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https://www.readbyqxmd.com/read/29661355/the-structure-of-medical-intensive-care-units-at-training-institutions
#1
Marc Heincelman, Ashley Duckett, Brad Keith, Andrew Schreiner, Jingwen Zhang, Edward Kilb, Benjamin Clyburn
BACKGROUND: As a result of the 2011 Accreditation Council for Graduate Medical Education (ACGME) work hour guideline implementation, the structure of intensive care unit (ICU) teams at training institutions has been affected. The impact these changes have had on the current work environment has not been well described. METHODS: The authors conducted an online survey of internal medicine program directors in 2016. The survey investigated how training institutions structure their intensive care units in reference to volume, resident housestaff and alternative coverage options, with a focus on changes made after the implementation of the 2011 ACGME duty hour restrictions...
April 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29619354/canadian-plastic-surgery-resident-work-hour-restrictions-practices-and-perceptions-of-residents-and-program-directors
#2
Colin W McInnes, Joshua Vorstenbosch, Ryan Chard, Sarvesh Logsetty, Edward W Buchel, Avinash Islur
Background: The impact of resident work hour restrictions on training and patient care remains a highly controversial topic, and to date, there lacks a formal assessment as it pertains to Canadian plastic surgery residents. Objective: To characterize the work hour profile of Canadian plastic surgery residents and assess the perspectives of residents and program directors regarding work hour restrictions related to surgical competency, resident wellness, and patient safety...
February 2018: Plastic Surgery
https://www.readbyqxmd.com/read/29578553/trends-in-inpatient-admission-comorbidity-and-electronic-health-data-implications-for-resident-workload-intensity
#3
Amanda V Clark, Charles M LoPresti, Todd I Smith
In the era of duty hour regulations, there is increasing concern regarding resident workload compression. We conducted a retrospective, observational assessment of all internal medicine resident admissions to a Veterans Affairs hospital over a 15-year period to evaluate several admission components that impact resident workload and workload intensity, including electronic health record (EHR) data burden and patient comorbidity. A total of 67,346 admissions were included in the analysis. Mean patient comorbidity, as measured by the Charlson Comorbidity Index, increased throughout the study period...
March 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29534115/gender-time-use-and-overweight-and-obesity-in-adults-results-of-the-brazilian-longitudinal-study-of-adult-health-elsa-brasil
#4
Karina Araujo Pinto, Rosane Harter Griep, Lucia Rotenberg, Maria da Conceição Chagas Almeida, Rosane Sousa Barreto, Estela M L Aquino
Perceived time constraints have been highlighted in sociological studies as representing a core issue in determining quality of life. The objective of this study was to test the hypothesis that gender inequalities regarding insufficiency of time play a role in the development of overweight and obesity in adults. The study used baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), which monitors a cohort of 15,105 civil servants of 35 to 74 years of age. Insufficient time for personal care and leisure due to professional and domestic duties, as detailed in a structured questionnaire, comprised the main exposure variable...
2018: PloS One
https://www.readbyqxmd.com/read/29528467/association-of-resident-duty-hour-restrictions-level-of-trainee-and-number-of-available-residents-with-mortality-in-the-neonatal-intensive-care-unit
#5
Marc Beltempo, Karin Clement, Guy Lacroix, Sylvie Bélanger, Anne-Sophie Julien, Bruno Piedboeuf
OBJECTIVE:  This article assesses the effect of reducing consecutive hours worked by residents from 24 to 16 hours on yearly total hours worked per resident in the neonatal intensive care unit (NICU) and evaluates the association of resident duty hour reform, level of trainee, and the number of residents present at admission with mortality in the NICU. STUDY DESIGN:  This is a 6-year retrospective cohort study including all pediatric residents working in a Level 3 NICU ( N  = 185) and infants admitted to the NICU ( N  = 8,159)...
February 8, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29506459/a-pilot-study-a-teaching-electronic-medical-record-for-educating-and-assessing-residents-in-the-care-of-patients
#6
Joshua Smith, W Graham Carlos, Cynthia S Johnson, Blaine Takesue, Debra Litzelman
OBJECTIVE: We tested a novel, web-based teaching electronic medical record to teach and assess residents' ability to enter appropriate admission orders for patients admitted to the intensive care unit. The primary objective was to determine if this tool could improve the learners' ability to enter an evidence-based, comprehensive initial care plan for critically ill patients. METHODS: The authors created three modules using de-identifed real patient data from selected patients that were admitted to the intensive care unit...
December 2018: Medical Education Online
https://www.readbyqxmd.com/read/29482883/implementation-of-an-academic-half-day-in-a-vascular-surgery-residency-program-improves-trainee-and-faculty-satisfaction-with-surgical-indications-conference
#7
Riann Robbins, Sarah Sullivan, Brigitte Smith
BACKGROUND: The Accreditation Council for Graduate Medical Education mandates scheduled didactics for residency programs but allows flexibility in implementation. Work-hour restrictions, patient care duties, and operative schedules create barriers to attendance for surgical trainees. We explored vascular surgery trainees and faculty perceptions on trainees operative preparation and participation, and overall fund of knowledge after implementing an academic half day conference (AHD) schedule...
February 23, 2018: Surgery
https://www.readbyqxmd.com/read/29457248/duty-hours-restriction-for-our-surgical-trainees-an-ethical-obligation-or-a-bad-idea
#8
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/29354324/comparison-of-patient-outcome-measures-between-a-traditional-teaching-hospitalist-service-and-a-non-teaching-hospitalist-service-at-an-academic-children-s-hospital
#9
Tony R Tarchichi, Jessica Garrison, Kwonho Jeong, Anthony Fabio
Background and objectives: Inpatient pediatric care is increasingly provided by pediatric hospitalists. This, in addition to changes in resident duty hour restrictions, has led to the creation of new models of care for inpatient pediatric patients. The objective of this study was to compare traditional outcome measures between a pediatric hospitalist-only service and a more traditional academic service in which care was provided by pediatric hospitalists, residents, and medical students...
December 2017: Pediatrics & Therapeutics: Current Research
https://www.readbyqxmd.com/read/29290595/the-media-response-to-the-acgme-s-2017-relaxed-resident-duty-hour-restrictions
#10
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...
March 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29286272/landmark-lecture-on-surgery-paediatric-cardiothoracic-surgery-training-the-next-generation-of-congenital-heart-surgeons
#11
Vaughn A Starnes, Maura E Sullivan
Introduction Recent changes in surgical education have had an impact on our congenital training programmes. The mandate of the 8-hour workweek, a rapidly expanding knowledge base, and a host of other mandates has had an impact on the readiness of the fellows who are entering congenital programmes. To understand these issues completely, we interviewed the top congenital experts in the United States of America. The purpose of this paper is to share their insight and offer suggestions to address these challenges...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29273338/increased-academic-productivity-of-orthopaedic-surgery-residents-following-2011-duty-hour-reform
#12
Joey P Johnson, Kevin Savage, Joseph A Gil, Craig P Eberson, Mary K Mulcahey
BACKGROUND: In 2003 and again in 2011, the Accreditation Council for Graduate Medical Education (ACGME) mandated increasingly stringent resident duty hour restrictions. With less time required at the hospital, residents theoretically have more time for other academic activities, such as research. Our study seeks to examine whether the number of research publications by orthopaedic residents increased following implementation of the 2011 ACGME duty hour restrictions. DESIGN: Pubmed was queried using publicly available alumni lists from programs across the United States...
December 19, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29190403/family-medicine-didactics-revisited
#13
Dennis J Butler, Joseph Brocato, Mark Yeazel
BACKGROUND AND OBJECTIVES: All family medicine programs are required to provide specialty-specific didactic conferences for residents. Since a baseline study of family medicine didactic formats was published in 2000, training requirements have changed, core content has evolved, and new teaching strategies have been recommended. The present study examines the characteristics of current family medicine didactics, compares current and past conference format data, and identifies factors affecting content selection...
November 2017: Family Medicine
https://www.readbyqxmd.com/read/29097172/beyond-250-a-comprehensive-strategy-to-maximize-the-operative-experience-for-junior-residents
#14
James M Healy, Mark W Maxfield, Daniel G Solomon, Walter E Longo, Peter S Yoo
OBJECTIVES: Among surgical educators, duty-hour restrictions led to concern regarding the adequacy of operative experience during residency, especially for junior residents. The American Board of Surgery recently instituted guidelines mandating "a minimum of 250 operations by the end of the PGY-2 year". A series of programmatic and institutional changes were implemented at our institution to augment the junior resident operative experience and to exceed compliance with this mandate...
October 30, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29073389/impact-of-extended-duty-hours-on-medical-trainees
#15
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/29066315/surgery-website-as-a-24-7-adjunct-to-a-surgical-curriculum
#16
Apram Jyot, Mohamed S Baloul, Eric J Finnesgard, Samuel J Allen, Nimesh D Naik, Miguel A Gomez Ibarra, Eduardo F Abbott, Becca Gas, Francisco J Cardenas-Lara, Muhammad H Zeb, Rachel Cadeliña, David R Farley
OBJECTIVE: Successfully teaching duty hour restricted trainees demands engaging learning opportunities. Our surgical educational website and its associated assets were assessed to understand how such a resource was being used. DESIGN: Our website was accessible to all Mayo Clinic employees via the internal web network. Website access data from April 2015 through October 2016 were retrospectively collected using Piwik. SETTING: Academic, tertiary care referral center with a large general surgery training program...
October 21, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29059986/energy-efficient-lora-gps-tracker-for-dementia-patients
#17
Tim Hadwen, Vanessa Smallbon, Qing Zhang, Matthew D'Souza
Continuous GPS tracking devices always suffer short battery life when used by caregivers to reduce the risk of wandering to dangerous areas by dementia patients. Currently the best existing tracker for dementia patients on the market only supports less than 10 hours battery life with a gigantic battery. It not only requires daily battery charging from patients/caregivers, but also becomes a very restrictive device. In this paper we inspected individual energy consumption of the components in a GPS tracker and proposed a novel energy efficient, small wristband by integrating the latest LoRa communication and GPS duty cycling technologies...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29042335/neurosurgical-resident-error-a-survey-of-u-s-neurosurgery-residency-training-program-directors-perceptions
#18
Raghav Gupta, Justin M Moore, Nimer Adeeb, Christoph J Griessenauer, Anna M Schneider, Chirag D Gandhi, Griffith R Harsh, Ajith J Thomas, Christopher S Ogilvy
BACKGROUND: Efforts to address resident errors and to enhance patient safety have included systemic reforms, such as the Accreditation Council for Graduate Medical Education's (ACGME's) mandated duty-hour restrictions, and specialty-specific initiatives such as the neurosurgery Milestone Project. However, there is currently little data describing the basis for these errors or outlining trends in neurosurgical resident error. METHODS: An online questionnaire was distributed to program directors of 108 U...
January 2018: World Neurosurgery
https://www.readbyqxmd.com/read/28994515/role-of-pelvic-ultrasound-simulation
#19
Sushila Arya, Zuber D Mulla, Sanja Kupesic Plavsic
BACKGROUND: Pelvic ultrasound is a critical diagnostic imaging tool in obstetrics and gynaecology. Training opportunities in transvaginal ultrasound have not kept pace with the demand among learners because of the increased complexity of modern ultrasound technology and duty-hour restrictions. Ultrasound simulation training has the potential to overcome this gap. Training opportunities in transvaginal ultrasound have not kept pace with the demand OBJECTIVE: Our study aimed to determine the usefulness, applicability and attitudes toward pelvic ultrasound simulation training among residents, sonographers and practising doctors...
October 10, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28971499/restoration-of-resident-sleep-and-wellness-with-block-scheduling
#20
James Bordley, Algene G Agustin, Mohamed A Ahmed, Raeesa Khalid, Anthony M Paluso, Bethany S Kobza, Aaron W Spaugy, Jonathan Emens, Sima S Desai, Akram Khan
CONTEXT: Block scheduling during residency is an innovative model in which in-patient and ambulatory rotations are separated. We hypothesised that this format may have a positive impact on resident sleep and wellness in comparison with a traditional format. METHODS: We performed a single-centre, cross-sectional, observational study of residents rotating in the medical intensive care unit (MICU). Residents were observed for 4 weeks at a time: internal medicine (IM) residents were observed for 3 weeks in the MICU followed by 1 week in an ambulatory context, and non-IM residents were observed for 4 weeks in the MICU...
December 2017: Medical Education
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