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Ambulatory teaching

Patrick Leung, David M Dickerson, Sahitya K Denduluri, Maryam K Mohammed, Min Lu, Magdalena Anitescu, Hue H Luu
STUDY OBJECTIVE: Investigate the use of a postoperative continuous adductor canal block (cACB) after epidural analgesia to decreases opioid consumption and improve visual analog scale (VAS) scores compared to a sham catheter. DESIGN: Double-blinded randomized placebo-controlled trial. SETTING: Inpatient setting in tertiary care teaching hospital with outpatient follow-up. PATIENTS: One-hundred and sixty-five subjects (cACB n = 82 and sham catheter n = 83) with end-stage degenerative joint disease undergoing elective unilateral total knee arthroplasty...
June 8, 2018: Journal of Clinical Anesthesia
Ashley Aluko, Jasmine Rana, Susan Burgin
Challenge: "Case-based teaching" is a buzzword for engaging clinical teaching through cases, but how can it be implemented effectively in practice? We review popular case-based teaching methods (i.e., one-minute preceptor, SNAPPS, and the "Aunt Minnie method") for use during traditional one-on-one clinical preceptorships in the ambulatory dermatological setting.
July 2018: International Journal of Dermatology
Sherif El Desoky, Suleiman Mashat, Suliman Bana, Mohamed Alama, Nawaf Dhabab, Ghassan M Malibari, Manal Halwani, Amr S Albanna, Jameela A Kari
OBJECTIVE: The aim of the study was to evaluate the pediatric emergency department (PED) in a main teaching hospital. METHODS: Retrospective review of all children presented to PED at King Abdulaziz University Hospital from September to November 2014 was performed. We classified priority into the following 5 stages: 1, need resuscitation; 2, emergent; 3, urgent; 4, less urgent; and 5, nonurgent. RESULTS: A total of 2567 children (58.9% boys) attended PED for 3 months...
June 2018: Pediatric Emergency Care
Naghma Naeem, Margaret Elzubeir, Mohammad Al-Houqani, Luai Awad Ahmed
Objective: To explore undergraduate medical students' perception of variation in teaching and supervision at different clinical teaching sites. Methods: This descriptive cross-sectional study was conducted at the College of Medicine & Health Sciences, United Arab Emirates University, UAE during 2017. Four clinical teaching sites affiliated with CMHS were evaluated namely Shaikh Khalifa Medical City (SKMC), Ambulatory Care Clinics (AC), Tawam Hospital (TH) and Al-Ain Hospital (AH)...
March 2018: Pakistan Journal of Medical Sciences Quarterly
Elizabeth A Harrington, Kristen M Gawronski
INTRODUCTION: Within the curriculum, students gain exposure to careers in community, ambulatory, and institutional pharmacy. Students may not consider alternative options, like academia. Perceived barriers to incorporation by faculty may limit opportunities for students. The following commentary describes one student and faculty member's experience with an academic advanced pharmacy practice experience (APPE), and offers suggestions for overcoming potential barriers to implementation...
April 2018: Currents in Pharmacy Teaching & Learning
Muna Al Jalaf, Hanan Fadali, Rasha Alanee, Firas Najjar, Zulfa Al Deesi, Rania M Seliem, Eric J Nilles
BACKGROUND: Since the 1990s, community-associated methicillin resistant staphylococcus aureus (CA-MRSA) has emerged as an important global cause of skin and soft tissue infections. Little is known about the epidemiology of this pathogen in the Middle East. METHODS: We conducted a prospective observational study in a single large teaching hospital in Dubai to identify the incidence of community-acquired methicillin resistant staphylococcus aureus (MRSA) among ambulatory patients presenting with purulent skin and soft tissue infections...
May 15, 2018: BMC Emergency Medicine
Karla Seaman, Rosemary Saunders, Helen Dugmore, Claire Tobin, Rachel Singer, Fiona Lake
AIM AND OBJECTIVES: To examine students' beliefs, behaviours and attitudes in relation to interprofessional socialisation, and their expectations and experience, before and after a two-week clinical placement in ambulatory care. BACKGROUND: Interprofessional clinical placements for students are important for developing an understanding of interprofessional collaboration and identity, for the benefit of patient care. Ambulatory care environment involves collaborative management of complex chronic problems...
May 12, 2018: Journal of Clinical Nursing
Ashley Aluko, Jasmine Rana, Susan Burgin
Challenge: Clinical teaching in dermatology largely occurs in the outpatient setting. Herein, we review common barriers to teaching in the ambulatory setting and discuss strategies preceptors can take to "teach on the run" during clinic sessions.
June 2018: International Journal of Dermatology
Julian Jakob, Christine Cohidon, Jacques Cornuz, Kevin Selby
BACKGROUND: Few data exist to support the observation that general practitioners (GPs) occupy many important positions in our communities or to characterize which GPs devote more of their time to such activities. We sought to characterize community-based complementary medical activities performed by GPs in the canton Vaud, Switzerland. METHODS: All GPs in a region were invited to participate in a cross-sectional study (n = 600) examining engagement in complementary activities beyond standard ambulatory consultations...
May 3, 2018: BMC Family Practice
Blake J Lesselroth, Kathleen Adams, Victoria L Church, Stephanie Tallett, Yelizaveta Russ, Jack Wiedrick, Christopher Forsberg, David A Dorr
BACKGROUND:  The Veterans Affairs Portland Healthcare System developed a medication history collection software that displays prescription names and medication images. OBJECTIVE:  This article measures the frequency of medication discrepancy reporting using the medication history collection software and compares with the frequency of reporting using a paper-based process. This article also determines the accuracy of each method by comparing both strategies to a best possible medication history...
April 2018: Applied Clinical Informatics
Marsha Regenstein, John E Snyder, Mariellen Malloy Jewers, Kiki Nocella, Fitzhugh Mullan
Background : Despite considerable federal investment, graduate medical education financing is neither transparent for estimating residency training costs nor accountable for effectively producing a physician workforce that matches the nation's health care needs. The Teaching Health Center Graduate Medical Education (THCGME) program's authorization in 2010 provided an opportunity to establish a more transparent financing mechanism. Objective : We developed a standardized methodology for quantifying the necessary investment to train primary care physicians in high-need communities...
April 2018: Journal of Graduate Medical Education
Emily M Hawes
Given the potential harm associated with anticoagulant use, patient education is often provided as a standard of care and emphasized across healthcare settings. Effective anticoagulation education involves face-to-face interaction with a trained professional who ensures that the patient understands the risks involved, the precautions that should be taken, and the need for regular monitoring. The teaching should be tailored to each patient, accompanied with written resources and utilize the teach-back method...
April 20, 2018: Pharmacy (Basel, Switzerland)
Rawabi Aljadani, Mohammed Aseeri
OBJECTIVE: A cross-sectional study was performed from February to May 2015, to estimate the prevalence of drug-drug interactions in geriatric patients at the ambulatory care pharmacy at King Abdul-Aziz Medical City in Jeddah, Saudi Arabia. RESULTS: A total of 310 patients were included, with a mean age (± SD) of 73.78 ± 6.96, and 48.70% were female. The overall prevalence of DDIs of all categories was 90.64%. Category B DDIs was 55.80%, category C DDIs 87...
April 5, 2018: BMC Research Notes
Scott C Graziano, Margaret L McKenzie, Jodi F Abbott, Samantha D Buery-Joyner, LaTasha B Craig, John L Dalrymple, David A Forstein, Brittany S Hampton, Sarah M Page-Ramsey, Archana Pradhan, Abigail Wolf, Laura Hopkins
ISSUE: This article, from the "To the Point" series that is prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is a review of commonly cited barriers to recruiting and retaining community-based preceptors in undergraduate medical education and potential strategies to overcome them. EVIDENCE: Community-based preceptors have traditionally served as volunteer, nonsalaried faculty, with academic institutions relying on intrinsic teaching rewards to sustain this model...
March 26, 2018: Teaching and Learning in Medicine
William Y Huang, Larissa Grigoryan, Anjali Aggarwal
BACKGROUND: Little is known on ambulatory clerkship students' use of an electronic medical record (EMR). We investigated students' use of recommended EMR tasks across different types of sites and studied the predictors of these recommended tasks. METHODS: Students documented how often they performed recommended EMR tasks and suggested improvements to enhance EMR use. We compared student performance of recommended tasks across different types of sites using χ2 tests and the Fisher's exact test...
March 25, 2018: Clinical Teacher
Jan Hundertmark, Sandra Karina Apondo, Jobst-Hendrik Schultz
Background: Direct patient contact is crucial in learning important interactional and examination skills. However, medical students have limited opportunity to self-responsibly practise these skills in authentic clinical settings and typically receive insufficient feedback on their performance. We developed a novel single-session ambulatory teaching concept (Heidelberg Student Ambulatory training, "HeiSA") to prepare students more adequately for clinical-practical responsibilities. Methods: To identify challenges and target group needs, we reviewed current literature and consulted an expert group of faculty lecturers and training researchers...
2018: GMS Journal for Medical Education
Martin Dusch, Elisabeth Narciß, Renate Strohmer, Katrin Schüttpelz-Brauns
Aim: As part of the MaReCuM model curriculum at Medical Faculty Mannheim Heidelberg University, a final year rotation in ambulatory care was implemented and augmented to include ambulatory care simulation. In this paper we describe this ambulatory care simulation, the designated competency-based learning objectives, and evaluate the educational effect of the ambulatory care simulation training. Method: Seventy-five final year medical students participated in the survey (response rate: 83%). The control group completed the ambulatory rotation prior to the implementation of the ambulatory care simulation...
2018: GMS Journal for Medical Education
Christopher P Childers, Melinda Maggard-Gibbons
Importance: Increasing value requires improving quality or decreasing costs. In surgery, estimates for the cost of 1 minute of operating room (OR) time vary widely. No benchmark exists for the cost of OR time, nor has there been a comprehensive assessment of what contributes to OR cost. Objectives: To calculate the cost of 1 minute of OR time, assess cost by setting and facility characteristics, and ascertain the proportion of costs that are direct and indirect...
April 18, 2018: JAMA Surgery
Rosemary Saunders, Helen Dugmore, Karla Seaman, Rachel Singer, Fiona Lake
BACKGROUND: Interprofessional practice amongst health care professionals can facilitate effective collaboration and can improve health outcomes for patients. Interprofessional clinical placements have mainly been established within inpatient settings; however, ambulatory care settings can also provide interprofessional education. This study evaluates an interprofessional placement in ambulatory care for medical and nursing students. METHODS: Medical and nursing students undertook a 2-week interprofessional placement in respiratory, diabetes and chronic pain clinics, as well as within the patient's home...
February 12, 2018: Clinical Teacher
Alexandra Di Bella, Claire Blake, Adrienne Young, Anita Pelecanos, Teresa Brown
BACKGROUND: The prevalence of malnutrition in patients with cancer is reported as high as 60% to 80%, and malnutrition is associated with lower survival, reduced response to treatment, and poorer functional status. The Malnutrition Screening Tool (MST) is a validated tool when administered by health care professionals; however, it has not been evaluated for patient-led screening. OBJECTIVES: This study aims to assess the reliability of patient-led MST screening through assessment of inter-rater reliability between patient-led and dietitian-researcher-led screening and intra-rater reliability between an initial and a repeat patient screening...
February 1, 2018: Journal of the Academy of Nutrition and Dietetics
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