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https://www.readbyqxmd.com/read/28808863/warm-handoffs-a-novel-strategy-to-improve-end-of-rotation-care-transitions
#1
Harry S Saag, Jingjing Chen, Joshua L Denson, Simon Jones, Leora Horwitz, Patrick M Cocks
BACKGROUND: Hospitalized medical patients undergoing transition of care by house staff teams at the end of a ward rotation are associated with an increased risk of mortality, yet best practices surrounding this transition are lacking. AIM: To assess the impact of a warm handoff protocol for end-of-rotation care transitions. SETTING: A large, university-based internal medicine residency using three different training sites. PARTICIPANTS: PGY-2 and PGY-3 internal medicine residents...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28801218/urology-residents-experience-and-attitude-towards-surgical-simulation-presenting-our-four-year-experience-with-a-multi-institutional-multi-modality-simulation-model
#2
Alexander Chow, B Sherer, E Yura, S Kielb, E Kocjancic, S Eggener, T Turk, S Park, S Psutka, M Abern, K Latchamsetty, C Coogan
OBJECTIVE: To evaluate the Urological resident's attitude and experience with surgical simulation in residency education using a multi-institutional, multi-modality model. MATERIALS AND METHODS: Residents from six area urology training programs rotated through simulation stations in four consecutive sessions from 2014 to 2017. Workshops included GreenLight photovaporization of the prostate(PVP), ureteroscopic stone extraction, laparoscopic peg transfer, 3-dimensional laparoscopy rope pass, transobturator sling placement, intravesical injection, high definition video system trainer (VITOM), vasectomy, and Urolift...
August 8, 2017: Urology
https://www.readbyqxmd.com/read/28756968/fundamentals-of-laparoscopic-surgery-not-only-for-senior-residents
#3
Darren R Cullinan, Matthew R Schill, Angelia DeClue, Arghavan Salles, Paul E Wise, Michael M Awad
OBJECTIVE: Fundamentals of laparoscopic surgery (FLS) was developed by the Society of American Gastrointestinal and Endoscopic Surgeons to teach the physiology, fundamental knowledge, and technical skills required for basic laparoscopic surgery. We hypothesize that residents are doing more laparoscopic surgery earlier in residency, and therefore would benefit from an earlier assessment of basic laparoscopic skills. Here, we examine FLS test results and ACGME case logs to determine whether it is practical to administer FLS earlier in residency...
July 27, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28753833/training-research-and-working-conditions-for-urology-residents-in-germany-a-contemporary-survey
#4
Hendrik Borgmann, Hannah K Arnold, Christian P Meyer, Johannes Bründl, Justus König, Tim Nestler, Christian Ruf, Julian Struck, Johannes Salem
BACKGROUND: Excellent uniform training of urology residents is crucial to secure both high-quality patient care and the future of our specialty. Residency training has come under scrutiny following the demands of subspecialized care, economical aspects, and working hour regulations. OBJECTIVE: To comprehensively assess the surgical training, research opportunities, and working conditions among urology residents in Germany. DESIGN, SETTING, AND PARTICIPANTS: We sent a 29-item online survey via email to 721 members of the German Society of Residents in Urology...
December 16, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28731361/the-impact-of-teaching-prognostication-at-the-end-of-life-a-pre-post-interventional-study
#5
Alexandria Bear, Tucker Keuter, Jayshil J Patel
BACKGROUND: Providing accurate and valid prognostic information significantly influences end-of-life care. Disclosing a poor prognosis can be among the most difficult of physician responsibilities, thus having appropriate knowledge during training is crucial for appropriate prognostication. OBJECTIVE: To provide internal medicine (IM) house staff with a pre- and posteducational survey to determine their ability to accurately prognosticate 5 common end-stage diseases...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28726138/trainee-associated-outcomes-in-laparoscopic-colectomy-for-cancer-propensity-score-analysis-accounting-for-operative-time-procedure-complexity-and-patient-comorbidity
#6
Kevin R Kasten, Adam C Celio, Lauren Trakimas, Mark L Manwaring, Konstantinos Spaniolas
BACKGROUND: Surgical trainee association with operative outcomes is controversial. Studies are conflicting, possibly due to insufficient control of confounding variables such as operative time, case complexity, and heterogeneous patient populations. As operative complications worsen long-term outcomes in oncologic patients, understanding effect of trainee involvement during laparoscopic colectomy for cancer is of utmost importance. Here, we hypothesized that resident involvement was associated with worsened 30-day mortality and 30-day overall morbidity in this patient population...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28716300/the-effect-of-training-level-on-complications-after-free-flap-surgery-of-the-head-and-neck
#7
Jacob S Brady, Meghan M Crippen, Andrey Filimonov, Neil V Nadpara, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES: Analyze postoperative complications after free flap surgery based on PGY training level. METHODS: Data on free flap surgeries of the head and neck performed from 2005 to 2013 was collected from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Cases identifying the status of resident participation in the surgery and the PGY level were included. RESULTS: There were 582 cases with primary surgeon data available...
June 2, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28713525/orthopedic-in-training-examination-question-metrics-and-resident-test-performance
#8
John Mason DePasse, Jack Haglin, Adam E M Eltorai, Mary K Mulcahey, Craig P Eberson, Alan H Daniels
First administered in November 1963, the orthopedic in-training examination (OITE) is now distributed to more than 4000 residents in over 20 countries and has become important for evaluation of resident fund of knowledge. Several studies have assessed the effect of didactic programs on resident performance, but only recently has it become possible to assess detailed testtaking metrics such as time spent per question. Here, we report the first assessment of resident OITE performance utilizing this full electronic dataset from two large academic institutions...
June 23, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28698900/simulation-based-mastery-learning-for-endoscopy-using-the-endoscopy-training-system-a-strategy-to-improve-endoscopic-skills-and-prepare-for-the-fundamentals-of-endoscopic-surgery-fes-manual-skills-exam
#9
E Matthew Ritter, Zachary A Taylor, Kathryn R Wolf, Brenton R Franklin, Sarah B Placek, James R Korndorffer, Aimee K Gardner
INTRODUCTION: The fundamentals of endoscopic surgery (FES) program has considerable validity evidence for its use in measuring the knowledge, skills, and abilities required for competency in endoscopy. Beginning in 2018, the American Board of Surgery will require all candidates to have taken and passed the written and performance exams in the FES program. Recent work has shown that the current ACGME/ABS required case volume may not be enough to ensure trainees pass the FES skills exam...
July 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28685812/simulation-based-training-program-with-deliberate-practice-for-ultrasound-guided-jugular-central-venous-catheter-placement
#10
M A Corvetto, J C Pedemonte, D Varas, C Fuentes, F R Altermatt
BACKGROUND: Current evidence supports the utility of simulation training for bedside procedures such as ultrasound-guided jugular central venous catheter (CVC) insertion. However, a standardized methodology to teach procedural skills has not been determined yet. The aim of this study was to evaluate the effectiveness of a simulation-based training program for improving novice technical performance during ultrasound-guided internal jugular CVC placement. METHODS: Postgraduate year 1 (PGY-1) residents from anesthesiology, emergency medicine, cardiology, ICU, and nephrology specialties were trained in four deliberate practice sessions...
July 6, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28678134/protected-time-for-research-during-orthopaedic-residency-correlates-with-an-increased-number-of-resident-publications
#11
Benjamin R Williams, Julie A Agel, Ann E Van Heest
BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) requires orthopaedic residency programs to promote scholarship and research, which manifest differently among programs. We assess the impact of protected research time during orthopaedic residency on the number of resident publications. METHODS: Rotation schedules and resident names were collected from 125 ACGME-accredited U.S. orthopaedic residency programs. Protected research time was classified as 1 of 3 types: (1) block time, (2) longitudinal time, or (3) no dedicated time...
July 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28675639/prevalence-and-associations-of-psychological-distress-in-australian-junior-medical-officers
#12
Michelle W Lau, Wenlong Eric Li, Anthony Llewellyn, Allan M Cyna
AIMS: To determine the prevalence of psychological distress in Australian Junior Medical Officers (JMOs) and investigate the determinants associated with psychological distress over a three year (2014-2016) period. METHODS: JMOs were surveyed using the 2014-2016 JMO Census (n = 220, 399, and 466 each year, response rate approximately 15%). Levels of psychological distress were assessed using the Kessler Psychological Distress Scale (K10). A K10≥ 25 was chosen to indicate high psychological distress and this determinant was compared to various demographic and work-related factors...
July 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28673217/validity-evidence-of-non-technical-skills-assessment-instruments-in-simulated-anaesthesia-crisis-management
#13
T Jirativanont, K Raksamani, N Aroonpruksakul, P Apidechakul, S Suraseranivongse
We sought to evaluate the validity of two non-technical skills evaluation instruments, the Anaesthetists' Non-Technical Skills (ANTS) behavioural marker system and the Ottawa Global Rating Scale (GRS), to apply them to anaesthesia training. The content validity, response process, internal structure, relations with other variables and consequences were described for validity evidence. Simulated crisis management sessions were initiated during which two trained raters evaluated the performance of postgraduate first-, second- and third-year (PGY-1, PGY-2 and PGY-3) anaesthesia residents...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28666959/a-multicenter-prospective-comparison-of-the-accreditation-council-for-graduate-medical-education-milestones-clinical-competency-committee-vs-resident-self-assessment
#14
Ryan S Watson, Andrew J Borgert, Colette T O Heron, Kara J Kallies, Richard A Sidwell, John D Mellinger, Amit R Joshi, Joseph M Galante, Lowell W Chambers, Jon B Morris, Robert K Josloff, Marc L Melcher, George M Fuhrman, Kyla P Terhune, Lily Chang, Elizabeth M Ferguson, Edward D Auyang, Kevin R Patel, Benjamin T Jarman
OBJECTIVE: The Accreditation Council for Graduate Medical Education requires accredited residency programs to implement competency-based assessments of medical trainees based upon nationally established Milestones. Clinical competency committees (CCC) are required to prepare biannual reports using the Milestones and ensure reporting to the Accreditation Council for Graduate Medical Education. Previous research demonstrated a strong correlation between CCC and resident scores on the Milestones at 1 institution...
June 27, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28642083/colorectal-surgery-and-enhanced-recovery-impact-of-a-simulation-based-care-pathway-training-curriculum
#15
L Beyer-Berjot, P Pucher, V Patel, D A Hashimoto, P Ziprin, S Berdah, A Darzi, R Aggarwal
BACKGROUND: The aim was to determine whether a simulation-based care pathway approach (CPA) curriculum could improve compliance for enhanced recovery programs (ERP), and residents' participation in laparoscopic colorectal surgery (LCS). Indeed, trainee surgeons have limited access to LCS as primary operator, and ERP have improved patients' outcomes in colorectal surgery (CS). METHODS: All residents of our department were trained in a simulation-based CPA: perioperative training consisted in virtual patients built according to guidelines in both ERP and CS, whilst intraoperative training involved a virtual reality simulator curriculum...
June 19, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28640031/identifying-gaps-in-the-performance-of-pediatric-trainees-who-receive-marginal-unsatisfactory-ratings
#16
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/28638511/passing-a-technical-skills-examination-in-the-first-year-of-surgical-residency-can-predict-future-performance
#17
Sandra de Montbrun, Marisa Louridas, Teodor Grantcharov
BACKGROUND: The ability of an assessment to predict performance would be of major benefit to residency programs, allowing for early identification of residents at risk. OBJECTIVE: We sought to establish whether passing the Objective Structured Assessment of Technical Skills (OSATS) examination in postgraduate year 1 (PGY-1) predicts future performance. METHODS: Between 2002 and 2012, 133 PGY-1 surgery residents at the University of Toronto (Toronto, Ontario, Canada) completed an 8-station, simulated OSATS examination as a component of training...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28634517/introduction-of-a-quality-improvement-curriculum-in-the-department-of-internal-medicine-lincoln-medical-center
#18
Usha Venugopal, Moiz Kasubhai, Vikram Paruchuri
Community hospitals with limited resources struggle to engage physicians in Quality improvement initiatives. We introduced Quality Improvement (QI) curriculum for residents in response to ACGME requirements and surveyed the residents understanding of QI and their involvement in QI projects before and after the introduction of the curriculum. The current article describes our experiences with the process, the challenges and possible solutions to have a successful resident led QI initiative in a community hospital...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28632564/accuracy-of-percutaneous-pedicle-screw-placement-does-training-level-matter
#19
Evan O Baird, Steven J McAnany, Samuel Overley, Branko Skovrlj, Javier Z Guzman, Sheeraz A Qureshi
STUDY DESIGN: In vitro human cadaveric surgical technique study. OBJECTIVE: To assess the accuracy of percutaneous pedicle screw placement in a human cadaveric model using standard fluoroscopic guidance technique, compared across varying levels of experience. SUMMARY OF BACKGROUND DATA: The current literature varies widely in the reported frequency of facet violation during placement of percutaneous pedicle screws. However, as of yet there are no studies examining the effect that training level has on accuracy of placement...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28627415/examination-to-assess-the-clinical-exam-and-documentation-of-spine-pathology-among-orthopaedic-residents
#20
Jack M Haglin, John L Zeller, Kenneth A Egol, Donna P Phillips
BACKGROUND: The Accreditation Council of Graduate Medical Education (ACGME) guidelines require residency programs to teach and evaluate residents in six overarching "core competencies" and document progress through educational milestones. In order to assess the progress of orthopaedic interns' skills in performing a history, physical exam, and documentation of the encounter for a standardized patient with spinal stenosis, a Structured Objective Clinical Examination (OSCE) was conducted for 13 orthopaedic intern residents, following a one month boot camp that included communications skills and curriculum in history and physical examination...
June 13, 2017: Spine Journal: Official Journal of the North American Spine Society
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