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Internal medicine residency

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https://www.readbyqxmd.com/read/29792102/entrusting-internal-medicine-residents-to-use-point-of-care-ultrasound-towards-improved-assessment-and-supervision
#1
Daniel J Schnobrich, Benji K Mathews, Bernard E Trappey, Brian K Muthyala, Andrew P J Olson
BACKGROUND: Internal medicine physicians and trainees are increasingly using, and seeking training in, diagnostic point of care ultrasound (POCUS). Numerous internal medicine training programs have described their curricula, but little has been written about how learners should be assessed, supervised, and allowed to progress toward independent practice, yet these practices are imperative for safe and effective use. Entrustable professional activities (EPAs) offer a practical method to assess observable units of professional work and make supervision decisions...
May 23, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29790072/effect-of-social-comparison-feedback-on-laboratory-test-ordering-for-hospitalized-patients-a-randomized-controlled-trial
#2
Kira Ryskina, C Jessica Dine, Yevgeniy Gitelman, Damien Leri, Mitesh Patel, Gregory Kurtzman, Lisa Y Lin, Andrew J Epstein
BACKGROUND: Social comparison feedback is an increasingly popular strategy that uses performance report cards to modify physician behavior. Our objective was to test the effect of such feedback on the ordering of routine laboratory tests for hospitalized patients, a practice considered overused. METHODS: This was a single-blinded randomized controlled trial. Between January and June 2016, physicians on six general medicine teams at the Hospital of the University of Pennsylvania were cluster randomized with equal allocation to two arms: (1) those e-mailed a summary of their routine laboratory test ordering vs...
May 22, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29786021/developing-and-implementing-a-global-emergency-medicine-course-lessons-learned-from-rwanda
#3
Sojung Yi, Olivier Félix Umuhire, Doris Uwamahoro, Mindi Guptill, Giles N Cattermole
Background: There is a growing demand by medical trainees for meaningful, short-term global emergency medicine (EM) experiences. EM programs in high-income countries (HICs) have forged opportunities for their trainees to access this experience in low-and middle-income countries (LMICs). However, few programs in LMICs have created and managed such courses. As more LMICs establish EM programs, these settings are ideal for developing courses beneficial for all participants. We describe our experience of creating and implementing a short-term global EM course in Rwanda...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29784546/complexity-of-the-medication-regimen-for-polypathological-patients
#4
L Bellostas-Muñoz, J Díez-Manglano
OBJECTIVE: To determine the complexity of the therapeutic regimen for polypathological patients hospitalised in internal medicine departments. METHODS: A multicentre observational study included polypathological patients hospitalised in internal medicine departments. Patients who were readmitted or died were excluded. Data were collected on age, sex, residence, disease, Charlson, Barthel and Lawton-Brody indices, Pfeiffer questionnaire, Gijón scale, number of hospitalisations in the previous year, delirium, need for and availability of caregivers and the PROFUND index score...
May 18, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29780888/empathy-in-internal-medicine-residents-at-community-based-hospitals-a-cross-sectional-study
#5
Jami Foreback, Halina Kusz, Brenda Lovegrove Lepisto, Barbara Pawlaczyk
Introduction: Many research reports revealed declining empathy in medical schools that continues in postgraduate years of training. Objective: The aim of this study is to examine the self-reported empathy levels of internal medicine (IM) residents in 3 community-based teaching hospitals. Methods: The Jefferson Scale of Physician Empathy, Health Professionals version, is an online, self-administered, questionnaire that was offered to 129 current and incoming residents at 1 osteopathic and 2 allopathic, IM training programs in Flint, Michigan...
January 2018: Journal of Medical Education and Curricular Development
https://www.readbyqxmd.com/read/29775638/dermatology-education-in-internal-medicine-residency-programs-a-nationwide-survey-of-program-directors
#6
Connie R Shi, Joel T Katz, Ruth Ann Vleugels, Vinod E Nambudiri
No abstract text is available yet for this article.
May 15, 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29773700/implications-of-involving-pharmacy-technicians-in-obtaining-a-best-possible-medication-history-from-the-perspectives-of-pharmaceutical-medical-and-nursing-staff-a-qualitative-study
#7
Andrea Niederhauser, Chantal Zimmermann, Liat Fishman, David L B Schwappach
OBJECTIVES: In recent years, the involvement of pharmacy technicians in medication reconciliation has increasingly been investigated. The aim of this study was to assess the implications on professional roles and collaboration when a best possible medication history (BPMH) at admission is obtained by pharmacy technicians. DESIGN: Qualitative study with semistructured interviews. Data were analysed using a qualitative content analysis approach. SETTING: Internal medicine units in two mid-sized Swiss hospitals...
May 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29768480/internal-medicine-trainees-knowledge-and-confidence-in-using-the-american-society-of-hematology-choosing-wisely-guidelines-in-hemostasis-thrombosis-and-non-malignant-hematology
#8
Ariela L Marshall, Sarah Jenkins, Amy S Oxentenko, Alfred I Lee, Mark D Siegel, Joel T Katz, Jatin M Vyas, John Del Valle, Joseph R Mikhael
BACKGROUND: Several specialty societies participate in the Choosing Wisely (CW) campaign in an attempt to reduce waste in health care spending. We surveyed internal medicine (IM) residents with an objective of classifying knowledge of and confidence in using the American Society of Hematology (ASH) CW principles in hemostasis, thrombosis, and non-malignant hematology. METHODS: Multi-institutional study of IM residents at 5 academic training programs in the United States...
2018: PloS One
https://www.readbyqxmd.com/read/29767215/and-now-please-sign-on-the-dotted-line-teaching-residents-about-professional-life-after-residency
#9
Sherine Salib, Victoria Valencia, Alejandro Moreno
OBJECTIVES: Despite possible long-term repercussions, few training programs teach their residents about the business of medicine. In particular, certain contractual issues can adversely affect a young physician's career mobility. METHODS: We designed a business-of-medicine curriculum and used a survey to determine whether the curriculum satisfied attendees' perceived knowledge gaps about the topics covered in the course, which included four key contractual matters: physician employment contracts (including restrictive covenants), malpractice insurance, job search, and interviewing skills...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29761286/a-qualitative-analysis-of-stress-and-relaxation-themes-contributing-to-burnout-in-first-year-psychiatry-and-medicine-residents
#10
Nicole M Benson, Deanna Chaukos, Heather Vestal, Emma F Chad-Friedman, John W Denninger, Christina P C Borba
OBJECTIVE: Qualitative research on trainee well-being can add nuance to the understanding of propagators of burnout, and the role for interventions aimed at supporting well-being. This qualitative study was conducted to identify (i) situations and environments that cause stress for trainees, (ii) stress-reducing activities that trainees utilize, and (iii) whether trainees who report distress (high burnout and depression scores) describe different stressors and relaxation factors than those who do not...
May 14, 2018: Academic Psychiatry
https://www.readbyqxmd.com/read/29759257/developing-a-medical-scribe-program-at-an-academic-hospital-the-hennepin-county-medical-center-experience
#11
Marc L Martel, Brian H Imdieke, Kayla M Holm, Sara Poplau, William G Heegaard, Jon L Pryor, Mark Linzer
BACKGROUND: Medical scribes are frequently incorporated into the patient care model to improve provider efficiency and enable providers to refocus their attention to the patient rather than the electronic health record (EHR). The medical scribe program was based on four pillars (objectives): (1) provider satisfaction, (2) standardized documentation, (3) documentation components for risk adjustment, and (4) revenue enhancement. METHODS: The medical scribe program was deployed in nine non-resident-supported clinics (internal medicine, ophthalmology, orthopedics, hematology/oncology, urology), with the medical scribes (who have no clinical duties) supporting both physicians and advanced practice providers (nurse practitioners and physician assistants)...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29752645/a-tale-of-two-countries-innovation-and-collaboration-aimed-at-changing-the-culture-of-medicine-in-uruguay
#12
Juan J Dapueto, Mercedes Viera, Charles Samenow, William H Swiggart, Jeffrey Steiger
This is a case study of a program to address professionalism at the Universidad de la República in Uruguay. We describe a five-year ongoing international collaboration. Relevant characteristics of the context, the program components, activities, and results were analyzed. The expected outcomes were to introduce standards of professional practices in the curricula of medical students and residents and the implementation of a program that might lead to a significant change in the culture of medicine in the University...
May 11, 2018: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/29750550/knowledge-of-hiv-testing-guidelines-among-us-internal-medicine-residents-a-decade-after-the-centers-for-disease-control-and-prevention-s-routine-hiv-testing-recommendations
#13
Dima Dandachi, Bich N Dang, Rita Wilson Dib, Harvey Friedman, Thomas Giordano
Ten years after the Centers for Disease Control and Prevention recommended universal HIV screening, rates remain low. Internal medicine residents are the front-line medical providers for large groups of patients. We evaluated the knowledge of internal medicine residents about HIV testing guidelines and examined adherence to universal HIV testing in an outpatient setting. A cross-sectional survey of internal medicine residents at four residency programs in Chicago was conducted from January to March 2016. Aggregate data on HIV screening were collected from 35 federally qualified community health centers in the Chicago area after inclusion of an HIV testing best practice alert in patients' electronic medical records...
May 2018: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29750065/factors-associated-with-practicing-evidence-based-medicine-a-study-of-family-medicine-residents
#14
Justin Paulsen, Morhaf Al Achkar
Background: Evidence-based medicine (EBM) plays a critical part in ensuring that practitioners use the soundest available medical procedures while avoiding ineffective ones. As such, it plays a key role in medical residency education. However, little research has shown what factors influence residents' adoption of habits in, self-efficacy in, and skills of EBM. Materials and methods: This study gathered responses from a cross section of family medicine residents and new interns from 40 different residencies across the USA...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29748045/radiology-education-in-medical-school-and-residency-the-views-and-needs-of-program-directors
#15
Patrick T Schiller, Andrew W Phillips, Christopher M Straus
RATIONALE AND OBJECTIVES: The authors of this study used the perspectives of residency program directors (PDs) nationally to explore whether trainees are adequately prepared to utilize and interpret medical imaging as interns, to identify the types of imaging skills most important for residency, and to begin to address current shortcomings in radiology education. MATERIALS AND METHODS: The authors created a survey using a modified version of Accreditation Council for Graduate Medical Education radiology milestones and sent it to 100 randomly selected PDs each in pediatrics, internal medicine, obstetrics and gynecology, and general surgery...
May 7, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29746221/interprofessional-population-health-advocacy-developing-and-implementing-a-panel-management-curriculum-in-five-veterans-administration-primary-care-practices
#16
Maya Dulay, Judith L Bowen, William G Weppner, Abigail Eastburn, Anne P Poppe, Pete Spanos, Danielle Wojtaszek, Destiny Printz, Catherine P Kaminetzky
Health care systems expect primary care clinicians to manage panels of patients and improve population health, yet few have been trained to do so. An interprofessional panel management (PM) curriculum is one possible strategy to address this training gap and supply future primary care practices with clinicians and teams prepared to work together to improve the health of individual patients and populations. This paper describes a Veterans Administration (VA) sponsored multi-site interprofessional PM curriculum development effort...
May 10, 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29744004/gadolinium-induced-nephrogenic-systemic-fibrosis
#17
Anita H Shah, Juan Jose Olivero
The column in this issue is supplied by Anita H. Shah, M.D., and Juan Jose Olivero, M.D. Dr. Shah obtained her medical degree at The University of Texas Medical Branch in Galveston and is currently an internal medicine resident at Houston Methodist Hospital. Dr. Olivero is a nephrologist at Houston Methodist Hospital and a member of the hospital's Nephrology Fellowship Training Program. He obtained his medical degree from the University of San Carlos School of Medicine in Guatemala, Central America, and completed his residency and nephrology fellowship at Baylor College of Medicine in Houston, Texas...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29743057/specialty-preferences-and-influencing-factors-a-repeated-cross-sectional-survey-of-first-to-sixth-year-medical-students-in-jena-germany
#18
Diana Grasreiner, Uta Dahmen, Utz Settmacher
BACKGROUND: Given the expected increase in those entering retirement, the number of practising physicians is predicted to decrease. Conversely, the number of physicians needed is set to increase, due to higher demands resulting from the increasing average age of the German population. This may cause a deficit in the availability and accessibility of medical care for the population in Germany, as well as in other countries. As such, there needs to be a specific focus on the next generation of physicians...
May 9, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29733097/the-effects-on-patient-retention-after-opioid-weaning-in-an-internal-medicine-residency-clinic
#19
Charles P Opperman, Melissa M Butler, Andrew K Stroud, Michael R Sun
A retrospective, cross-sectional study was completed on 220 patients to determine the effects of implementation of an aggressive policy to curb opioid misuse/abuse in an internal medicine residency clinic. Our findings suggest that the development of a clear and consistent protocol for approaching patients on chronic controlled substances, as well as the initiation of regular didactic sessions addressing chronic pain and pain management, led to a dramatic reduction in the number or opioid prescriptions written by our resident providers without much reduction in patient volume...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29730649/diagnostic-accuracy-in-family-medicine-residents-using-a-clinical-decision-support-system-dxplain-a-randomized-controlled-trial
#20
Adrian Israel Martinez-Franco, Melchor Sanchez-Mendiola, Juan Jose Mazon-Ramirez, Isaias Hernandez-Torres, Carlos Rivero-Lopez, Troy Spicer, Adrian Martinez-Gonzalez
BACKGROUND: Clinical reasoning is an essential skill in physicians, required to address the challenges of accurate patient diagnoses. The goal of the study was to compare the diagnostic accuracy in Family Medicine residents, with and without the use of a clinical decision support tool (DXplain http://www.mghlcs.org/projects/dxplain). METHODS: A total of 87 first-year Family Medicine residents, training at the National Autonomous University of Mexico (UNAM) Postgraduate Studies Division in Mexico City, participated voluntarily in the study...
May 7, 2018: Diagnosis
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