-based education and training. Ensuring direct observation in a consistent fashion has been a significant challenge for residency programs. OBJECTIVE : The purpose of this study was to evaluate the effects of a novel evaluation system, designed to achieve ongoing direct observation of residents, examine changes in resident observation practices, and understand faculty attitudes toward direct observation and the evaluation system...
February 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28261403/jgme-aliem-hot-topics-in-medical-education-analysis-of-a-multimodal-online-discussion-about-team-based-learning
#5
Jeff Riddell, Catherine Patocka, Michelle Lin, Jonathan Sherbino
BACKGROUND : Team-based learning (TBL) is an instructional method that is being increasingly incorporated in health professions education, although use in graduate medical education (GME) has been more limited. OBJECTIVE : To curate and describe themes that emerged from a virtual journal club discussion about TBL in GME, held across multiple digital platforms, while also evaluating the use of social media in online academic discussions. METHODS : The Journal of Graduate Medical Education (JGME) and the Academic Life in Emergency Medicine blog facilitated a weeklong, open-access, virtual journal club on the 2015 JGME article "Use of Team-Based Learning Pedagogy for Internal Medicine Ambulatory Resident Teaching...
February 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28152716/documentation-of-pharmacist-provided-patient-education-for-oral-chemotherapy
#6
Neeta K Venepalli, Patrick Joseph Fleming, Christina Haaf, Adam Bursua, Little Irene Park, Sandra Cuellar
237 Background: Pharmacist-provided patient education for oral chemotherapy is poorly documented in patient electronic medical records (EMR) at UIC Oncology Pharmacy. At baseline, 41% of patients who started new therapy with selected oral chemotherapies had a patient education note documented by a pharmacist in their EMR. Our aim is to provide and document patient education for at least 90% of patients who start new oral chemotherapy and fill their prescriptions at UIC Oncology Pharmacy over three months. The importance of patient counseling and documentation is recognized by the Quality Oncology Practice Initiative (QOPI) group...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28112526/evaluation-of-appropriateness-admission-and-hospital-stay-at-educational-hospital
#7
Alireza Jeddian, Ahmad Afzali, Nazila Jafari
BACKGROUND: Appropriate admissions and patients' length of stay are two of the most important indicators of efficient health care delivery in hospitals. Paying due attention to these indicators may lead to optimal use of hospital resources as well as provision of ambulatory services to a larger population of patients. The purpose of the current study is to quantify the rate of inappropriate hospital admissions and days of hospital stay to identify factors affecting them. METHODS: Data were collected regarding admissions and length of stay of 1815 patients admitted to an educational hospital in Tehran, Iran, with a total 12,629 days of hospitalization using the Appropriateness Evaluation Protocol...
January 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28110618/expanding-ambulatory-care-pharmacy-residency-education-through-a-multisite-university-affiliated-model
#8
Sarah K Schweiss, Sarah M Westberg, Jean Y Moon, Todd D Sorensen
INTRODUCTION: As the health-care system evolves and shifts to value-based payment systems, there is a recognized need to increase the number of ambulatory care trained pharmacists. OBJECTIVE: The objective of this article is to describe the administrative structure of the University of Minnesota Postgraduate Year 1 (PGY1) Pharmacy Residency program and to encourage adoption of similar models nationally in order to expand ambulatory care residency training opportunities and meet the demand for pharmacist practitioners...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28086770/social-pediatrics-weaving-horizontal-and-vertical-threads-through-pediatric-residency
#9
REVIEW
Meta van den Heuvel, Maria Athina Tina Martimianakis, Rebecca Levy, Adelle Atkinson, Elizabeth Ford-Jones, Michelle Shouldice
BACKGROUND: Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. METHODS: A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions...
January 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28068973/patterns-of-use-of-oral-health-care-services-and-barriers-to-dental-care-among-ambulatory-older-chilean
#10
Rodrigo Mariño, Rodrigo A Giacaman
BACKGROUND: This paper describes the patterns of use of oral health care services among ambulant 65-74 years or older adults, living in the Maule Region of Chile, factors associated with their use of oral health care services, and self-reported barriers to using oral health care services. METHODS: Four hundred and thirty eight older adults, aged 65-74 years, living independently in the community were orally examined and underwent an oral health interview. Recency of visits was related to the use of oral health care services within the 12 months prior to the study...
January 9, 2017: BMC Oral Health
https://www.readbyqxmd.com/read/28011943/pediatric-residency-education-and-the-behavioral-and-mental-health-crisis-a-call-to-action
#11
Julia A McMillan, Marshall Land, Laurel K Leslie
For at least 4 decades, the need for improved pediatric residency training in behavioral and mental health has been recognized. The prevalence of behavioral and mental health conditions in children, adolescents, and young adults has increased during that period. However, as recently as 2013, 65% of pediatricians surveyed by the American Academy of Pediatrics indicated that they lacked training in recognizing and treating mental health problems. Current pediatric residency training requirements do not stipulate curricular elements or assessment requirements in behavioral and mental health, and fewer than half of pediatric residents surveyed felt that their competence in dealing with mental health problems was good to excellent...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27893146/alternative-scheduling-models-improving-continuity-of-care-medical-outcomes-and-graduate-medical-education-in-resident-ambulatory-training
#12
Ali J Hussain
An association has been consistently made about continuity of care with improved quality of care and improved medical outcomes. However, resident ambulatory block scheduling prevents the optimization of continuity of care in ambulatory clinical education. The author performed a PubMed search for studies examining continuity of care and curriculum scheduling in US primary care residency clinics. These studies indicate the success of an X + Y scheduling model in resident ambulatory training. Additional benefits have also been noted, including improved clinical teaching and learning, increased sense of teamwork, increased resident satisfaction, improved recruitment and retention, improved patient satisfaction, and elimination of year-end patient care issues after graduation...
December 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27777663/factors-associated-with-resident-continuity-in-ambulatory-training-practices
#13
Robert J Fortuna, Lynn Garfunkel, Michael D Mendoza, Megan Ditty, Julia West, Karen Nead, Brett W Robbins
BACKGROUND : Continuity of care is a critical element of residents' educational experience in primary care programs. OBJECTIVE : We examined how continuity in resident practices compares to nonteaching practices, identified factors associated with increased continuity, and explored the association between continuity and quality measures. METHODS : We analyzed 117 235 patient visits to 4 resident practices (26 resident teams in internal medicine, pediatrics, family medicine, and medicine-pediatrics) and 270 242 visits to nonteaching community practices between July 2013 and May 2014...
October 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/27729824/psychometric-properties-of-the-persian-version-of-the-ambulatory-care-learning-educational-environment-measure-acleem-questionnaire-shiraz-iran
#14
Mohammad Mahdi Parvizi, Mitra Amini, Mohammad Reza Dehghani, Peyman Jafari, Zahra Parvizi
PURPOSE: Evaluation is the main component in design and implementation of educational activities and rapid growth of educational institution programs. Outpatient medical education and clinical training environment is one of the most important parts of training of medical residents. This study aimed to determine the validity and reliability of the Persian version of Ambulatory Care Learning Educational Environment Measure (ACLEEM) questionnaire, as an instrument for assessment of educational environments in residency medical clinics...
2016: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/27479831/direct-observation-assessing-orthopaedic-trainee-competence-in-the-ambulatory-setting
#15
Donna P Phillips, Joseph D Zuckerman, Adina Kalet, Kenneth A Egol
The Accreditation Council of Graduate Medical Education requires that residency programs teach and assess trainees in six core competencies. Assessments are imperative to determine trainee competence and to ensure that excellent care is provided to all patients. A structured, direct observation program is feasible for assessing nontechnical core competencies and providing trainees with immediate constructive feedback. Direct observation of residents in the outpatient setting by trained faculty allows assessment of each core competency...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27463641/identifying-high-risk-neighborhoods-using-electronic-medical-records-a-population-based-approach-for-targeting-diabetes-prevention-and-treatment-interventions
#16
Rose Gabert, Blake Thomson, Emmanuela Gakidou, Gregory Roth
BACKGROUND: Increasing attention is being paid to the marked disparities in diabetes prevalence and health outcomes in the United States. There is a need to identify the small-area geographic variation in diabetes risk and related outcomes, a task that current health surveillance methods, which often rely on a self-reported diagnosis of diabetes, are not detailed enough to achieve. Broad adoption of electronic health records (EHR) and routine centralized reporting of patient-level data offers a new way to examine diabetes risk and highlight hotspots for intervention...
2016: PloS One
https://www.readbyqxmd.com/read/27445093/where-you-live-matters-the-impact-of-place-of-residence-on-severe-sepsis-incidence-and-mortality
#17
Andrew J Goodwin, Nandita R Nadig, James T McElligott, Kit N Simpson, Dee W Ford
BACKGROUND: Medically underserved areas are composed of vulnerable populations with reduced access to ambulatory care services. Our goal was to determine the association between residence in a medically underserved area and severe sepsis incidence and mortality. METHODS: Using administrative data, we identified adults admitted with severe sepsis to nonfederal hospitals in South Carolina. We determined whether each resident lived in a medically underserved area or nonmedically underserved area from US Census and Department of Health and Human Services data...
October 2016: Chest
https://www.readbyqxmd.com/read/27439977/improving-ambulatory-training-in-internal-medicine-x%C3%A2-%C3%A2-y-or-why-not
#18
Alaka Ray, Danielle Jones, Kerri Palamara, Maryann Overland, Kenneth P Steinberg
The Accreditation Council for Graduate Medical Education (ACGME) requirement that internal medicine residents spend one-third of their training in an ambulatory setting has resulted in programmatic innovation across the country. The traditional weekly half-day clinic model has lost ground to the block or "X + Y" clinic model, which has gained in popularity for many reasons. Several disadvantages of the block model have been reported, however, and residency programs are caught between the threat of old and new challenges...
December 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27355783/modifying-the-primary-care-exception-rule-to-require-competency-based-assessment
#19
Daniel G Tobin, Benjamin R Doolittle, Matthew S Ellman, Christopher B Ruser, Rebecca S Brienza, Inginia Genao
Teaching residents to practice independently is a core objective of graduate medical education (GME). However, billing rules established by the Centers for Medicare and Medicaid Services (CMS) require that teaching physicians physically be present in the examination room for the care they bill, unless the training program qualifies for the Primary Care Exception Rule (PCER). Teaching physicians in programs that use this exception can bill for indirectly supervised ambulatory care once the resident who provides that care has completed six months of training...
June 28, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/27349625/decisions-to-transfer-nursing-home-residents-to-emergency-departments-a-scoping-review-of-contributing-factors-and-staff-perspectives
#20
Lisa M Trahan, Jude A Spiers, Greta G Cummings
OBJECTIVES: Nursing home (NH) residents are a frail and vulnerable population often faced with iatrogenic effects of hospital stays when transferred to emergency departments for acute changes in health status. Avoidable or unnecessary transfers of care need to be identified and defined to prevent unintended harm. The aim of this scoping review was to identify characteristics of avoidable or unnecessary transitions of NH residents to emergency departments, and examine factors influencing decision-making by NH staff, residents, and their family members to transfer nursing home residents to emergency departments...
June 24, 2016: Journal of the American Medical Directors Association
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