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What’s New and In the Queue for Academic Medicine
What’s New: A Preview of the February Issue
The February issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. The issue includes a cluster of articles on entrustment; other highlights include:
Health Care Transformation: A Strategy Rooted in Data and Analytics
In this New Conversations piece, Koster and colleagues review three examples of the transformational force of data and analytics to improve health care and examine academic medicine’s vital role in guiding the needed changes.
Amending Miller’s Pyramid to In...
Source: Academic Medicine Blog - February 1, 2016 Category: Universities & Medical Training Authors: Journal Staff Tags: Featured Issue Preview big data cognitive disabilities faculty development medical errors professional identity formation residency veteran-centered care Source Type: blogs
The Impact of Enhanced Critical Care Training and 24/7 (Tele ‐ICU) Support on Medicare Spending and Postdischarge Utilization Patterns
ConclusionsInnovations in workforce training and technology specific to the ICU may be useful in addressing the shortage of intensivist physicians, yielding benefits to patients and payers.
Source: Health Services Research - December 27, 2017 Category: Health Management Authors: Matthew J. Trombley, Andrea Hassol, Jennifer T. Lloyd, Timothy G. Buchman, Allison F. Marier, Alan White, Erin Colligan Tags: Research Article Source Type: research
Bridging the Gap: Increasing Critical Care Knowledge and Skills in PACU Nurse Residents
A recent development of a Post-Anesthesia Care Unit (PACU) Nurse Residency Program (NRP) at a large teaching institution placed new graduate Nurse Residents (NR) in the PACU. The extent of NR Critical Care (CC) experience is limited to the time spent during nursing school clinical rotations, and observational CC shifts during the NRP. As a result, PACU stakeholders voiced concerns regarding NR lack of CC knowledge and skills. The PACU is a rapidly evolving unit that not only cares for post-surgical patients, but as also Intensive Care Unit (ICU) patients who necessitate hemodynamic monitoring, ventilator management, and va...
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Ayumi Fielden, Pamela Northrop, Laura Ortiz, Holly Rodriguez Tags: ASPAN National Conference Abstract Source Type: research
A New Conversation on Trust in Health Care and Health Professions Education
Broken hands on broken ploughs
Broken treaties, broken vows
Broken pipes, broken tools
People bending broken rules
Hound dog howling, bullfrog croaking
Everything is broken.
—Bob Dylan, “Everything is Broken”
For many patients, Bob Dylan’s lyrics may as well have been written about the U.S. health care system. While everything may not actually be broken, there has certainly been an erosion of trust in physicians during my career. In 1966, 73% of Americans reported having great confidence in the leaders of medicine; in 2012, that number had fallen to 34%.1
I see this lack of trust most keenly in the eyes of p...
Source: Academic Medicine Blog - September 20, 2018 Category: Universities & Medical Training Authors: David P. Sklar, M.D. Tags: Featured From the Editor health care teams learning environment New Conversations patient care trust Source Type: blogs
Improving Advance Care Planning in a Resident Primary Care Clinic.
CONCLUSION: A relatively modest intervention to increase advance care planning discussions is feasible in an internal medicine primary care clinic and can improve the confidence of residents with end-of-life discussion.
PMID: 31476887 [PubMed - as supplied by publisher]
Source: The American Journal of Hospice and Palliative Care - September 1, 2019 Category: Palliative Care Authors: Nassikas NJ, Baird GL, Duffy CM Tags: Am J Hosp Palliat Care Source Type: research
Creating a Satisfying Continuity Clinic Experience for Primary Care Trainees
The considerable gap in the primary care workforce of the United States is anticipated to widen over the next 10 to 15 years.1 Numerous physician groups have called for increased focus on primary care training in medical education.2-4 In 2009, the Accreditation Council on Graduate Medical Education (ACGME) mandated an increase for ambulatory training during internal medicine residency, requiring a minimum of 130 half-day clinics over three years. This increased requirement presupposes greater exposure will inevitably lead to more primary care physicians, but some have argued it is increased exposure to high-quality, high-f...
Source: The American Journal of Medicine - December 29, 2020 Category: General Medicine Authors: Associate Professor of Medicine Stephen R. Holt, Associate Professor of Medicine Daniel G. Tobin, Assistant Professor of Medicine Laura Whitman, Professor of Medicine Matthew Ellman, Associate Professor of Medicine John P. Moriarty, Associate Professor of Tags: AAIM Perspectives Source Type: research
Point-of-care ultrasound training for residents in anaesthesia and critical care: results of a national survey comparing residents and training program directors ’ perspectives
Point-of-care ultrasound (POCUS) has become an essential tool for anaesthesia and critical care physicians and dedicated training is mandatory. This survey describes the current state of Italian residency trai...
Source: BMC Medical Education - August 28, 2022 Category: Universities & Medical Training Authors: Silvia Mongodi, Francesca Bonomi, Rosanna Vaschetto, Chiara Robba, Giulia Salve, Carlo Alberto Volta, Elena Bignami, Luigi Vetrugno, Francesco Corradi, Salvatore Maurizio Maggiore, Paolo Pelosi and Francesco Mojoli Tags: Research Source Type: research
Geriatrics and Palliative Care Medicine
That’s what this month has been all about.
Ok, so I did get a week of vacation at the beginning of the month, but after that I have been dealing with senior citizen patients, quite a few of whom are hospice care patients.
It has been strange — the palliative care side of things, that is. I feel like I have spent the last few years preparing for a career in which I do everything I can in order to help someone get better. And on occasion, we must get out of nature’s way and allow death to happen. However, this month I feel like that model of medicine has been flipped upside down — that my role has now...
Source: JeffreyMD.com - November 19, 2012 Category: Medical Students Authors: Jeff W Tags: My Life Residency death dying geriatrics hospice medicine palliative care patients Source Type: blogs
Unsettling Situations in the Pediatric Intensive Care Unit: A Curriculum for Improving Resident Confidence and Competence When Negotiating Challenging Encounters
Past research has shown that residents rotating through the Pediatric Intensive Care Unit (PICU) feel unequipped to manage 3 unsettling situations: angry parents, acute de-compensation of a previously healthy patient, and conflict between provider teams. There is a dearth of residency curriculum designed to address the management skills for these situations.
Source: Academic Pediatrics - July 1, 2013 Category: Pediatrics Authors: Melissa J. Sacco, Khaliah A. Johnson, Nicole A. Shilkofski, Lewis H. Romer, Janet R. Serwint Tags: APPD 2013 Research Abstracts Source Type: research
Mental health from the perspective of primary care residents: a pilot survey.
CONCLUSIONS: The current training model to acclimate primary care residents to the field of mental health appears to have major limitations. RESULTS of this pilot survey can serve as a guide to conduct prospective, multicenter studies to identify and improve psychiatric training for primary care residency programs.
PMID: 25664216 [PubMed]
Source: The Primary Care Companion for CNS Disorders - February 12, 2015 Category: Primary Care Tags: Prim Care Companion CNS Disord Source Type: research
A Simulation Curriculum for Management of Trauma and Surgical Critical Care Patients
Expectations continue to rise for residency programs to provide integrated simulation training to address clinical competence. How to implement such training sustainably remains a challenge. We developed a compact module for first-year surgery residents integrating theory with practice in high-fidelity simulations, to reinforce the preparedness and confidence of junior residents in their ability to manage common emergent patient care scenarios in trauma and critical care surgery.
Source: Journal of Surgical Education - April 23, 2015 Category: Surgery Authors: Kiyoyuki W. Miyasaka, Niels D. Martin, Jose L. Pascual, Joseph Buchholz, Rajesh Aggarwal Tags: Original Article Source Type: research
Medical Students' Professionalism Narratives Reveal That Experiences With Death, Dying, or Palliative Care Are More Positive Than Other Experiences During Their Internal Medicine Clerkship.
CONCLUSION: Less than 10% of the narratives were related to DDPC, but the majority was positive. There was a significant overlap in professionalism themes between DDPC and control narratives. The results suggest student preparedness for primary palliative care may be improved by addressing the common professionalism challenges of clinical clerkships.
PMID: 26430135 [PubMed - as supplied by publisher]
Source: The American Journal of Hospice and Palliative Care - September 30, 2015 Category: Palliative Care Authors: Cripe LD, Hedrick DG, Rand KL, Burns D, Banno D, Cottingham A, Litzelman D, Hoffmann ML, Martenyi N, Frankel RM Tags: Am J Hosp Palliat Care Source Type: research
Longitudinal survey on integrative medicine education at an underserved health centre.
This study evaluated the impact of these programmes on physicians' CAM/IM knowledge and receptiveness. Online surveys assessing self-reported attitudes, knowledge and practices were distributed in 2012 (baseline) and 2014 (follow-up) to family physicians with response rates of 83% (35/42) and 62% (23/37), respectively. At baseline, 91.5% of physicians believed that patient satisfaction would moderately/strongly increase if offered CAM/IM consultations and therapies. At follow- up, physician understanding of clinical applications of massage, acupuncture, meditation/relaxation, yoga and Tai Chi increased. Percentage of physi...
Source: Education for Primary Care - January 26, 2016 Category: Primary Care Tags: Educ Prim Care Source Type: research
Primary Care Residents Improve Knowledge, Skills, Attitudes, and Practice After a Clinical Curriculum With a Hospice.
We examined the feasibility and impact of a single palliative care residency curriculum, including a clinical rotation with a hospice program, across 5 cohorts of residents in 7 divergent primary care residency programs (both family medicine and internal medicine). The didactic content was drawn from the national Education for Physicians on End-of-Life Care Project. A total of 448 residents completed the curriculum. A large effect size was seen in measures of knowledge change (*Cohen d = .89) when compared to a national sample of primary care residency programs. Additionally, measures of confidence to perform palliative ca...
Source: The American Journal of Hospice and Palliative Care - June 25, 2016 Category: Palliative Care Authors: von Gunten CF, Mullan PB, Nelesen R, Garman K, McNeal H, Savoia M, Muchmore E, Ikeda T, Amundson S, McKennett M, Diamant J, Pepper P, Gray C, Weissman D Tags: Am J Hosp Palliat Care Source Type: research
General Surgery Resident Rotations in Surgical Critical Care, Trauma and Burns: What is Optimal for Residency Training?
Conclusion There is significant variability in total duration of SCC, trauma and burn rotations and PGY level in U.S. general surgery residency programs, which may result in significant variability in the fund of knowledge and clinical experience of the trainee completing general surgery residency training. As acute care surgery programs have begun to integrate emergency general surgery with SCC, trauma and burn rotations, it is an ideal time to determine the optimal curriculum and duration of these important rotations for general surgery residency training.
Source: The American Journal of Surgery - August 12, 2016 Category: Surgery Source Type: research
