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https://www.readbyqxmd.com/read/28104806/reducing-unnecessary-testing-an-intervention-to-improve-resident-ordering-practices
#1
Jose Melendez-Rosado, Kristine M Thompson, Jed C Cowdell, Catalina Sanchez Alvarez, Ryan L Ung, Armando Villanueva, Kayin B Jeffers, Jaafer S Imam, Mario V Mitkov, Tasneem A Kaleem, Lewis Jacob, Nancy L Dawson
PURPOSE OF THE STUDY: To reduce the number of unnecessary laboratory tests ordered through a measurement of effects of education and cost awareness on laboratory ordering behaviour by internal medicine residents for common tests, including complete blood cell count (CBC) and renal profile (RP), and to evaluate effects of cost awareness on hospitalisation, 30-day readmission rate and mortality rate. STUDY DESIGN: 567 patients admitted during February, March and April 2014 were reviewed as the control group...
January 19, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28102439/reconstruction-of-radionuclide-intakes-for-the-residents-of-east-urals-radioactive-trace-1957-2011
#2
Evgenia I Tolstykh, Lyudmila M Peremyslova, Marina O Degteva, Bruce A Napier
The East Urals Radioactive Trace (EURT) was formed after a chemical explosion in the radioactive waste-storage facility of the Mayak Production Association in 1957 (Southern Urals, Russia) and resulted in an activity dispersion of 7.4 × 10(16) Bq into the atmosphere. Internal exposure due to ingestion of radionuclides with local foodstuffs was the main factor of public exposure at the EURT. The EURT cohort, combining residents of most contaminated settlements, was formed for epidemiological study at the Urals Research Center for Radiation Medicine, Russia (URCRM)...
January 19, 2017: Radiation and Environmental Biophysics
https://www.readbyqxmd.com/read/28100274/using-medical-specialty-and-selection-criteria-clusters-to-study-specialty-selection-by-israeli-medical-students
#3
Yoram G Weiss, Rachel Yaffa Zisk-Rony, Howard Tandeter, Uriel Elchalal, Alex Avidan, Josh E Schroeder, Charles Weissman
BACKGROUND: During their final year of medical school, Israeli students must consider which specialty to choose for residency. Based on the vocational counseling literature we presumed that choices are made by selecting from a cluster of related specialties while considering professional and socio-economic issues. METHODS: Questionnaires distributed to final-year medical students at two Israeli medical schools ascertained inclinations toward various medical specialties and the importance of various selection criteria...
January 18, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28099054/association-between-do-not-resuscitate-do-not-intubate-status-and-resident-physician-decision-making-a-national-survey
#4
Elizabeth K Stevenson, Hashim M Mehter, Allan J Walkey, Renda Soylemez Wiener
RATIONALE: Compared to their Full Code counterparts, patients with Do Not Resuscitate/Do Not Intubate (DNR/DNI) status receive fewer interventions and have higher mortality than predicted by clinical characteristics. OBJECTIVES: To assess whether internal medicine residents, the front-line providers for many hospitalized patients, would manage hypothetical patients differently based on code status. We hypothesized respondents would be less likely to provide a variety of interventions to DNR/DNI patients than Full Code patients...
January 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28099046/death-notification-someone-needs-to-call-the-family
#5
Rachel Ombres, Lauren Montemorano, Daniel Becker
BACKGROUND: The death notification process can affect family grief and bereavement. It can also affect the well-being of involved physicians. There is no standardized process for making death notification phone calls. We assumed that residents are likely to be unprepared before and troubled after. OBJECTIVE: We investigated current death notification practices to develop an evidence-based template for standardizing this process. DESIGN: We used results of a literature review and open-ended interviews with faculty, residents, and widows to develop a survey regarding resident training and experience in death notification by phone...
January 18, 2017: Journal of Palliative 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
#6
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
https://www.readbyqxmd.com/read/28093833/cracking-the-code-residents-interpretations-of-written-assessment-comments
#7
Shiphra Ginsburg, Cees Pm van der Vleuten, Kevin W Eva, Lorelei Lingard
CONTEXT: Interest is growing in the use of qualitative data for assessment. Written comments on residents' in-training evaluation reports (ITERs) can be reliably rank-ordered by faculty attendings, who are adept at interpreting these narratives. However, if residents do not interpret assessment comments in the same way, a valuable educational opportunity may be lost. OBJECTIVES: Our purpose was to explore residents' interpretations of written assessment comments using mixed methods...
January 16, 2017: Medical Education
https://www.readbyqxmd.com/read/28092429/residents-understanding-of-adult-congenital-heart-disease
#8
Paul Cooper, Morgan Hindes, Timothy M Maul, Stephen C Cook
OBJECTIVE: Medical residents are exposed to increasing numbers of adults with congenital heart disease (ACHD). While inadequate ACHD knowledge may lead to inappropriate practice, this educational deficit has not been investigated. Our aim was to analyze residents' attitudes, perceived ability, and knowledge of ACHD medicine. DESIGN, METHODS, OUTCOME MEASURES: A single center, multiprogram cross-sectional study was conducted in 2015 using an electronic survey to assess 472 medical residents' perceived knowledge and self-assessed skills related to ACHD medicine...
January 16, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28089310/take-the-heat-a-pilot-study-on-improving-communication-with-angry-families
#9
Nicolas Delacruz, Suzanne Reed, Ansley Splinter, Amy Brown, Stacy Flowers, Nicole Verbeck, Debbie Turpening, John D Mahan
OBJECTIVE: Our objective was to evaluate the utility of an educational program consisting of a workshop based on the Take the HEAT communication strategy, designed specifically for addressing patients who are angry, using a novel tool to evaluate residents' skills in employing this method. METHODS: 33 first-year pediatric and internal medicine-pediatrics residents participated in the study. The workshop presented the Take the HEAT (Hear, Empathize, Apologize, Take action) strategy of communication...
December 19, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/28079727/how-supervisor-experience-influences-trust-supervision-and-trainee-learning-a-qualitative-study
#10
Leslie Sheu, Jennifer R Kogan, Karen E Hauer
PURPOSE: Appropriate trust and supervision facilitate trainees' growth toward unsupervised practice. The authors investigated how supervisor experience influences trust, supervision, and subsequently trainee learning. METHOD: In a two-phase qualitative inductive content analysis, phase one entailed reviewing 44 internal medicine resident and attending supervisor interviews from two institutions (July 2013 to September 2014) for themes on how supervisor experience influences trust and supervision...
January 10, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28078778/texting-preferences-in-a-paediatric-residency
#11
Lauren Draper, Cadence Kuklinski, Amy Ladley, Greg Adamson, Matthew Broom
PURPOSE: Text messaging is ubiquitous among residents, but remains an underused educational tool. Though feasibility has been demonstrated, evidence of its ability to improve standardised test scores and provide insight on resident texting preferences is lacking. The authors set out to evaluate: (1) satisfaction with a hybrid question-and-answer (Q&A) texting format; and (2) pre-/post-paediatric in-training exam (ITE) performance. METHODS: A prospective study with paediatrics and internal medicine-paediatrics residents...
January 12, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28072712/seniorlab-a-prospective-observational-study-investigating-laboratory-parameters-and-their-reference-intervals-in-the-elderly
#12
Martin Risch, Urs Nydegger, Lorenz Risch
BACKGROUND: In clinical practice, laboratory results are often important for making diagnostic, therapeutic, and prognostic decisions. Interpreting individual results relies on accurate reference intervals and decision limits. Despite the considerable amount of resources in clinical medicine spent on elderly patients, accurate reference intervals for the elderly are rarely available. The SENIORLAB study set out to determine reference intervals in the elderly by investigating a large variety of laboratory parameters in clinical chemistry, hematology, and immunology...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28056512/palliative-care-exposure-in-internal-medicine-residency-education
#13
Asher Edwards, Samuel Nam
As the baby boomer generation ages, the need for palliative care services will be paramount and yet training for palliative care physicians is currently inadequate to meet the current palliative care needs. Nonspecialty-trained physicians will need to supplement the gap between supply and demand. Yet, no uniform guidelines exist for the training of internal medicine residents in palliative care. To our knowledge, no systematic study has been performed to evaluate how internal medicine residencies currently integrate palliative care into their training...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28052170/differences-in-routine-laboratory-ordering-between-a-teaching-service-and-a-hospitalist-service-at-a-single-academic-medical-center
#14
Michael I Ellenbogen, Madeleine Ma, Nicholas P Christensen, Jungwha Lee, Kevin J O'Leary
OBJECTIVES: Studies have shown that the overutilization of laboratory tests ("labs") for hospitalized patients is common and can cause adverse health outcomes. Our objective was to compare the ordering tendencies for routine complete blood counts (CBC) and chemistry panels by internal medicine residents and hospitalists. METHODS: This observational study included a survey of medicine residents and hospitalists and a retrospective analysis of labs ordering data. The retrospective data analysis comprised patients admitted to either the teaching service or nonteaching hospitalist service at a single hospital during 2014...
January 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28051967/introducing-a-novel-applicant-ranking-tool-to-predict-future-resident-performance-a-pilot-study
#15
Sarah N Bowe, Erik K Weitzel, William N Hannah, Brian M Fitzgerald, Gregory P Kraus, Christopher J Nagy, Stephen A Harrison
The purposes of this study are to (1) introduce our novel Applicant Ranking Tool that aligns with the Accreditation Council for Graduate Medical Education competencies and (2) share our preliminary results comparing applicant rank to current performance. After a thorough literature review and multiple roundtable discussions, an Applicant Ranking Tool was created. Feasibility, satisfaction, and critiques were discussed via open feedback session. Inter-rater reliability was assessed using weighted kappa statistic (κ) and Kendall coefficient of concordance (W)...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051351/the-need-to-enhance-women-s-health-training-opportunities-in-internal-medicine-residency-programs
#16
Scott G Hartman
No abstract text is available yet for this article.
January 4, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28050222/validity-reliability-and-acceptability-of-the-team-standardized-assessment-of-clinical-encounter-report
#17
Camilla L Wong, Mireille Norris, Samir S Sinha, Maria L Zorzitto, Sushma Madala, Jemila S Hamid
BACKGROUND: The Team Standardized Assessment of a Clinical Encounter Report (StACER) was designed for use in Geriatric Medicine residency programs to evaluate Communicator and Collaborator competencies. METHODS: The Team StACER was completed by two geriatricians and interdisciplinary team members based on observations during a geriatric medicine team meeting. Postgraduate trainees were recruited from July 2010-November 2013. Inter-rater reliability between two geriatricians and between all team members was determined...
December 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28049272/associations-between-depression-and-unhealthy-behaviours-related-to-metabolic-syndrome-a-cross-sectional-study
#18
Yumi Ohmori, Hiroto Ito, Akemi Morita, Kijo Deura, Motohiko Miyachi
BACKGROUND AND OBJECTIVES: The purpose of the present study was to determine whether depression was associated with metabolic syndrome and unhealthy behaviours in community residents. METHODS AND STUDY DESIGN: Using the 2009-2010 baseline data of the Saku Cohort Study, 1,225 men and women who participated in a community health screening were included in the cross-sectional analyses. Depression was assessed using the Zung Self-Rating Depression Scale. Consistent with the Japanese Society of Internal Medicine's definition, we defined metabolic syndrome as abdominal obesity plus two or more of the following: high blood pressure, hyperglycaemia, and dyslipidaemia...
January 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28045764/implementation-and-quality-improvement-of-a-screening-and-counseling-program-for-unhealthy-alcohol-use-in-an-academic-general-internal-medicine-practice
#19
Daniel E Jonas, Thomas Miller, Shana Ratner, Brooke McGuirt, Carol E Golin, Catherine Grodensky, Emily Sturkie, Jennifer Kinley, Maureen Dale, Michael Pignone
Unhealthy alcohol use is the third leading cause of preventable death in the United States. The U.S. Preventive Services Task Force (USPSTF) recommends screening for unhealthy alcohol use but little is known about how best to do so. We used quality improvement techniques to implement a systematic approach to screening and counseling primary care patients for unhealthy alcohol use. Components included use of validated screening and assessment instruments; an evidence-based two-visit counseling intervention using motivational interviewing techniques for those with risky drinking behaviors who did not have an alcohol use disorder (AUD); shared decision making about treatment options for those with an AUD; support materials for providers and patients; and training in motivational interviewing for faculty and residents...
January 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28033485/acculturation-needs-of-pediatric-international-medical-graduates-a-qualitative-study
#20
Amanda D Osta, Michelle M Barnes, Regina Pessagno, Alan Schwartz, Laura E Hirshfield
: Phenomenon: International medical graduates (IMGs) play a key role in host countries' health systems but face unique challenges, which makes effective, tailored support for IMGs essential. Prior literature describing the acculturation needs of IMGs focused primarily on communication content and style. We conducted a qualitative study to explore acculturation that might be specific to IMG residents who care for children. APPROACH: In a study conducted from November 2011 to April 2012, we performed four 90-minute semistructured focus groups with 26 pediatric IMG residents from 12 countries...
December 29, 2016: Teaching and Learning in Medicine
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