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https://www.readbyqxmd.com/read/28711345/working-at-the-intersection-of-context-culture-and-technology-provider-perspectives-on-antimicrobial-stewardship-in-the-emergency-department-using-electronic-health-record-clinical-decision-support
#1
Phillip Chung, Jean Scandlyn, Peter S Dayan, Rakesh D Mistry
BACKGROUND: Antibiotic stewardship programs (ASPs) have not been fully developed for the emergency department (ED), in part the result of the barriers characteristic of this setting. Electronic health record-based clinical decision support (EHR CDS) represents a promising strategy to implement ASPs in the ED. We aimed to determine the cultural beliefs and structural barriers and facilitators to implementation of antimicrobial stewardship in the pediatric ED using EHR CDS. METHODS: Interviews and focus groups were conducted with hospital and ED leadership, attending ED physicians, nurse practitioners, physician assistants, and residents at a single health system in Colorado...
July 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28708273/pediatric-obesity-related-curricular-content-and-training-in-dental-schools-and-dental-hygiene-programs-systematic-review-and-recommendations
#2
Kimon Divaris, Vaishnavi Bhaskar, Kathleen A McGraw
OBJECTIVES: The authors conducted a systematic review to determine: a) What dental schools and dental hygiene programs are doing to promote knowledge and skills related to addressing childhood obesity and to reduce consumption of sugar-sweetened beverages (SSBs) and b) What else these schools and programs could do to better equip future oral health professionals to address childhood obesity and reduce consumption of SSBs. METHODS: The authors searched PubMed, Scopus, Education Full Text (EBSCOHost), and ERIC (EBSCOHost) to identify peer-reviewed publications reporting on obesity or dietetic-related curricula in dental and dental hygiene education within the last 20 years...
July 14, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28702307/childhood-pneumonia-and-meningitis-in-the-eastern-highlands-province-papua-new-guinea-in-the-era-of-conjugate-vaccines-study-methods-and-challenges
#3
Christopher C Blyth, Rebecca Ford, Joycelyn Sapura, Tonny Kumani, Geraldine Masiria, John Kave, Lapule Yuasi, Andrew Greenhill, Ilomo Hwaihwanje, Amanda Lang, Deborah Lehmann, William Pomat
BACKGROUND: Pneumonia and meningitis are common causes of severe childhood illness in Papua New Guinea (PNG). The etiology of both clinical conditions in PNG has not been recently assessed. Changes in lifestyle, provision and access to healthcare, antimicrobial utilization and resistance, and the national childhood vaccination schedule necessitate reassessment. METHODS: A prospective case-control study was undertaken, enrolling children <5 years of age to determine the contemporary etiology of clinically defined moderate or severe pneumonia or suspected meningitis...
2017: Pneumonia
https://www.readbyqxmd.com/read/28700460/a-novel-pediatric-residency-coaching-program-outcomes-after-one-year
#4
Caroline E Rassbach, Rebecca Blankenburg
PROBLEM: The ACGME requires all residency programs to assess residents on specialty-specific milestones. Optimal assessment of competence is through direct observation of performance in clinical settings, which is challenging to implement. APPROACH: The authors developed the Stanford Pediatric Residency Coaching Program to improve residents' clinical skill development, reflective practice, feedback, and goal setting, and to improve learner assessment. All residents are assigned a dedicated faculty coach who coaches them throughout their training in various settings in an iterative process...
July 11, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28690941/a-simulation-based-quality-improvement-approach-to-improve-pediatric-resident-competency-with-required-procedures
#5
Michelle Starr, Taylor Sawyer, Maya Jones, Maneesh Batra, Heather McPhillips
INTRODUCTION: Pediatric residents report a lack of confidence and competence with procedural skills at graduation. Training programs could benefit from improved approaches to target these needs. Using the Institute for Healthcare Improvement (IHI) Model for Improvement and three Plan-Do-Study-Act (PDSA) cycles, we examined the impact of a procedure simulation boot camp on self-reported procedural confidence and competence as well as the longitudinal impacts of these sequential interventions on Accreditation Council for Graduate Medical Education (ACGME) Graduating Resident Survey (GRS) results...
June 3, 2017: Curēus
https://www.readbyqxmd.com/read/28688664/a-novel-flight-surgeon-training-model-at-a-joint-military-and-civilian-surgical-residency-program
#6
Erik S DeSoucy, Scott A Zakaluzny, Joseph M Galante
BACKGROUND: Graduating military preliminary interns are often required to fill flight surgeon billets. General surgery preliminary interns get experience evaluating surgical and trauma patients, but receive very little training in primary care and flight medicine. At a joint military and civilian training program, we developed a supplemental curriculum to help transition our interns into flight medicine. METHODS: From 2013 to 2016, we developed a lecture series focused on aerospace medicine, primary care, and specialty topics including dermatology, ophthalmology, orthopedics, pediatrics, psychiatry, and women's health...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28669648/-teaching-pediatrics-to-residents-via-conventional-lectures-in-france-a-national-survey-from-students
#7
B Girard, M Bendavid, J-C Faivre, J Salleron, T Debillon, O Claris, B Chabrol, C Schweitzer, V Gajdos
OBJECTIVE: To assess the point of view of young physicians training in pediatrics in France on their theoretical courses during residency. METHODS: A free-access electronic anonymous survey was sent three times by e-mail to the 1215 residents in pediatrics, from July to October 2015. RESULTS: Fifty-seven percent of French residents in pediatrics responded to the survey. It was established that they took part in six (range, 3-10) half-days of specific theoretical teaching in pediatrics from November 2014 to mid-April 2015...
June 29, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28668724/integrating-education-and-service-in-pediatric-residency-training-results-of-a-national-survey
#8
Jennifer C Kesselheim, Alan Schwartz, Debra Boyer
OBJECTIVES: The definition and proper role of service, as it relates to education, in the residency training experience has been long debated. This study aimed to develop definitions for service and education, delineate how each are perceived to contribute value to training, and to measure respondents' ratings of service and education using case vignettes. METHODS: We conducted a multi-site cohort survey study of pediatric residents (N=797) and program directors' (N=37) using a region-stratified sample of 2-3 participating pediatric residency programs per region...
June 28, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28665808/disparities-in-access-to-pediatric-hearing-health-care
#9
Matthew L Bush, Michael R Kaufman, Beth N McNulty
PURPOSE OF REVIEW: There are significant disparities in care facing children with hearing loss. The objective of this review is to assess the current disparities in pediatric hearing healthcare delivery, describe the barriers of efficient and effective pediatric hearing health care, and explore the innovations to improve pediatric hearing healthcare delivery. RECENT FINDINGS: Children with hearing loss from certain geographic regions or ethnic background are significantly delayed in diagnosis and treatment...
June 29, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28647929/vitamin-d-status-among-israeli-medical-residents
#10
Hadar Moran-Lev, Dror Mandel, Yosef Weisman, Amit Ovental, Ronit Lubetzky
BACKGROUND: Israel is a country with a sunny climate; however, vitamin D deficiency and insufficiency are common findings in certain populations whose exposure to sunlight is limited. Medical residency is known for long indoor working hours, thus theoretically limiting the opportunities for sun exposure. OBJECTIVES: To evaluate whether the vitamin D status among residents in a single medical center in Tel Aviv is below the normal range. METHODS: Forty-six residents (28 females, 18 males, average age 33...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28647048/-resident-as-teacher-in-pediatric-surgery-innovation-is-overdue-in-central-europe
#11
REVIEW
S Zundel, M Stocker, P Szavay
PURPOSE: We set out to evaluate how residents in pediatric surgery learn and how they teach. We hypnotized that European residents learn as much from their peers and teach as much as their fellows worldwide, but that they receive comparably less educational training. METHODS: An online questionnaire was distributed to the participants of the combined annual meeting for German, Swiss and Austrian residents in pediatric surgery. Participants were asked whom they learn from in different workplace environments (ward, operating room, emergency department), how, when and why they adopt the role of teacher and how they were prepared for this role...
June 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28640031/identifying-gaps-in-the-performance-of-pediatric-trainees-who-receive-marginal-unsatisfactory-ratings
#12
Su-Ting T Li, Daniel J Tancredi, Alan Schwartz, Ann Guillot, Ann Burke, R Franklin Trimm, Susan Guralnick, John D Mahan, Kimberly A Gifford
PURPOSE: To perform a derivation study to determine in which subcompetencies marginal/unsatisfactory pediatric residents had the greatest deficits compared with their satisfactorily performing peers and which subcompetencies best discriminated between marginal/unsatisfactory and satisfactorily performing residents. METHOD: Multi-institutional cohort study of all 21 milestones (rated on four or five levels) reported to the Accreditation Council for Graduate Medical Education, and global marginal/unsatisfactory versus satisfactory performance reported to the American Board of Pediatrics...
June 20, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28638518/automated-reporting-of-trainee-metrics-using-electronic-clinical-systems
#13
Jonathan C Levin, Jonathan Hron
BACKGROUND: The Accreditation Council for Graduate Medical Education has called for increased emphasis on reporting objective performance measures to trainees and programs. However, reporting of objective measures, including clinical volume, is largely omitted from training programs. OBJECTIVE: To use automated electronic medical systems at a tertiary pediatric care hospital to create a dashboard that reports objective trainee and program metrics, including clinical volume and diagnoses in a pediatrics residency...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28638509/resident-experiences-with-implementation-of-the-i-pass-handoff-bundle
#14
Maitreya Coffey, Kelly Thomson, Shelly-Anne Li, Zia Bismilla, Amy J Starmer, Jennifer K O'Toole, Rebecca L Blankenburg, Glenn Rosenbluth, F Sessions Cole, Clifton E Yu, Jennifer H Hepps, Theodore C Sectish, Nancy D Spector, Rajendu Srivastava, April D Allen, Sanjay Mahant, Christopher P Landrigan
BACKGROUND: The I-PASS Handoff Study found that introduction of a handoff bundle (handoff and teamwork training for residents, a mnemonic, a handoff tool, a faculty development program, and a sustainability campaign) at 9 pediatrics residency programs was associated with improved communication and patient safety. OBJECTIVE: This parallel qualitative study aimed to understand resident experiences with I-PASS and to inform future implementation and sustainability strategies...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28629684/united-states-medical-licensing-examination-and-american-board-of-pediatrics-certification-examination-results-does-the-residency-program-contribute-to-trainee-achievement
#15
Thomas R Welch, Brad G Olson, Elizabeth Nelsen, Gary L Beck Dallaghan, Gloria A Kennedy, Ann Botash
OBJECTIVE: To determine whether training site or prior examinee performance on the US Medical Licensing Examination (USMLE) step 1 and step 2 might predict pass rates on the American Board of Pediatrics (ABP) certifying examination. STUDY DESIGN: Data from graduates of pediatric residency programs completing the ABP certifying examination between 2009 and 2013 were obtained. For each, results of the initial ABP certifying examination were obtained, as well as results on National Board of Medical Examiners (NBME) step 1 and step 2 examinations...
June 16, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28599029/transition-consultation-models-in-two-academic-medical-centers
#16
Jessica I Gold, Rebecca Boudos, Parag Shah, Rita Rossi-Foulkes
Health care transition (HCT), the organized progression from pediatric- to adult-focused models of care, is crucial for patients with chronic childhood conditions. More adolescents with chronic conditions now survive into adulthood and have increased risk of adverse events during HCT. Got Transition-an agreement between the Maternal and Child Health Bureau and the National Alliance to Advance Adolescent Health-developed the Six Core Elements of Health Care Transition 2.0, defining the components of HCT. Most HCT programs incorporate these elements, but delivery varies...
June 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28598494/decreased-radiation-exposure-among-orthopedic-residents-is-maintained-when-using-the-mini-c-arm-after-undergoing-radiation-safety-training
#17
David Gendelberg, William L Hennrikus, Carissa Sawyer, Douglas Armstrong, Steven King
The resident curriculum of the American Board of Orthopaedic Surgery emphasizes radiation safety. Gendelberg showed that, immediately after a program on fluoroscopic safety, residents used less radiation when using the mini C-arm to reduce pediatric fractures. The current study evaluated whether this effect lasted. Residents underwent a new annual 3-hour session on mini C-arm use and radiation. Group A included 53 reductions performed before training. Group B included 45 reductions performed immediately after training...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28590563/a-multi-state-initiative-to-implement-pediatric-oral-health-in-primary-care-practice-and-clinical-education
#18
Hugh Silk, Ellen Sachs Leicher, Veronica Alvarado, Elizabeth Cote, Susan Cote
OBJECTIVES: To implement and study the effect of improving pediatric oral health by training primary care practices and training programs. METHOD: In six New England States, primary care practices and clinical training programs (medical schools, residencies, physician assistant programs) were recruited and trained to incorporate pediatric oral health into medical practice. We measured the results of varying practice recruitment approaches and measured training outcomes based on self-reported implementation and state reported EPSDT CMS oral health claims...
June 7, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28583702/barriers-to-genetic-testing-for-pediatric-medicaid-beneficiaries-with-epilepsy
#19
Eric J Kutscher, Sucheta M Joshi, Anup D Patel, Baria Hafeez, Zachary M Grinspan
BACKGROUND: Children with public insurance (Medicaid) have increased barriers to specialty care in the United States. For children with epilepsy, the relationship between public insurance and barriers to genetic testing is understudied. METHODS: We surveyed a sample of US child neurology clinicians. We performed quantitative and qualitative analysis of responses. RESULTS: There were 302 responses (of 1982 surveyed; response rate 15%) from clinicians from 46 states, the District of Columbia, and Puerto Rico, including board-certified child neurologists (82%), resident physicians (6%), nurses (3%), and nurse practitioners (3%)...
April 20, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28583426/studying-behaviors-among-neurosurgery-residents-using-web-2-0-analytic-tools
#20
Benjamin Davidson, Naif M Alotaibi, Daipayan Guha, Sandi Amaral, Abhaya V Kulkarni, Andres M Lozano
BACKGROUND: Web 2.0 technologies (e.g., blogs, social networks, and wikis) are increasingly being used by medical schools and postgraduate training programs as tools for information dissemination. These technologies offer the unique opportunity to track metrics of user engagement and interaction. Here, we employ Web 2.0 tools to assess academic behaviors among neurosurgery residents. METHODS: We performed a retrospective review of all educational lectures, part of the core Neurosurgery Residency curriculum at the University of Toronto, posted on our teaching website (www...
June 2, 2017: Journal of Surgical Education
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