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Internal medicine residency

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https://www.readbyqxmd.com/read/27907982/learners-perspective-where-and-when-pre-residency-trainees-learn-more-to-achieve-their-core-clinical-competencies
#1
Eusang Ahn, Ducksun Ahn, Young-Mee Lee
PURPOSE: While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. METHODS: A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews...
December 2016: Korean Journal of Medical Education
https://www.readbyqxmd.com/read/27905006/guidelines-on-the-management-of-atrial-fibrillation-in-the-emergency-department-a-critical-appraisal
#2
Giorgio Costantino, Gian Marco Podda, Lorenzo Falsetti, Primiano Iannone, Ana Lages, Alberto M Marra, Maristella Masala, Olaug Marie Reiakvam, Florentia Savva, Jan Schovanek, Sjoerd van Bree, Inês João da Silva Chora, Graziella Privitera, Silvio Ragozzino, Matthias von Rotz, Lycke Woittiez, Christopher Davidson, Nicola Montano
Several guidelines often exist on the same topic, sometimes offering divergent recommendations. For the clinician, it can be difficult to understand the reasons for this divergence and how to select the right recommendations. The aim of this study is to compare different guidelines on the management of atrial fibrillation (AF), and provide practical and affordable advice on its management in the acute setting. A PubMed search was performed in May 2014 to identify the three most recent and cited published guidelines on AF...
November 30, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27903252/shifting-tides-in-the-emigration-patterns-of-canadian-physicians-to-the-united-states-a-cross-sectional-secondary-data-analysis
#3
Thomas R Freeman, Stephen Petterson, Sean Finnegan, Andrew Bazemore
BACKGROUND: The relative ease of movement of physicians across the Canada/US border has led to what is sometimes referred to as a 'brain drain' and previous analysis estimated that the equivalent of two graduating classes from Canadian medical schools were leaving to practice in the US each year. Both countries fill gaps in physician supply with international medical graduates (IMGs) so the movement of Canadian trained physicians to the US has international ramifications. Medical school enrolments have been increased on both sides of the border, yet there continues to be concerns about adequacy of physician human resources...
December 1, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27897470/faculty-development-efforts-to-promote-screening-brief-intervention-and-referral-to-treatment-sbirt-in-an-internal-medicine-faculty-resident-practice
#4
Alanna Stone, Maria Wamsley, Patricia O'Sullivan, Jason Satterfield, Derek D Satre, Katherine Julian
BACKGROUND: Screening, brief intervention, and referral to treatment (SBIRT) is a practical means to address substance misuse in primary care. Important barriers to implementing SBIRT include adequacy of training and provider confidence as well as logistical hurdles and time constraints. A faculty development initiative aimed at increasing SBIRT knowledge and treatment of substance use disorders (SUDs) should lead to increased use of SBIRT by faculty and the residents they teach. This study examined how a faculty development program to promote SBIRT influenced faculty practice and resident teaching...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27896691/a-pilot-study-of-the-chronology-of-present-illness-restructuring-the-hpi-to-improve-physician-cognition-and-communication
#5
Laura M Mazer, Tina Storage, Sylvia Bereknyei, Jeffrey Chi, Kelley Skeff
BACKGROUND: Patient history-taking is an essential clinical skill, with effects on diagnostic reasoning, patient-physician relationships, and more. We evaluated the impact of using a structured, timeline-based format, the Chronology of Present Illness (CPI), to guide the initial patient interaction. OBJECTIVE: To determine the feasibility and impact of the CPI on the patient interview, written notes, and communication with other providers. DESIGN: Internal medicine residents used the CPI during a 2-week night-float rotation...
November 28, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27893952/acceptability-and-impact-of-a-required-palliative-care-rotation-with-prerotation-and-postrotation-observed-simulated-clinical-experience-during-internal-medicine-residency-training-on-primary-palliative-communication-skills
#6
Maxwell T Vergo, Sharona Sachs, Meredith A MacMartin, Kathryn B Kirkland, Amelia M Cullinan, Lisa A Stephens
BACKGROUND: Improving communication training for primary palliative care using a required palliative care rotation for internal medicine (IM) residents has not been assessed. OBJECTIVE: To assess skills acquisition and acceptability for IM residents not selecting an elective. DESIGN: A consecutive, single-arm cohort underwent preobjective structured clinical examination (OSCE) with learner-centric feedback, two weeks of clinical experience, and finally a post-OSCE to crystallize learner-centric take home points...
November 28, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27893012/surgeons-and-trauma-care-physicians-perception-of-the-impact-of-the-globalization-of-medical-education-on-quality-of-care-in-lima-peru
#7
Lacey N LaGrone, Leah N Isquith-Dicker, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Alfredo Allagual, Fernando Revoredo, Charles N Mock
Importance: The globalization of medical education-the process by which trainees in any region gain access to international training (electronic or in-person)-is a growing trend. More data are needed to inform next steps in the responsible stewardship of this process, from the perspective of trainees and institutions at all income levels, and for use by national and international policymakers. Objective: To describe the impact of the globalization of medical education on surgical care in Peru from the perspective of Peruvian surgeons who received international training...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27888177/study-protocol-for-a-cluster-randomised-controlled-trial-of-an-ncd-access-to-medicines-initiative-evaluation-of-novartis-access-in-kenya
#8
Peter C Rockers, Veronika J Wirtz, Taryn Vian, Monica A Onyango, Paul G Ashigbie, Richard Laing
INTRODUCTION: Novartis recently launched Novartis Access, an initiative to provide a basket of reduced price medicines for non-communicable diseases (NCDs) to be sold through the public and private non-profit sectors in programme countries. This study will evaluate the impact of Novartis Access on the availability and price of NCD medicines at health facilities and households in Kenya, the first country to receive the programme. METHODS AND ANALYSIS: This study will be a cluster-randomised controlled trial...
November 25, 2016: BMJ Open
https://www.readbyqxmd.com/read/27870544/referrals-and-the-pcmh-how-well-do-we-know-our-neighborhood
#9
Andrew Schreiner, Patrick Mauldin, Jingwen Zhang, Justin Marsden, William Moran
OBJECTIVES: Characterize patterns of referral from a patient-centered medical home (PCMH) and observe the association of provider experience, patient chronic disease burden, and risk of utilization on referral placement. STUDY DESIGN: Descriptive analysis of referral patterns in an academic, internal medicine PCMH. METHODS: We examined referrals (eg, specialist visit, testing, ancillary services) placed between July and December of 2014 in an academic PCMH caring for a total of 12,000 patients...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27866639/innovation-within-a-university-setting
#10
Elisabeth K Wynne, Thomas M Krummel
Elisabeth K. Wynne, MD, completed her undergraduate degree in bioengineering and is currently a surgical resident in training at the University of Washington. From 2014-2016, she served as a Biodesign Fellow at Stanford University. She plans to pursue a career of innovation as an academic surgeon. Thomas M. Krummel, MD, is the Emile Holman Professor and Chair Emeritus of the Department of Surgery at Stanford University School of Medicine. Throughout his career, Dr Krummel has been a pioneer and an innovator...
December 2016: Surgery
https://www.readbyqxmd.com/read/27856295/street-smarts-and-a-scalpel-emotional-intelligence-in-surgical-education
#11
Mary Kate Erdman, Alisha Bonaroti, Gina Provenzano, Rachel Appelbaum, Marybeth Browne
OBJECTIVE: To evaluate trends of emotional intelligence (EI) in surgical education and to compare the incorporation of EI in surgical education to other fields of graduate medical education. DESIGN: A MEDLINE search was performed for publications containing both "surgery" and "emotional intelligence" with at least one term present in the title. Articles were included if the authors deemed EI in surgical education to be a significant focus. A separate series of MEDLINE searches were performed with the phrase "emotional intelligence" in any field and either "surg*," "internal medicine," "pediatric," "neurology," "obstetric," "gynecology," "OBGYN," "emergency," or "psychiat*" in the title...
November 14, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27850081/441-bedside-ultrasound-training-for-university-of-missouri-internal-medicine-residents
#12
Tabitha Ku, Julie Alexander, Joseph Puetz, Tushar Tarun, Devin Kennedy, Angel Peralta, Harjyot Sohal
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27845703/older-swedish-adults-with-high-self-perceived-health-show-optimal-25-hydroxyvitamin-d-levels-whereas-vitamin-d-status-is-low-in-patients-with-high-disease-burden
#13
Martin Carlsson, Pär Wanby, Lars Brudin, Erik Lexne, Karin Mathold, Rebecca Nobin, Lisa Ericson, Ola Nordqvist, Göran Petersson
Controversy pervades the definition of adequate and optimal vitamin D status. The Institutes of Medicine have recommended serum 25(OH)D levels above 50 nmol/L based upon evidence related to bone health, but some experts, including the Endocrine Society and International Osteoporosis Foundation, suggest a minimum serum 25(OH)D level of 75 nmol/L to reduce the risk of falls and fractures in older adults. In a cross-sectional study, we compared vitamin D status in people ≥75 years selected from four groups with a frailty phenotype, combined with a control group free from serious illness, and who considered themselves completely healthy...
November 11, 2016: Nutrients
https://www.readbyqxmd.com/read/27837452/catatonia-education-needs-assessment-and-brief-online-intervention
#14
Joseph J Cooper, Joan Roig Llesuy
OBJECTIVES: There are no studies investigating physicians' knowledge of catatonia. The authors aimed to assess and increase physicians' awareness of catatonia. METHODS: A survey with clinical questions about catatonia was administered, followed by a brief online teaching module about catatonia and a post-education survey. RESULTS: Twenty-one psychiatry residents (response rate, 70%) and 36 internal medicine residents (response rate, 34%) participated in the pre-education survey...
November 11, 2016: Academic Psychiatry
https://www.readbyqxmd.com/read/27831613/-evaluation-of-an-intervention-for-the-use-of-thromboprophylaxis-based-on-electronic-alert-transmission-to-first-year-medical-residents-from-two-hospitals-of-lima-peru
#15
Roberto Delgado-Zapata, Ray Ticse, María de Los Ángeles Gamarra, Katherine Gómez, Wilfredo Mormontoy
Objectives.: To assess the implementation of an intervention based on the sending of text messages and e-mails to internal medicine residents in order to achieve an increase in the prescription of thromboprophylaxis according to Clinical Practice Guidelines (CPG). Materials and methods.: A quasi-experimental study was conducted in the inpatient units of internal medicine at two general hospitals in Lima, Peru: one selected to implement the intervention and the other as control...
July 2016: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/27828869/knowledge-of-medical-professionalism-in-medical-students-and-physicians-at-shahid-beheshti-university-of-medical-sciences-and-affiliated-hospitals-iran
#16
Mehran Seif-Farshad, Shabnam Bazmi, Farzad Amiri, Faeze Fattahi, Mehrzad Kiani
Although medical professionalism is a fundamental aspect of competence in medicine and a distinct facet of physicians' competence, evidence suggests that the subject of professionalism is not taught or assessed as part of medical students' curricula in Iran and many other countries. Assessing the knowledge of medical students and physicians about medical professionalism seems to be helpful in identifying the weaknesses of training in the field of professionalism and devise plans for future training on the subject...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27815762/acceptability-of-naloxone-co-prescription-among-primary-care-providers-treating-patients-on-long-term-opioid-therapy-for-pain
#17
Emily Behar, Christopher Rowe, Glenn-Milo Santos, Diana Coffa, Caitlin Turner, Nina C Santos, Phillip O Coffin
BACKGROUND: Naloxone co-prescription is recommended for patients on long-term opioids for pain, yet there are few data on the practice. OBJECTIVE: To explore naloxone co-prescribing acceptability among primary care providers for patients on long-term opioids. DESIGN: We surveyed providers at six safety-net primary care clinics in San Francisco that had initiated naloxone co-prescribing. Providers were encouraged to offer naloxone to patients on long-term opioids or otherwise at risk of witnessing or experiencing an overdose...
November 4, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27811599/physician-perspectives-on-interhospital-transfers
#18
Stephanie K Mueller, Jeffrey L Schnipper
OBJECTIVE: The transfer of patients between acute care hospitals (interhospital transfer [IHT]) is a common but nonstandardized process leading to variable quality and safety. The goal of this study was to survey accepting physicians regarding problems encountered in the transfer process. METHODS: A cross-sectional survey of residents and inpatient attendings from internal medicine, neurology, and surgery services at a large tertiary care referral hospital was undertaken to identify problematic aspects of the IHT process as perceived by accepting frontline providers...
November 2, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27810065/social-media-as-a-tool-for-antimicrobial-stewardship
#19
Jennifer Pisano, Natasha Pettit, Allison Bartlett, Palak Bhagat, Zhe Han, Chuanhong Liao, Emily Landon
BACKGROUND: To increase the reach of our antimicrobial stewardship program (ASP), social media platforms, Facebook and Twitter, were used to increase internal medicine residents' (IMRs') antibiotic (Abx) knowledge and awareness of ASP resources. METHODS: Fifty-five of 110 (50%) IMRs consented to participate; 39 (71%) completed both pre- and postintervention surveys and followed our ASP on social media. Along with 20 basic Abx and infectious diseases (IDs) questions, this survey assessed IMR awareness of ASP initiatives, social media usage, and attitudes and beliefs surrounding Abx resistance...
November 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27807020/miliary-tuberculosis-in-an-immunocompetent-male-with-a-fatal-outcome
#20
Louise Dunphy, Elizabeth Keating, T Parke
A man aged 33 years, born in Nepal, but resident in the UK for 7 years presented to the emergency department with a 4-day history of general malaise, fever (temperature 38.6°C) and a non-productive cough. His medical history was unremarkable and no high-risk behaviour was identified. Clinical examination confirmed decreased air entry bilaterally with bibasal crackles. He was tachycardic, with a heart rate of 120 bpm. Further investigation with a 12-lead ECG confirmed supraventricular tachycardia (SVT) which was terminated with vagal manoeuvres...
November 2, 2016: BMJ Case Reports
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