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Internal medicine Resident

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https://www.readbyqxmd.com/read/28817780/us-internists-awareness-and-use-of-overtreatment-guidelines-a-national-survey
#1
Kira L Ryskina, Eric S Holmboe, Elizabeth Bernabeo, Rachel M Werner, Judy A Shea, Judith A Long
OBJECTIVES: To assess physician views and perceived adoption of overtreatment guidelines and measure whether adoption of these guidelines influenced the recommendation of a targeted service. STUDY DESIGN: A cross-sectional survey mailed from July 2014 to January 2015 to 902 internists who completed residency between 2003 and 2013, randomly selected from the American Medical Association Masterfile. METHODS: Poisson regression was used to model the rate of recommending a targeted service included in the guidelines, based on the level of guideline adoption...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28817304/medical-education-and-leadership-in-breastfeeding-medicine
#2
Julie Scott Taylor, Esther Bell
Physicians' experience with high quality training in breastfeeding during their medical education is historically varied. The process of becoming a board-certified physician entails more than 20 years of education, and although medical school and residency training timelines and courses are relatively standardized across the United States and even internationally, breastfeeding education varies greatly across schools and programs. The Academy of Breastfeeding Medicine (ABM) exists, in part, because historically, physicians have received too little clinical training in breastfeeding and infant nutrition...
August 17, 2017: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/28814910/a-15-year-review-of-the-stanford-internal-medicine-residency-program-predictors-of-resident-satisfaction-and-dissatisfaction
#3
James S Kahn, Ronald M Witteles, Kenneth W Mahaffey, Sumbul A Desai, Errol Ozdalga, Paul A Heidenreich
INTRODUCTION: Satisfaction with training and with educational experiences represents important internal medicine (IM) programmatic goals. Graduates from IM residency programs are uniquely poised to provide insights into their educational and training experiences and to assess whether these experiences were satisfactory and relevant to their current employment. METHODS: We surveyed former IM residents from the training program held during the years 2000-2015 at the Department of Medicine, Stanford University...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28808863/warm-handoffs-a-novel-strategy-to-improve-end-of-rotation-care-transitions
#4
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/28808509/an-educational-intervention-to-increase-awareness-reduces-unnecessary-laboratory-testing-in-an-internal-medicine-resident-run-clinic
#5
Erika Leung, Shuang Song, Omar Al-Abboud, Shahed Shams, John English, Wisam Naji, Yafei Huang, Leon Robison, Fred Balis, Hameem I Kawsar
At our resident-run clinic in an underserved community, laboratory test costs in 2013 exceeded the government subsidy by $400 000. To optimize limited resources and improve patient care, an education program to reduce testing was implemented. Between November 2014 and January 2015, residents attended lectures on utilization of laboratory testing, focusing on standard practice guidelines, and analyses of unnecessary tests. Multivariate nonparametric statistical methods and subgroup analysis were used to evaluate cost reduction...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28803605/management-of-adult-growth-hormone-deficiency-at-peking-union-medical-college-hospital-a-survey-among-physicians
#6
Hong-Bo Yang, Meng-Qi Zhang, Hui Pan, Hui-Juan Zhu
Objective To evaluate physicians' attitude and knowledge about the management of adult growth hormone deficiency (AGHD) at Peking Union Medical College Hospital and impact factors associated with better decision-making.Methods A 21-question anonymous survey was distributed and collected at Peking Union Medical College Hospital, a major teaching hospital in Chinese Academy of Medical Sciences. Data of physicians' educational background, clinical training, patient workload per year and continuing medical education in AGHD were collected...
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28799705/the-process-of-intrapartum-care-among-skilled-birth-attendants-in-the-dominican-republic-and-maternal-perceptions-of-care-during-labor-and-birth-a-case-report
#7
Peter Schindler, Rosa Burgos, Kimberly Vuong, Hilary Aviela Lerner, Elsa Evangelista, Flor Josefina Rodriguez, Lourdes Peralta Polanco, Jennifer Foster
INTRODUCTION: The World Health Organization calls for situation analyses of maternity settings globally to improve maternal-newborn health. This study evaluated the care processes of skilled birth attendants and women's satisfaction with the care in a public hospital in the Dominican Republic. The purpose of the assessment was to establish a baseline to build quality improvements. METHODS: A cross-sectional, mixed-methods, observational study was conducted by an international team...
August 11, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28790075/implementation-of-a-pharmacist-managed-clinic-for-patients-with-chronic-nonmalignant-pain
#8
Jessica L Norman, Miranda E Kroehl, Huong Mindy Lam, Carmen L Lewis, Chelsea N Mitchell, Cindy L O'Bryant, Katy E Trinkley
PURPOSE: A pharmacist-managed chronic pain clinic (PMCPC) in a primary care setting is described. SUMMARY: As primary care providers (PCPs) may be unprepared or lack time to manage high-risk patients receiving opioids for chronic nonmalignant pain, alternative models of care are needed. The University of Colorado PMCPC is integrated into an internal medicine outpatient clinic. The PMCPC is staffed by 1 clinical pharmacist, with pharmacy students and residents also performing clinic duties...
August 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28771651/bedside-rounds-valued-but-not-preferred-perceptions-of-internal-medicine-residents-and-attending-physicians-in-a-diverse-academic-training-program
#9
Naseema B Merchant, Daniel G Federman
OBJECTIVES: Bedside rounds/rounding (BDR) is an important tool for patient-centered care and trainee education. This study aimed at understanding the attitudes toward BDR among residents and attending physicians. METHODS: A survey was conducted using the Qualtrics survey tool. Responses were measured using a five-point Likert scale. RESULTS: The survey was sent to 301 attending physicians and 195 residents. Attending physicians conducted BDR 19% of the time...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28768590/use-of-a-patient-empowerment-tool-for-hand-hygiene
#10
Allison Lastinger, Kayeromi Gomez, Ellen Manegold, Rashida Khakoo
BACKGROUND: Patient empowerment is recognized as an important component of a multimodal strategy to improve hand hygiene adherence. We examined the attitudes of adult patients and parents of pediatric patients toward a new patient empowerment tool (PET) at our hospital. We also surveyed physicians to determine their perceptions about the PET. METHODS: A cross-sectional survey was performed of hospitalized children's parents and adult patients in a 531-bed tertiary care teaching hospital in West Virginia...
August 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28765717/assessing-the-performance-and-satisfaction-of-medical-residents-utilizing-standardized-patient-versus-mannequin-simulated-training
#11
Ali A Alsaad, Swetha Davuluri, Vandana Y Bhide, Amy M Lannen, Michael J Maniaci
BACKGROUND: Conducting simulations of rapidly decompensating patients are a key part of internal medicine (IM) residency training. Traditionally, mannequins have been the simulation tool used in these scenarios. OBJECTIVE: To compare IM residents' performance and assess realism in specific-simulated decompensating patient scenarios using standardized patients (SPs) as compared to mannequin. METHODS: Nineteen IM residents were randomized to undergo simulations using either a mannequin or an SP...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28760793/pim-check-development-of-an-international-prescription-screening-checklist-designed-by-a-delphi-method-for-internal-medicine-patients
#12
Aude Desnoyer, Anne-Laure Blanc, Valérie Pourcher, Marie Besson, Caroline Fonzo-Christe, Jules Desmeules, Arnaud Perrier, Pascal Bonnabry, Caroline Samer, Bertrand Guignard
OBJECTIVES: Potentially inappropriate medication (PIM) occurs frequently and is a well-known risk factor for adverse drug events, but its incidence is underestimated in internal medicine. The objective of this study was to develop an electronic prescription-screening checklist to assist residents and young healthcare professionals in PIM detection. DESIGN: Five-step study involving selection of medical domains, literature review and 17 semistructured interviews, a two-round Delphi survey, a forward/back-translation process and an electronic tool development...
July 31, 2017: BMJ Open
https://www.readbyqxmd.com/read/28759312/wanted-and-unwanted-care-the-double-edged-sword-of-partial-do-not-resuscitate-orders
#13
Nobuhiro Ariyoshi, Masayuki Nogi, Damon Sakai, Eiji Hiraoka, Daniel Fischberg
BACKGROUND: The interpretation of do-not-resuscitate orders (DNRs) may vary in nonarrest situations. To reduce ambiguity, many hospitals allow patients to elect partial DNRs. OBJECTIVE: To investigate the effect of partial DNRs on physicians' willingness to perform cardiopulmonary resuscitation (CPR) and nonarrest procedures. DESIGN: Cross-sectional study using scenario-based questionnaires between October 2015 and March 2016. A partial DNR was identified as a DNR with Adult Emergency Protocols (AEP) order...
July 31, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28758564/do-medical-residents-perform-patient-centered-medical-home-tasks-a-mixed-methods-study
#14
Lauren Block, Nancy LaVine, Jennifer Verbsky, Ankita Sagar, Miriam A Smith, Susan Lane, Joseph Conigliaro, Saima A Chaudhry
BACKGROUND: Increasingly, residents are being trained in Patient-centered Medical Home (PCMH) settings. A set of PCMH entrustable professional activities (EPAs) for residents has been defined but not evaluated in practice. OBJECTIVE: To understand whether residents trained at PCMH sites reported higher likelihood of engaging in PCMH tasks than those training in non-PCMH sites. DESIGN: Survey and nominal group data from post-graduate trainees at three residency programs...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28753038/physician-experiences-with-high-value-care-in-internal-medicine-residency-mixed-methods-study-of-2003-2013-residency-graduates
#15
Kira L Ryskina, Eric S Holmboe, Judy A Shea, Esther Kim, Judith A Long
Phenomenon: High healthcare costs and relatively poor health outcomes in the United States have led to calls to improve the teaching of high value care (defined as care that balances potential benefits of interventions with their harms including costs) to physicians-in-training. Numerous interventions to increase high value care in graduate medical education were implemented at the national and local levels over the past decade. However, there has been little evaluation of their impact on physician experiences during training and perceived preparedness for practice...
July 28, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28752276/nutrition-education-for-cardiologists-the-time-has-come
#16
REVIEW
Stephen Devries, Andrew M Freeman
PURPOSE OF REVIEW: Nutrition is a cornerstone of cardiovascular health, yet the training of cardiovascular specialists in nutrition has been called into question. This report summarizes the current state of nutrition education in the training of cardiovascular specialists and offers recommendations for curricular enhancements. RECENT FINDINGS: Medical students receive an average of fewer than 20 h of nutrition education, largely confined to basic sciences and discussion of vitamin deficiency states...
September 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28750417/prediction-of-potentially-avoidable-readmission-risk-in-a-division-of-general-internal-medicine
#17
Marc Uhlmann, Estelle Lécureux, Anne-Claude Griesser, Hong Dung Duong, Olivier Lamy
INTRODUCTION: The 30-day post-discharge readmission rate is a quality indicator that may reflect suboptimal care. The computerised algorithm SQLape® can retrospectively identify a potentially avoidable readmission (PARA) with high sensitivity and specificity. We retrospectively analysed the hospital stays of patients readmitted to the Department of Internal Medicine of the CHUV (Centre Hospitalier Universitaire Vaudois) in order to quantify the proportion of PARAs and derive a risk prediction model...
July 27, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28738746/how-do-clinical-competency-committees-use-different-sources-of-data-to-assess-residents-performance-on-the-internal-medicine-milestones-a-mixed-methods-pilot-study
#18
Andem Ekpenyong, Elizabeth Baker, Ilene Harris, Ara Tekian, Richard Abrams, Shalini Reddy, Yoon Soo Park
PURPOSE: This study examines how Clinical Competency Committees (CCCs) synthesize assessment data to make judgments about residents' clinical performances. METHODS: Between 2014 and 2015, after four six-month reporting periods to the Accreditation Council for Graduate Medical Education (ACGME), 7 of 16 CCC faculty at Rush University Medical Center completed questionnaires focused on their perspectives about rating residents on their achievement of the milestones and participated in a focus group...
July 25, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28734046/effect-of-a-community-based-service-learning-experience-in-geriatrics-on-internal-medicine-residents-and-community-participants
#19
Rachel K Miller, Jennifer Michener, Phyllis Yang, Karen Goldstein, Jennine Groce-Martin, Gala True, Jerry Johnson
Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources...
July 22, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28724505/readmission-to-hospital-of-medical-patients-a-cohort-study
#20
Mette Gothardt Rasmussen, Pernille Ravn, Stig Molsted, Lise Tarnow, Susanne Rosthøj
INTRODUCTION: The incidence of acute readmissions is higher among elderly medical patients than in the general population. Risk factor identification is needed in order to prevent readmissions. OBJECTIVE: To estimate the incidence of acute readmissions among medical patients ≥65years discharged from departments of internal medicine and to identify risk factors associated with readmissions. MATERIAL AND METHODS: We included patients discharged between 1st of January 2011 and 1st of December 2014 and collected data regarding primary diagnosis and comorbidities...
July 16, 2017: European Journal of Internal Medicine
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