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https://www.readbyqxmd.com/read/28439354/residents-procedural-experience-does-not-ensure-competence-a-research-synthesis
#1
Jeffrey H Barsuk, Elaine R Cohen, Joe Feinglass, William C McGaghie, Diane B Wayne
BACKGROUND: Many medical certifying bodies require that a minimum number of clinical procedures be completed during residency training to obtain board eligibility. However, little is known about the relationship between the number of procedures residents perform and their clinical competence. OBJECTIVE: This study evaluated associations between residents' medical procedure skills measured in a simulation laboratory and self-reported procedure experience and year of training...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28431420/generative-retrieval-improves-learning-and-retention-of-cardiac-anatomy-using-transesophageal-echocardiography
#2
Amanda M Kleiman, Katherine T Forkin, Allison J Bechtel, Stephen R Collins, Jennie Z Ma, Edward C Nemergut, Julie L Huffmyer
BACKGROUND: Transesophageal echocardiography (TEE) is a valuable monitor for patients undergoing cardiac and noncardiac surgery as it allows for evaluation of cardiovascular compromise in the perioperative period. It is challenging for anesthesiology residents and medical students to learn to use and interpret TEE in the clinical environment. A critical component of learning to use and interpret TEE is a strong grasp of normal cardiovascular ultrasound anatomy. METHODS: Fifteen fourth-year medical students and 15 post-graduate year (PGY) 1 and 2 anesthesiology residents without prior training in cardiac anesthesia or TEE viewed normal cardiovascular anatomy TEE video clips; participants were randomized to learning cardiac anatomy in generative retrieval (GR) and standard practice (SP) groups...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28419618/correspondence-response-to-letter-to-the-editor-ultrasound-assisted-lumbar-puncture-on-infants-in-the-pediatric-emergency-department
#3
Michael Gorn
We would like to thank our reader for his/her interest in our work and continuing support of point-of-care ultrasound in pediatric emergency medicine. Our study was conducted at a large academic emergency department with pediatrics and emergency medicine residents, nurse practitioners who function at or above the level of a senior resident (PGY-3 and 4), and pediatric emergency fellows who function as attending physicians. As a routine, all initial lumbar puncture (LP) attempts are made by learners. This article is protected by copyright...
April 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28408272/successful-management-of-a-neck-hematoma-following-simulation-training
#4
Marie-Ève Bélanger, Issam Tanoubi, Mihai Georgescu, Roger Perron, Arnaud Robitaille, Marie-Pierre Charron, Pierre Drolet
Simulation-based education is gaining widespread acceptance in many medical specialties as an effective method to teach technical and non-technical skills. The ultimate goal of simulation is to improve health care and patient safety. Boet et al. [1] published a review on simulation-based crisis resources management (CRM) teaching, looking for evidence that it can lead to improved workplace practices and patient safety. Amongst hundreds of studies pertaining to CRM, he found only nine that were relevant, and only one that showed reduced mortality...
April 10, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28403004/the-hidden-value-of-narrative-comments-for-assessment-a-quantitative-reliability-analysis-of-qualitative-data
#5
Shiphra Ginsburg, Cees P M van der Vleuten, Kevin W Eva
PURPOSE: In-training evaluation reports (ITERs) are ubiquitous in internal medicine (IM) residency. Written comments can provide a rich data source, yet are often overlooked. This study determined the reliability of using variable amounts of commentary to discriminate between residents. METHOD: ITER comments from two cohorts of PGY-1s in IM at the University of Toronto (graduating 2010 and 2011; n = 46-48) were put into sets containing 15 to 16 residents. Parallel sets were created: one with comments from the full year and one with comments from only the first three assessments...
April 11, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28378619/analysis-of-pgy-1-pharmacy-resident-candidate-letters-of-recommendation-at-an-academically-affiliated-residency-program
#6
Milena M McLaughlin, Dalila Masic, Jacob P Gettig
BACKGROUND: Letters of recommendation (LORs) are a critical component for differentiating among similarly qualified pharmacy residency candidates. These letters contain information that is difficult to ascertain from curricula vitae and pharmacy school transcripts. LOR writers may use any words or phrases appropriate for each candidate as there is no set framework for LORs. OBJECTIVE: The objective of this study was to characterize descriptive themes in postgraduate year 1 (PGY-1) pharmacy residency candidates' LORs and to examine which themes of PGY-1 pharmacy residency candidates' LORs are predictive of an interview invitation at an academically affiliated residency program...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28378154/plant-derived-phosphocholine-facilitates-cellular-uptake-of-anti-pulmonary-fibrotic-hjt-srna-m7
#7
Jianchao Du, Zhu Liang, Jiantao Xu, Yan Zhao, Xiaoyun Li, Yanli Zhang, Dandan Zhao, Ruxuan Chen, Yang Liu, Trupti Joshi, Jiahui Chang, Zhiqing Wang, Yanxu Zhang, Jindong Zhu, Qiang Liu, Dong Xu, Chengyu Jiang
Pulmonary fibrosis, a progressive chronic disease with a high mortality rate, has limited treatment options. Currently, lung transplantation remains the only effective treatment. Here we report that a small RNA, HJT-sRNA-m7, from a Chinese herbal medicine Hong Jing Tian (HJT, Rhodiola crenulata can effectively reduce the expressions of fibrotic hallmark genes and proteins both in alveolar in vitro and in mouse lung tissues in vivo. We also discovered over one hundred oil-soluble chemicals from HJT decoctions, most of which are found in lipid extracts from other Chinese herbals decoctions, including Pu Gong Ying (PGY, Taraxacum mongolicum), Chuan Xin Lian (CXL, Andrographis paniculata), and Jin Yin Hua (JYH, lonicera japonica or Honeysuckle)...
March 31, 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28376020/head-camera-video-recordings-of-trauma-core-competency-procedures-can-evaluate-surgical-resident-s-technical-performance-as-well-as-co-located-evaluators
#8
Colin F Mackenzie, Jason Pasley, Evan Garofalo, Stacy Shackelford, Hegang Chen, Nyaradzo Longinaker, Guinevere Granite, Kristy Pugh, George Hagegeorge, Samuel A Tisherman
BACKGROUND: Unbiased evaluation of trauma core competency procedures is necessary to determine if residency and pre-deployment training courses are useful. We tested whether a previously validated Individual Procedure Score (IPS) for individual procedure vascular exposure and fasciotomy (FAS) performance skills, could discriminate training status, by comparing IPS of evaluators co-located with surgeons to blind video evaluations. METHODS: Performance of axillary (AA), brachial (BA) and femoral artery (FA) vascular exposures and lower extremity FAS on fresh cadavers by 40 PGY 2-6 residents was video recorded from head- mounted cameras...
April 4, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28374350/teaching-the-basics-development-and-validation-of-a-distal-radius-reduction-and-casting-model
#9
Mark A Seeley, Peter D Fabricant, J Todd R Lawrence
BACKGROUND: Approximately one-third of reduced pediatric distal radius fractures redisplace, resulting in further treatment. Two major modifiable risk factors for loss of reduction are reduction adequacy and cast quality. Closed reduction and immobilization of distal radius fractures is an Accreditation Council for Graduate Medical Education residency milestone. Teaching and assessing competency could be improved with a life-like simulation training tool. QUESTIONS/PURPOSES: Our goal was to develop and validate a realistic distal radius fracture reduction and casting simulator as determined by (1) a questionnaire regarding the "realism" of the model and (2) the quantitative assessments of reduction time, residual angulation, and displacement...
April 3, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28373078/objective-measurement-of-clinical-competency-in-surgical-education-using-electrodermal-activity
#10
Jacob A Quick, Alex D Bukoski, Jennifer Doty, Bethany J Bennett, Megan Crane, Stephen L Barnes
OBJECTIVE: Within the realm of surgical education, there is a need for objective means to determine surgical competence and resident readiness to operate independently. We propose a novel, objective method of assessing resident confidence and clinical competence based on measurement of electrodermal activity (EDA) during live surgical procedures. We hypothesized that with progressive training, EDA responses to the stress of performing surgery would exhibit decline, elucidating an objective correlate of clinical competence...
March 31, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28362467/exploring-discrepancies-in-perceived-nursing-competence-between-postgraduate-year-nurses-and-their-preceptors
#11
Shu-Hwa Chen, Li-Yu Chien, Mei-Ling Kuo, Yi-Hui Li, Ming-Chu Chiang, Ya-Ching Liu
BACKGROUND: Postgraduate clinical training programs improve the core competence of nurses. How postgraduate-year (PGY) nurses perceive their clinical competence and their preceptors' perceptions may affect program effectiveness. This study compared the perspectives of clinical competencies of PGY nurses engaged in a residency program in Taiwan with their preceptors' perspectives. METHOD: A cross-sectional study was conducted at a medical center in Taiwan. The Nursing Competence Questionnaire was used to obtain data from 99 pairs of PGY nurses and preceptors...
April 1, 2017: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/28329124/sleep-and-alertness-in-medical-interns-and-residents-an-observational-study-on-the-role-of-extended-shifts
#12
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
#13
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...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28327273/factors-affecting-orthopedic-residency-selection-a-cross-sectional-survey
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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