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https://www.readbyqxmd.com/read/29399852/effects-of-training-physicians-in-electronic-prescribing-in-the-outpatient-setting-on-clinical-learning-and-behavioural-outcomes-a-cluster-randomized-trial
#1
F van Stiphout, J E F Zwart-van Rijkom, J Versmissen, H Koffijberg, J E C M Aarts, I H van der Sijs, T van Gelder, R A de Man, C B Roes, A C G Egberts, E W M T Ter Braak
AIMS: Electronic prescribing systems may improve medication safety, but only when used appropriately. Effects of a task-analysis based training were evaluated in the outpatient setting on clinical, learning and behavioral outcomes, compared with usual educational approach. METHODS: Multicenter, cluster-randomized trial (MEDUCATE trial) with physicians as unit of analysis. SETTING: Outpatient clinics of two academic hospitals. PARTICIPANTS: Specialist and residents of internal medicine and their patients...
February 4, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29383073/using-medical-student-quality-improvement-projects-to-promote-evidence-based-care-in-the-emergency-department
#2
Michael W Manning, Eric W Bean, Andrew C Miller, Suzanne J Templer, Richard S Mackenzie, David M Richardson, Kristin A Bresnan, Marna R Greenberg
Introduction: The Association of American Medical Colleges' (AAMC) initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to "identify system failures and contribute to a culture of safety and improvement." We set out to determine the feasibility of using medical students' action learning projects (ALPs) to expedite implementation of evidence-based pathways for three common patient diagnoses in the emergency department (ED) setting (Atrial fibrillation, congestive heart failure, and pulmonary embolism)...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29383056/acgme-clinical-and-educational-work-hour-standards-perspectives-and-recommendations-from-emergency-medicine-educators
#3
Stephen J Wolf, Saadia Akhtar, Eric Gross, David Barnes, Michael Epter, Jonathan Fisher, Maria Moreira, Michael Smith, Hans House
Introduction: The American College of Emergency Physicians (ACEP) and the Council of Emergency Medicine Residency Directors (CORD) were invited to contribute to the 2016 Accreditation Council for Graduate Medical Education's (ACGME) Second Resident Duty Hours in the Learning and Working Environment Congress. We describe the joint process used by ACEP and CORD to capture the opinions of emergency medicine (EM) educators on the ACGME clinical and educational work hour standards, formulate recommendations, and inform subsequent congressional testimony...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29377731/there-s-a-lot-more-to-being-a-physician-insights-from-an-intensive-clinical-shadowing-experience-in-internal-medicine
#4
Lauren Block, Kevin Wang, Catherine C Gao, Albert W Wu, Leonard S Feldman
Phenomenon: Although most premedical students shadow physicians prior to starting medical school, there is no set of guidelines or expectations to facilitate effective experiences for students and physicians, nor is there data on the value of shadowing medical trainees as a way to learn about the training environment. We sought to understand premedical student perspectives on an intensive resident shadowing experience. APPROACH: This was a qualitative study using anonymous data from focus groups conducted with premedical student participants in a month-long time motion analysis of internal medicine interns at two large academic medical centers...
January 29, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29290595/the-media-response-to-the-acgme-s-2017-relaxed-resident-duty-hour-restrictions
#5
Zi Zhang, Alan V Krauthamer, Andrew B Rosenkrantz
PURPOSE: In March 2017, the ACGME relaxed resident duty-hour restrictions to allow first-year residents to work 24-hour shifts, affecting the internship experience of incoming radiology residents. The aim of this study was to assess the media response to this duty-hour change, comparing news articles with favorable and unfavorable views. METHODS: Google News was used to identify 36 relevant unique news articles published over a 4-week period after the announcement...
December 28, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29288642/improving-staff-communication-and-transitions-of-care-between-obstetric-triage-and-labor-and-delivery
#6
Kathleen O'Rourke, Joseph Teel, Erika Nicholls, Daniel D Lee, Alyssa Covelli Colwill, Sindhu K Srinivas
OBJECTIVE: To improve staff perception of the quality of the patient admission process from obstetric triage to the labor and delivery unit through standardization. DESIGN: Preassessment and postassessment online surveys. SETTING: A 13-bed labor and delivery unit in a quaternary care, Magnet Recognition Program, academic medical center in Pennsylvania. PARTICIPANTS: Preintervention (n = 100), postintervention (n = 52), and 6-month follow-up survey respondents (n = 75) represented secretaries, registered nurses, surgical technicians, certified nurse-midwives, nurse practitioners, maternal-fetal medicine fellows, anesthesiologists, and obstetric and family medicine attending and resident physicians from triage and labor and delivery units...
December 27, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/29166902/a-national-stakeholder-consensus-study-of-challenges-and-priorities-for-clinical-learning-environments-in-postgraduate-medical-education
#7
Caroline Kilty, Anel Wiese, Colm Bergin, Patrick Flood, Na Fu, Mary Horgan, Agnes Higgins, Bridget Maher, Grainne O'Kane, Lucia Prihodova, Dubhfeasa Slattery, Slavi Stoyanov, Deirdre Bennett
BACKGROUND: High quality clinical learning environments (CLE) are critical to postgraduate medical education (PGME). The understaffed and overcrowded environments in which many residents work present a significant challenge to learning. The purpose of this study was to develop a national expert group consensus amongst stakeholders in PGME to; (i) identify important barriers and facilitators of learning in CLEs and (ii) indicate priority areas for improvement. Our objective was to provide information to focus efforts to provide high quality CLEs...
November 22, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29132218/infant-reflux-in-the-primary-care-setting-a-brief-educational-intervention-and-management-changes
#8
Brendan Ryan Harris, William E Bennett
There has been a significant increase in prescription of acid suppression therapy to infants despite limited support for efficacy and safety. Prior studies have shown that educational interventions can improve clinician practices. Our aim is to implement an educational module with high-yield evidence to decrease the rate of prescribing these medications. Chart review of infants seen by residents after completing module was performed. Twelve clinic sessions before and after intervention were examined. 28 residents completed the intervention and required clinics...
November 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/29126406/perceptions-of-the-2011-acgme-duty-hour-requirements-among-residents-in-all-core-programs-at-a-large-academic-medical-center
#9
Benjamin J Sandefur, Diana M Shewmaker, Christine M Lohse, Steven H Rose, James E Colletti
BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) implemented revisions to resident duty hour requirements (DHRs) in 2011 to improve patient safety and resident well-being. Perceptions of DHRs have been reported to vary by training stage and specialty among internal medicine and general surgery residents. The authors explored perceptions of DHRs among all residents at a large academic medical center. METHODS: The authors administered an anonymous cross-sectional survey about DHRs to residents enrolled in all ACGME-accredited core residency programs at their institution...
November 10, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29095169/what-every-graduating-resident-needs-to-know-about-quality-improvement-and-patient-safety-a-content-analysis-of-26-sets-of-acgme-milestones
#10
Meghan Lane-Fall, Joshua J Davis, Justin Clapp, Jennifer S Myers, Lee Ann Riesenberg
PURPOSE: Quality improvement (QI) and patient safety (PS) are broadly relevant to the practice of medicine, but specialty-specific milestones demonstrate variable expectations for trainee competency in QI/PS. The purpose of this study was to develop a unifying portrait of QI/ PS expectations for graduating residents irrespective of specialty. METHOD: Milestones from 26 residency programs representing the 24 member boards of the American Board of Medical specialties were downloaded from the Accreditation Council for Graduate Medical Education (ACGME) website in 2015...
October 31, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29078624/the-role-of-wet-lab-in-thoracic-surgery
#11
REVIEW
Benedetta Bedetti, Philipp Schnorr, Joachim Schmidt, Marco Scarci
During the last three decades, minimally invasive surgery has become common practice in all kinds of surgical disciplines and, in Thoracic Surgery, the minimally invasive approach is recommended as the treatment of choice for early-stage non-small cell lung cancer. Nevertheless, all over the world a large number of lobectomies is still performed by conventional open thoracotomy and not as video-assisted thoracic surgery (VATS), which shows the need of a proper training for this technique. Development and improvement of surgical skills are not only challenging and time-consuming components of the training curriculum for resident or fellow surgeons, but also for more experienced consultants learning new techniques...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29076970/improving-the-clinical-skills-performance-of-graduating-medical-students-using-wise-oncall-a-multimedia-educational-module
#12
Demian Szyld, Kristen Uquillas, Brad R Green, Steven D Yavner, Hyuksoon Song, Michael W Nick, Grace M Ng, Martin V Pusic, Thomas S Riles, Adina Kalet
INTRODUCTION: "Transitions to residency" programs are designed to maximize quality and safety of patient care, as medical students become residents. However, best instructional or readiness assessment practices are not yet established. We sought to study the impact of a screen-based interactive curriculum designed to prepare interns to address common clinical coverage issues (WISE OnCall) on the clinical skills demonstrated in simulation and hypothesize that performance would improve after completing the module...
December 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29073389/impact-of-extended-duty-hours-on-medical-trainees
#13
Pnina Weiss, Meir Kryger, Melissa Knauert
Many studies on resident physicians have demonstrated that extended work hours are associated with a negative impact on well-being, education, and patient care. However, the relationship between the work schedule and the degree of impairment remains unclear. In recent years, because of concerns for patient safety, national minimum standards for duty hours have been instituted (2003) and revised (2011). These changes were based on studies of the effects of sleep deprivation on human performance and specifically on the effect of extended shifts on resident performance...
December 2016: Sleep Health
https://www.readbyqxmd.com/read/29068945/impact-of-an-event-reporting-system-on-resident-complication-reporting-in-plastic-surgery-training-addressing-an-acgme-and-plastic-surgery-milestone-project-core-competency
#14
Rajiv P Parikh, Alison Snyder-Warwick, Sybill Naidoo, Gary B Skolnick, Kamlesh B Patel
BACKGROUND: The Accreditation Council for Graduate Medical Education and Plastic Surgery Milestone Project has identified practice-based learning and improvement, which involves systematically analyzing current practices and implementing changes, as a core competency in residency education. In surgical care, complication reporting is an essential component of practice-based learning and improvement as complications are analyzed in morbidity and mortality conference for quality improvement...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29059269/the-practice-and-implications-of-finding-fluid-during-point-of-care-ultrasonography-a-review
#15
REVIEW
Rachel B Liu, Joseph H Donroe, Robert L McNamara, Howard P Forman, Chris L Moore
Importance: Point-of-care ultrasonography (POCUS) is an increasingly affordable and portable technology that is an important part of 21st-century medicine. When appropriately used, POCUS has the potential to expedite diagnosis and improve procedural success and safety. POCUS is now being adopted in medical education as early as the first year of medical school. While potentially powerful and versatile, POCUS is a user-dependent technology that has not been formalized or standardized yet within internal medicine residency training programs...
December 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29055891/using-an-alumni-survey-to-target-improvements-in-an-emergency-medicine-training-programme
#16
Theodore Gaeta, Gowtham Mahalingam, Matthew Pyle, Aaron Dam, Annette Visconti
INTRODUCTION: The Accreditation Council for Graduate Medical Education (ACGME) is the governing body responsible for accrediting graduate medical training programme in the USA. The Emergency Medicine Milestones (EM-Milestones) were developed by the ACGME and American Board of Emergency Medicine as a guide and monitoring tool for the knowledge, skills, abilities and experiences to be acquired during training. Alumni surveys have been reported as a valuable resource for training programme to identify areas for improvement; however, there are few studies regarding programme improvement in emergency medicine...
October 21, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29049076/fatigue-risk-management-the-impact-of-anesthesiology-residents-work-schedules-on-job-performance-and-a-review-of-potential-countermeasures
#17
Lily R Wong, Erin Flynn-Evans, Keith J Ruskin
Long duty periods and overnight call shifts impair physicians' performance on measures of vigilance, psychomotor functioning, alertness, and mood. Anesthesiology residents typically work between 64 and 70 hours per week and are often required to work 24 hours or overnight shifts, sometimes taking call every third night. Mitigating the effects of sleep loss, circadian misalignment, and sleep inertia requires an understanding of the relationship among work schedules, fatigue, and job performance. This article reviews the current Accreditation Council for Graduate Medical Education guidelines for resident duty hours, examines how anesthesiologists' work schedules can affect job performance, and discusses the ramifications of overnight and prolonged duty hours on patient safety and resident well-being...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29037823/the-development-of-a-novel-perfused-cadaver-model-with-dynamic-vital-sign-regulation-and-real-world-scenarios-to-teach-surgical-skills-and-error-management
#18
Michael Minneti, Craig J Baker, Maura E Sullivan
The landscape of graduate medical education has changed dramatically over the past decade and the traditional apprenticeship model has undergone scrutiny and modifications. The mandate of the 80-hour work-week, the introduction of integrated residency programs, increased global awareness about patient safety along with financial constraints have spurred changes in graduate educational practices. In addition, new technologies, more complex procedures, and a host of external constraints have changed where and how we teach technical and procedural skills...
October 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29034649/implementation-a-medical-simulation-curriculum-in-emergency-medicine-residency-program
#19
Amirhossein Jahanshir, Maryam Bahreini, Mohsen Banaie, Mohammad Jallili, Shahram Hariri, Fatemeh Rasooli, Hamed Sotoodehnia, Javad Seyed Hosseini, Arash Safaie, Ehsan Karimi, Ali Labaf, Hadi Mir Fazaelian, Elnaz Vahidi
Applying simulation in medical education is becoming more and more popular. The use of simulation in medical training has led to effective learning and safer care for patients. Nowadays educators have confronted with the challenge of respecting patient safety or bedside teaching. There is widespread evidence, supported by robust research, systematic reviews and meta-analysis, on how much effective simulation is. Simulation supports the acquisition of procedural, technical and non-technical skills through repetitive practice with feedbacks...
August 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28992149/using-an-online-quiz-based-reinforcement-system-to-teach-healthcare-quality-and-patient-safety-and-care-transitions-at-the-university-of-california
#20
Ulfat Shaikh, Nasim Afsar-Manesh, Alpesh N Amin, Brian Clay, Sumant R Ranji
Quality issue: Implementing quality improvement (QI) education during clinical training is challenging due to time constraints and inadequate faculty development in these areas. Initial assessment: Quiz-based reinforcement systems show promise in fostering active engagement, collaboration, healthy competition and real-time formative feedback, although further research on their effectiveness is required. Choice of solution: An online quiz-based reinforcement system to increase resident and faculty knowledge in QI, patient safety and care transitions...
October 1, 2017: International Journal for Quality in Health Care
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