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https://www.readbyqxmd.com/read/28329124/sleep-and-alertness-in-medical-interns-and-residents-an-observational-study-on-the-role-of-extended-shifts
#1
Mathias Basner, David F Dinges, Judy A Shea, Dylan S Small, Jingsan Zhu, Laurie Norton, Adrian J Ecker, Cristina Novak, Lisa M Bellini, Kevin G Volpp
Study Objectives: Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Methods: Sleep-wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy...
February 24, 2017: Sleep
https://www.readbyqxmd.com/read/28328640/we-are-going-to-name-names-and-call-you-out-improving-the-team-in-the-academic-operating-room-environment
#2
Richard Bodor, Brian J Nguyen, Kevin Broder
INTRODUCTION: Communication failures between multidisciplinary teams can impact efficiency, performance, and morale. Academic operating rooms (ORs) often have surgical, anesthesia, and nursing teams, each teaching multiple trainees. Incorrectly identifying name and "rank" (postgraduate year [PGY]) of resident trainees can disrupt performance evaluations and team morale and even potentially impair delivery of quality care when miscommunication errors proliferate. METHODS: Our OR-based survey asked 50 participants (18 surgeons, 14 anesthesiologists, and 18 nursing members), to recall basic identification data including provider names and PGY levels from their recent collaborating OR teams...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28327273/factors-affecting-orthopedic-residency-selection-a-cross-sectional-survey
#3
Jason Strelzow, Robert Petretta, Henry M Broekhuyse
BACKGROUND: Annually, orthopedic residency programs rank and recruit the best possible candidates. Little evidence exists identifying factors that potential candidates use to select their career paths. Recent literature from nonsurgical programs suggests hospital, social and program-based factors influence program selection. We sought to determine what factors influence the choice of an orthopedic career and a candidate's choice of orthopedic residency program. METHODS: We surveyed medical student applicants to orthopedic programs and current Canadian orthopedic surgery residents (postgraduate year [PGY] 1-5)...
April 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28281477/impact-of-seniority-on-operative-time-and-short-term-outcome-in-laparoscopic-cholecystectomy-experience-of-an-academic-surgical-department-in-a-developing-country
#4
Amine Souadka, Mohammed Sayed Naya, Badr Serji, Hadj Omar El Malki, Raouf Mohsine, Lahsen Ifrine, Abdelkader Belkouchi, Amine Benkabbou
INTRODUCTION: Resident participation in laparoscopic cholecystectomy (LC) is one of the first steps of laparoscopic training. The impact of this training is not well-defined, especially in developing countries. However, this training is of critical importance to monitor surgical teaching programmes. OBJECTIVE: The aim of this study was to determine the impact of seniority on operative time and short-term outcome of LC. DESIGNS AND SETTINGS: We performed a retrospective study of all consecutive laparoscopic cholecystectomies for gallbladder lithiasis performed over 2 academic years in an academic Surgical Department in Morocco...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28261404/using-the-electronic-health-record-to-identify-educational-gaps-for-internal-medicine-interns
#5
Alvin Rajkomar, Sumant R Ranji, Bradley Sharpe
BACKGROUND : An important component of internal medicine residency is clinical immersion in core rotations to expose first-year residents to common diagnoses. OBJECTIVE : Quantify intern experience with common diagnoses through clinical documentation in an electronic health record. METHODS : We analyzed all clinical notes written by postgraduate year (PGY) 1, PGY-2, and PGY-3 residents on medicine service at an academic medical center July 1, 2012, through June 30, 2014...
February 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28261399/validity-and-reliability-of-a-tool-to-assess-quality-improvement-knowledge-and-skills-in-pediatrics-residents
#6
Stephanie K Doupnik, Sonja I Ziniel, Eric W Glissmeyer, James M Moses
BACKGROUND : Residency programs are expected to educate residents in quality improvement (QI). Effective assessments are needed to ensure residents gain QI knowledge and skills. Limitations of current tools include poor interrater reliability and requirement for scorer training. OBJECTIVE : To provide evidence for the validity of the Assessment of Quality Improvement Knowledge and Skills (AQIKS), which is a new tool that provides a summative assessment of pediatrics residents' ability to recall QI concepts and apply them to a clinical scenario...
February 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28261393/examining-the-functioning-and-reliability-of-the-family-medicine-milestones
#7
Michael R Peabody, Thomas R O'Neill, Lars E Peterson
BACKGROUND : The Family Medicine (FM) Milestones are a framework designed to assess development of residents in key dimensions of physician competency. Residency programs use the milestones in semiannual reviews of resident performance from entry toward graduation. OBJECTIVE : To examine the functioning and reliability of the FM Milestones and to determine whether they measure the amount of a latent trait (eg, knowledge or ability) possessed by a resident or simply indicate where a resident falls along the training sequence...
February 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28259204/perioperative-self-reflection-among-surgical-residents
#8
Andi N Peshkepija, Marc D Basson, Alan T Davis, Muhammad Ali, Pam S Haan, Rama N Gupta, John C Hardaway, Cody A Nebeker, Michael K McLeod, Robert L Osmer, Cheryl I Anderson
BACKGROUND: We studied prevalence and predictors of meaningful self-reflection among surgical residents and with prompting/structured interventions, sought to improve/sustain resident skills. METHODS: Residents from six programs recorded 1032 narrative self-reflective comments (120 residents), using a web-based platform. If residents identified something learned or to be improved, self-reflection was deemed meaningful. Independent variables PGY level, resident/surgeon gender, study site/Phase1: July2014-August2015 vs...
December 23, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28244929/can-a-novel-low-cost-simulation-model-be-used-to-teach-anterior-cruciate-ligament-graft-preparation
#9
Christopher M Brusalis, John Todd R Lawrence, Sheena C Ranade, Joy C Kerr, Nicholas Pulos, Lawrence Wells, Theodore J Ganley
BACKGROUND: This study evaluated an anterior cruciate ligament (ACL) graft preparation simulation learning model for use by orthopaedic surgery trainees. METHODS: A simulation model for ACL graft preparation was constructed using shoelace as graft material and a wooden graft preparation board that matched the dimensions of existing products. A 12-minute instructional video targeted at novice learners was created to accompany the simulation model. A prospective randomized controlled trial was conducted on orthopaedic surgery residents divided into 2 groups with equal distributions of postgraduate year (PGY) status...
February 27, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28236930/an-intensive-vascular-surgical-skills-and-simulation-course-for-vascular-trainees-improves-procedural-knowledge-and-self-rated-procedural-competence
#10
William P Robinson, Danielle R Doucet, Jessica P Simons, Allison Wyman, Francesco A Aiello, Elias Arous, Andres Schanzer, Louis M Messina
BACKGROUND: Surgical skills and simulation courses are emerging to meet the demand for vascular simulation training for vascular surgical skills, but their educational effect has not yet been described. We sought to determine the effect of an intensive vascular surgical skills and simulation course on the procedural knowledge and self-rated procedural competence of vascular trainees and to assess participant feedback regarding the course. METHODS: Participants underwent a 1...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28228339/the-effect-on-reliability-and-sensitivity-to-level-of-training-of-combining-analytic-and-holistic-rating-scales-for-assessing-communication-skills-in-an-internal-medicine-resident-osce
#11
Vijay John Daniels, Dwight Harley
OBJECTIVE: Although previous research has compared checklists to rating scales for assessing communication, the purpose of this study was to compare the effect on reliability and sensitivity to level of training of an analytic, a holistic, and a combined analytic-holistic rating scale in assessing communication skills. METHODS: The University of Alberta Internal Medicine Residency runs OSCEs for postgraduate year (PGY) 1 and 2 residents and another for PGY-4 residents...
February 14, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28199127/development-of-rad-score-a-tool-to-assess-the-procedural-competence-of-diagnostic-radiology-residents
#12
Inga Isupov, Matthew D F McInnes, Stan J Hamstra, Geoffrey Doherty, Ashish Gupta, Susan Peddle, Zaid Jibri, Kawan Rakhra, Rebecca M Hibbert
OBJECTIVE: The purpose of this study is to develop a tool to assess the procedural competence of radiology trainees, with sources of evidence gathered from five categories to support the construct validity of tool: content, response process, internal structure, relations to other variables, and consequences. SUBJECTS AND METHODS: A pilot form for assessing procedural competence among radiology residents, known as the RAD-Score tool, was developed by evaluating published literature and using a modified Delphi procedure involving a group of local content experts...
April 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28190366/predictors-of-remote-practice-location-in-the-first-seven-cohorts-of-james-cook-university-mbbs-graduates
#13
Torres Woolley, Tarun Sen Gupta, Maria Bellei
INTRODUCTION: This article describes factors predicting James Cook University (JCU) medical graduates undertaking at least 1 year of remote practice. The cross-sectional design involved point-in-time (2015) analysis of the JCU medical school's ongoing longitudinal graduate tracking database. Participants were the first seven cohorts of graduates from the JCU medical school who had completed at least their postgraduate year (PGY) 4 in Australia (<i>n</i>=529); that is, PGY 4 to PGY 10 graduates...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28178728/advanced-choice-employment-ace-factors-influencing-pgy-1-workplace-selection-and-future-career-intentions-of-a-cohort-of-doctors-in-waikato
#14
Helen Clark, Wayne de Beer, Veronique Gibbons
AIM: To assess whether or not a sample of PGY-1 doctors in the Waikato region remained satisfied with the ACE system for employment 12 years after its inception. METHOD: An anonymous paper-based survey was completed by a cohort (n=60) of 2015 and 2016 PGY-1 doctors based at the Waikato DHB. Questions were based around reasons for selecting the DHB, satisfaction with the ACE process and future career intentions. RESULTS: Overall satisfaction with the ACE selection process was reasonable (63%)...
January 27, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28153385/video-review-as-a-tool-to-improve-orthopedic-residents-performance-of-closed-manipulative-reductions
#15
Nickul S Jain, Ran Schwarzkopf, John A Scolaro
OBJECTIVE: Orthopedic residents commonly perform closed manipulative reductions as a part of their training. Traditionally, this skill is taught early in training but difficult to simulate. Proficiency is achieved through repetition and experience; faculty observation and instruction is unfortunately often limited. Direct resident teaching has been shown to increase competency, comfort, and long-term skill retention. We hypothesize that video review of closed fracture reductions will provide an inexpensive and valuable tool for resident education and improve skill performance...
January 30, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28145736/central-line-proficiency-test-outcomes-after-simulation-training-vs-traditional-training-to-competence
#16
Ali A Alsaad, Vandana Y Bhide, Jimmy L Moss, Scott M Silvers, Margaret M Johnson, Michael J Maniaci
RATIONALE: Studies have shown the importance of simulation-based training on the outcomes of central venous catheter (CVC) insertion by trainees. OBJECTIVES: To compare the performance of internal medicine trainees who underwent standardized simulation training of CVC insertion to that of internal medicine trainees who had traditional CVC training and were already deemed competent to perform the procedure during a proficiency evaluation using a training mannequin...
February 1, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28139201/do-female-surgeons-learn-or-teach-differently
#17
Cody A Nebeker, Marc D Basson, Pam S Haan, Alan T Davis, Muhammad Ali, Rama N Gupta, Robert L Osmer, John C Hardaway, Andi N Peshkepija, Michael K McLeod, Cheryl I Anderson
BACKGROUND: Gender and/or gender-stereotypes might influence surgical education. We hypothesized that female surgeons might focus their learning and teaching differently from male surgeons. METHODS: Residents and surgeons (multi-institutional) individually recorded preoperatively discussed learning objectives (LO) for matching cases. Narratives were classified as knowledge-based, skill-based, or attitude-based. Multinomial logistic regression analyses, LO = dependent variable; independent variables = resident/surgeon gender, PGY level, timing of entry-to-procedure date, and quarters-of-year...
February 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28116012/are-all-competencies-equal-in-the-eyes-of-residents-a-multicenter-study-of-emergency-medicine-residents-interest-in-feedback
#18
Suzanne Bentley, Kevin Hu, Anne Messman, Tiffany Moadel, Sorabh Khandelwal, Heather Streich, Joan Noelker
INTRODUCTION: Feedback, particularly real-time feedback, is critical to resident education. The emergency medicine (EM) milestones were developed in 2012 to enhance resident assessment, and many programs use them to provide focused resident feedback. The purpose of this study was to evaluate EM residents' level of interest in receiving real-time feedback on each of the 23 competencies/sub-competencies. METHODS: This was a multicenter cross-sectional study of EM residents...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28110994/modeling-hourly-resident-productivity-in-the-emergency-department
#19
Joshua W Joseph, Daniel J Henning, Connie S Strouse, David T Chiu, Larry A Nathanson, Leon D Sanchez
STUDY OBJECTIVE: Resident productivity, defined as new patients per hour, carries important implications for emergency department operations. In high-volume academic centers, essential staffing decisions can be made on the assumption that residents see patients at a static rate. However, it is unclear whether this model mirrors reality; previous studies have not rigorously examined whether productivity changes over time. We examine residents' productivity across shifts to determine whether it remained consistent...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28095816/awareness-and-knowledge-among-internal-medicine-house-staff-for-dose-adjustment-of-commonly-used-medications-in-patients-with-ckd
#20
Sikander Surana, Neeru Kumar, Amita Vasudeva, Gulvahid Shaikh, Kenar D Jhaveri, Hitesh Shah, Deepa Malieckal, Joshua Fogel, Gurwinder Sidhu, Sofia Rubinstein
BACKGROUND: Drug dosing errors result in adverse patient outcomes and are more common in patients with chronic kidney disease (CKD). As internists treat the majority of patients with CKD, we study if Internal Medicine house-staff have awareness and knowledge about the correct dosage of commonly used medications for those with CKD. METHODS: A cross-sectional survey was performed and included 341 participants. The outcomes were the awareness of whether a medication needs dose adjustment in patients with CKD and whether there was knowledge for the level of glomerular filtration rate (GFR) a medication needs to be adjusted...
January 17, 2017: BMC Nephrology
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