Are Cardiology Fellows Receiving Enough Basic Level I Cardiovascular Computed Tomography Education During their General Fellowship Training? Insights from a Needs Assessment Survey at an Academic Medical Center

2021 ◽  
Author(s):  
David J. Hur ◽  
Judith L. Meadows ◽  
Lauren A. Baldassarre ◽  
Hamid R. Mojibian ◽  
Todd C. Villines ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Needs Assessment ◽  
Medical Center ◽  
Academic Medical Center ◽  
Fellowship Training ◽  
Academic Medical ◽  
Assessment Survey ◽  
Level I ◽  
Needs Assessment Survey ◽  
Basic Level

In-Practice Endocrine Surgery Fellowship: A Novel Training Model

2020 ◽  
pp. 019459982096279
Author(s):  
Hien T. Tierney ◽  
Leslie S. Eldeiry ◽  
Jeffrey R. Garber ◽  
Chia A. Haddad ◽  
Mark A. Varvares ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Medical Center ◽  
Academic Medical Center ◽  
Training Model ◽  
Time Frame ◽  
Fellowship Training ◽  
Endocrine Surgery ◽  
Community Practice ◽  
Senior Surgeon ◽  
Academic Medical

Objective Endocrine surgery is an expanding field within otolaryngology. We hypothesized that a novel endocrine surgery fellowship model for in-practice otolaryngologists could result in expert-level training. Study Design Qualitative clinical study with chart review. Setting Urban community practice and academic medical center. Methods Two board-certified general otolaryngologists collaborated with a senior endocrine surgeon to increase their endocrine surgery expertise between March 2015 and December 2017. The senior surgeon provided intensive surgical training to both surgeons for all of their endocrine surgeries. Both parties collaborated with endocrinology to coordinate medical care and receive referrals. All patients undergoing endocrine surgery during this time frame were reviewed retrospectively. Results A total of 235 endocrine surgeries were performed. Of these, 198 thyroid surgeries were performed, including 98 total thyroidectomies (48%), 90 lobectomies (45%), and 10 completion thyroidectomies (5%). Sixty cases demonstrated papillary thyroid carcinoma, 11 follicular thyroid carcinoma, and 4 medullary thyroid carcinoma. Neck dissections were performed in 14 of the cases. Thirty-seven parathyroid explorations were performed. There were no reports of permanent hypoparathyroidism. Thirteen patients (5.5%) developed temporary hypoparathyroidism. Six patients (2.5%) developed postoperative seroma. Three patients (1.3%) developed postoperative hematomas requiring reoperation. One patient (0.4%) developed permanent vocal fold paralysis, and 3 patients (1.3%) had temporary dysphonia. Thirty-five of 37 (94.5%) parathyroid explorations resulted in biochemical resolution of the patient’s primary hyperparathyroidism. Conclusion This is the first description of a new fellowship paradigm where a senior surgeon provides fellowship training to attending surgeons already in practice.

scholarly journals 1949. Putting Out Fires: Assessing Burnout within an Infectious Diseases Fellowship at an Academic Medical Center

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S58-S59
Author(s):  
Leslie-Ann Alexander ◽  
Barbra M Blair ◽  
Wendy Stead
Keyword(s):  
Infectious Diseases ◽  
Needs Assessment ◽  
Medical Center ◽  
Academic Medical Center ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Medical Community ◽  
Personal Factors ◽  
Academic Medical ◽  
Participant Understanding

Abstract Background Burnout, “a psychological syndrome of emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA),” is a well-described problem in the medical community. National surveys report 45% of practicing physicians and 60% of residents and fellows are burnt out. A longitudinal study of medical students and residents reported 45% burnout, as well as career choice regret in 14% of trainees. There are little data about burnout in Infectious Diseases (ID) physicians, including fellows. We sought to measure burnout prevalence in an academic ID Division, identify factors that modified the risk of burnout, and assess knowledge and attitudes about fellow and faculty burnout in the division. Methods The study population included 33 ID physicians (10 fellows, 23 faculties). Level of burnout was assessed via the Maslach Burnout Inventory (MBI), a validated 22-item tool. An additional survey was distributed as a needs assessment to determine participant understanding of “burnout” and “wellness,” ability to recognize burnout in colleagues, attitudes about the scope of the problem, and specific programmatic and personal factors felt to contribute to burnout. Results The MBI was completed by 10 fellows and 16 faculties (76%). A high score in ≥ 1 domain of burnout was reported in 50% of respondents, and 19% received a high score in both EE and DP. Fellows had moderate to high levels of EE (90%) and DP (70%), though all fellows reported at least a moderate sense of PA. The survey needs assessment was completed by 9 fellows and 17 faculties (79%). In a hypothetical case, 100% and 58% of participants correctly identified elements of DP and EE, respectively. Respondents identified several factors contributing to burnout risk, most commonly being lack of schedule autonomy (100%), increasing patient load (96%), and inability to attend teaching conferences (88%). Fellows felt burnt out when seeing ≥ 4 new consults per day and/or carrying a census of 10–11 patients. Conclusion ID fellows at an academic medical center recognize burnout and report levels on par with national data. Fellows and faculty can identify personal and programmatic factors that increase and decrease their risk of burnout. These data can guide programmatic and divisional interventions to improve trainee wellness. Disclosures All Authors: No reported Disclosures.

scholarly journals Barriers to and facilitators of a screening procedure for PTSD risk in a level I trauma center

2019 ◽  
Vol 4 (1) ◽  
pp. e000345 ◽  
Author(s):  
Sacha A McBain ◽  
Kevin W Sexton ◽  
Brooke E Palmer ◽  
Sara J Landes
Keyword(s):  
Trauma Center ◽  
Medical Center ◽  
Academic Medical Center ◽  
Screening Tools ◽  
Screening Procedure ◽  
Acute Care Surgery ◽  
Level Of Evidence ◽  
Academic Medical ◽  
Level I ◽  
Care Surgery

BackgroundPatients admitted to the hospital after an injury are at a greater risk for developing post-traumatic stress disorder (PTSD) due to the nature of the injury and the traumatic nature of necessary medical interventions. Many level I trauma centers have yet to implement screening protocols for PTSD risk. The goal of the study was to characterize the barriers to and facilitators of implementation of a screening procedure for PTSD risk in a level I trauma center.MethodsWe conducted semistructured qualitative interviews with multidisciplinary academic medical center stakeholders (N=8) including those with clinical, research, teaching, and administrative roles within an urban academic medical center’s Department of Surgery, Division of Acute Care Surgery. We analyzed the qualitative data using summative template analysis to abstract data related to participants’ opinions about implementation of a screener for PTSD.ResultsParticipants’ general perception of screening for PTSD risk after injury was positive. Identified challenges to implementation included timing of screening, time burden, care coordination, addressing patients with traumatic brain injury or an altered mental status, and ensuring appropriate care after screening. Reported facilitators included existing psychosocial screening tools and protocols that would support inclusion of a PTSD screener, a patient-centered culture that would facilitate buy-in from providers, a guideline-driven culture, and a commitment to continuity of care.ConclusionsThis study offers concrete preliminary information on barriers to and facilitators of PTSD screening that can be used to inform planning of implementation efforts within a trauma center.Level of evidenceLevel V, qualitative.

scholarly journals Needs Assessment for Research Use of High-Throughput Sequencing at a Large Academic Medical Center

PLoS ONE ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. e0131166 ◽  
Author(s):  
Albert Geskin ◽  
Elizabeth Legowski ◽  
Anish Chakka ◽  
Uma R Chandran ◽  
M. Michael Barmada ◽  
...  
Keyword(s):  
Needs Assessment ◽  
High Throughput ◽  
High Throughput Sequencing ◽  
Medical Center ◽  
Academic Medical Center ◽  
Research Use ◽  
Academic Medical

Feed and Swaddle: An Alternative to Infant Sedation for Craniofacial Imaging

2019 ◽  
Vol 56 (10) ◽  
pp. 1373-1376
Author(s):  
Nick Esmonde ◽  
Breanna Jedrzejewski ◽  
Beth Fitzpatrick ◽  
Jeffrey Koh ◽  
Dianna Bardo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Surgical Planning ◽  
Medical Center ◽  
Academic Medical Center ◽  
Diagnostic Quality ◽  
Academic Medical ◽  
Successful Group ◽  
Developmental Risks ◽  
Head Computed Tomography

Objective: The gold standard for diagnosis of craniosynostosis is a clinical examination and motionless head computed tomography (CT). Computed tomography sedation is associated with increased cost, resource utilization, medical, and possible developmental risks. This study investigates whether a “feed and swaddle” protocol can be used to achieve diagnostic quality craniofacial imaging without the use of infant sedation. Design: Prospective cohort study. Setting: Tertiary academic medical center. Patients: Ninety patients <18 months of age undergoing evaluation for craniosynostosis from 2012 to 2018. Interventions: A feed and swaddle protocol. Main Outcome Measures: Diagnostic level imaging without the use of infant sedation. Results: Eighty-five (94%) achieved a diagnostic quality craniofacial CT scan using the “feed and swaddle” method. Mean patient age was 24.0 ± 10.0 weeks. Craniosynostosis was diagnosed in 74% of patients. Mean age of patients with successful completion of a CT scan was 23.7 ± 9.6 weeks, compared to 27.2 ± 17.1 weeks for unsuccessful completion. Mean weight for the successful group was 15.6 ± 2.9 pounds and 15.9 ± 2.5 pounds for the unsuccessful group. Mean travel distance was 59.2 ± 66.5 miles for successful patients and 66.5 ± 61.5 miles for unsuccessful patients. For the unsuccessful patients, there were no delays in surgical planning or scheduling. Conclusion: The “feed and swaddle” protocol described here is an effective alternative to infant sedation for motionless craniofacial CT imaging.

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